20110570 All Versions_Certification of Completion_20160401

PA9' MCCRORY
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DONALD R. VAN D�R VAAR'I'
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WaterResources S. JAY ZIMMGRMAN
ENVIRONMENTAL �UALITY �����,������
NCDWR Project No.: c'�OI� d��d ✓. �£V. a County: � zv��
Applicant: ��'�
Project Name• " � � a. o✓�- v i�u
Date of Issuance of 40l Water Quality Certification: �/ 3'/� £ a7-'l0 ���
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable BuR'er Rules, and
any subsequent modifications, the applicant is required to retum this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be returned to NCDWR by thz epplicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicnni's Certifirntion '
��j�� �, �%�/�,�' , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such that the construction was observed ta be built within substantial
compliance and intent ofthe 401 Water Quality CeRification and Buffer Rules, the approved plans and
specifications, and other sup orting mater'
` Date: �� �p �%(p
Signature: ,� _ - �
Agent's Certrficr.lio;�
� , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the conshuction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and o[her supporting materials.
Signature:
Eng6reer's Cer(ifrrntion
Partial Final
� as a duly registered Professional Engineer in the State of Nor[h
Carolina, having been authorized to observe (periodically, weekly, full time) the construction ofthe project for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantial compliance and intent ofthe 401
Water Qualily Certi£cation and Buffer Rules, [he approved pians and specifications, and ather supporting materials.
Signature Registration
Date --------- ' n � � � � l/ � D
���� APR - 1 2016
OENR • WA'(ER RESOURCES
Slak of Nun6 Czrolina �Fnvi�onmenlal Quality � Wnitt Resources
TRANSPORTATION PERMITf1NG UNR