20150205 Ver 1_Certification of Completion_20160630

Pat McCrory
Govemor
North Carolina Department of Environmental Quality
Donald R. van der Vaart
Secretary
NCDWR Project No.: 2p�S02,0 $�V 1 County• �AIZ..�
Applicant: _TflW� D� �O(�"i�rv� cs�0��$. ---.
Project Name:'f%(.(. �1N�i � D����t2l�G� Na. t� 2���j,�.C�h'1 �.�17T
Date of Issuance of 401 Water Quality Certitication: ��R�j2-Y �.�' �Q l�
CertiPx�te af Campletioo
Upon comp{etian of ail work approved within the 401 Water Quality Certification or applicable Suffcr Rules, and
any subsequent modifications, the applicant is required ta return this certificate to the 40f Transportation Pcrmitting
Unit, North Carolina Division of Water Resources, 1617 Mail 5ervice Center, Raleigh, NC, 27699-i617. This form
may be returned to NCDWR by the applicarrt, the applicant's suthorized agent, or thc project engineer. ft is not
necessary to send certificates from all oFthese.
Appllcunl's Cer1 fcalloa
�• ` A'� ��� "`�' , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such that the canstruction was observed tn be builc wirhi� ���t,�rAn,��i
campliance and intent oFthe 401 Water Quality Certificatioo and
specifications, and er supporting natcria s. .
Signature:
Agen1's CenlJi aliun
Buffer Rules. the approved plans and
Date: � ZZ � G
�� , hereby state that, to the best of my abilities, dua care and diligence
was used in the obscrvation of the constructian such that the construction was observed to be built within subst�ntial
compliance and intent of thc AO t Water Quatity Certificatioo and Buffer Rules, the approved plans and
specifcations, and other supporting materials.
Signature:
Englneer's CerllJ7callo�
Partial Finat
Date:
�� as a duly registered ProFessional Engineer in the Stete oFNorth
Catolina, having been autharized to observe (periodicatEy, weekly, full time} the construction of the 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 constrvction was observed to be buiit within substential complianee and intent of the 401
Water Quality Certification and Buf%r Rules, the approved plans and specifications, and other supporting materials.
Signature
Date
Re�istration No.
tfi17 Mail Service Cenler, Rateigh, North Carolina 27699-1617
Phone [phone] Internet www nc�enr gov
M E9+wl ODPatwNry ' l�firma6ve Acibn Empbyer

s°"ryFR Town of Southern Shores
�, ��
oF `�\ sy
3= � 5375 i�. Virginia Dare'I'rail, Southern Shores, 11C 27949
o m Phone [phone] / Fax [phone]
�. �
w w w. soutliernshores-nc. gov
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C'9ROLINP
June 28, 2016
401 Transportation Permitting Unit
North Carolina Division of Water Resources
1617 Maif Service Center
Raleigh, NC 27699-1617
To Whom It May Concern:
Please see enclosed a certificate of completion for the construction project for the replacement of the
South Dogwood Trail bridge across Snow Goose canal in Southern Shores, Dare County, NC, NCDWR
Project Number 20150205v1. Please let me know if you have any questions regarding this project.
Thank you.
Sincerely,
Rachel Patrick, LEED AP
Public Works Director
o���ad�
D
.IURI 3 0 2016
DENR • WHiER RESOURCES
TRANSPORTATION PERMITTING UNIT