20131123 Ver 1_Certification of Completion_20160802

Pat McCrory
Govemor
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NCI��NR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
S Jay Zimmerman Donald R van der Vaart
D�rector Secretary
NCDWR Pro�ect No 20131123v1 County Cherokee
Applicant NC Department of Transportation
Pro�ect Name Brid¢e No. 17 on SR 1340
Date of Issuance of 401 Water Quahty Certification: November 4, 2013
Certificate of Complet�on
Upon completion of all work approved within the 401 Water Quality Cerhfication or applicable Buffer Rules, and any
subsequent modtfications, the applicant is required to return this cerhficate to the 401 Transportatton Plamm�g Umt, North
Carolma Drvision of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617 This form may be returned to
NCDWR by the applicant, the applicant's authorized agent, or the pro�ect engmeer It is not necessary to send certificates
from all of these.
Applicant's Certificat�on
I, Mark S. Davis, Division 14 Environmental Prosram Sunervisor, hereby state that, to the best of my abilities, due care
and diligence was used m the observation of the construction such that the construction was observed to be built wrthm
substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supportmg materials
Signature Date. �� � r� �
Agent's Certaficataon
I, , hereby state that, to the best of my abilrties, due care and dingence was used
m the observation of the construction such that the construction was observed to be built withm substantial compliance and
mtent of the 401 Water Qual�ty Certification and Buffer Rules, the approved plans and specifications, and other supportmg
materials
Signature Date•
Eng�neer's Certzfication Partial Fcnal
I, , as a duly registered Professional Engmeer m the State of North Carolma,
having been authorized to observe (periodically, weekly, full time) the construction of the project, for the Permittee hereby
state that, to the best of my abilrties, due care and diligence was used m the observation of the construction such that the
construction was observed to be built wrthm substantial compliance and intent of the 401 Water Quality Certification and
Buffer Rules, the approved plans and specifications, and other supportmg materials.
Signature
Date
Registrahon No
Transporfation PertrntUng Unit
1617 Mad Serwce Center, Ralegh, North Carolina 27699-1617
Location 512 N Salisbury St Raleigh, NoRh Carolma 27604
Phone [phone]
Intemet www ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer
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