20010987 Ver 1_Certification of Completion_20080401

~ n J~
~ u~
'~ `~~ ~~~
DWQ Project No.: 0
Applicant:
County: ~,, ~ jv G'D ~ N _ ~) ~r ~ _""-._ ...
~."` -~
~ ~~~~ s ~ ~ l,.
~,;:r.,jR~ ~ ~ crtuu;-
qty;°,if1';'
_. _.:. _- ._..._,. ._....~G rr~~r,,1
Project Name:
Date of Issuance of 401 Water Quality Certification: ~ • ~~'
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and anv subsequent
modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolina Division of Water
Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ by the applicant. the
applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, ~~,t~~` ~~Y~'e 4 I ,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 of the 401 Water Quality Certification and. Buffer Rules, the approved plans and specifications,
and other supportjng raterials. n ~ ~ ~
Signature: ~ ~,.1~ ~ ~ ~ ~ .Date: ~{ ' ~ ' ~
Agent's Certification
I, ,hereby state that, to the best of my abilities, dnP ~ ~d diligence was
used in the observation of the construction such that the construction was obser~Pa substantial
compliance and intent of the 401 Water Quality Certification and Buff°~ ~ d specifications.
and other supporting materials.
Signature: Date: ~/
Engineer's Certification ~~ " ~\
b
Partial Final
I, , as a duly registered Frofessional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for tltc
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 of the 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Registration No.
Date