20140256 Ver 2_Certification of Completion_20160802

Pat McCrory
Governor
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Resources
S Jay Zimmerman Donald R. van der Vaart
Director Secretary
NCDWR Pro�ect No. 2014-0256V.2 County: Jackson
Applicant NC Department of Transuortation
Pro�ect Name Bridge No. 207 on SR 1313
Date of Issuance of 401 Water Quahty Certification June 16. 2015
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Cerhfication or applicable Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401 Transportation Plamm�g Unrt, North
Carolma Divis�on of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form may be returned to
NCDWR by the applicant, the applicant's author�zed agent, or the proJect engmeer. It is not necessary to send certificates
from all of these
Applacant's Certification
I, Mark S. Davis, Div�s�on 14 Env�ronmental Pro�ram Sunervisor, hereby state that, to the best of my abilities, due care
and d�ltgence was used in the observat�on of the construction such that the constructton was observed to be built withm
substant�al comphance and mtent of the 401 Water Qualrty Certification and Buffer Rules, the approved plans and
specificattons, and other supportmg materi
Signature Date: / ��J '�!p
Agent's Certaficatron
I, , hereby state that, to the best of my ab�lrties, due care and dingence was used
m the observation of the construction such that the construction was observed to be built withm substant�al compliance and
mtent of the 401 Water Quality Certificahon and Buffer Rules, the approved plans and specifications, and other supportmg
matertals.
Signature• Date
Engineer's Cert�fication Partial Final
I, , as a duly registered Profess�onal Engineer m the State of North Carolma,
havtng been authorized to observe (periodically, weekly, full time) the construction of the pro�ect, for the Permittee hereby
state that, to the best of my abilrt�es, due care and diligence was used m the observation of the construction such that the
construction was observed to be built wtthm substant�al compl�ance and intent of the 401 Water Quality Cerhfication and
Buffer Rules, the approved plans and specifications, and other supporhng materials.
Stgnature•
Date
Registratton No
Transportation Pertnitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location 512 N Salisbury St Raleigh, North Carolina 27604
Phone [phone]
Internet www ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer
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