20010758 Ver 1_Certification of Completion_20080401

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DWQ Project iVo.: C7 I b 7 ~ ~5 Caun~y: 17 ~ c~z / ~ ? ~ ,_ `~ l~ ~~~~ ir';
Applicant; U ~ S A. ~~ r~ ' ~' S `~ - ~~ s
Project Name: `~ ~ - ~~, ~ ~ ~; , ~~ ~ r I
~,,-,R 5 2002.
Date of Issuance of 401 a r Qualify Certificati n: ~ ~ I
Certificate of Completion ~ WETLANDS G1t0UP
sF"P i E' UfiLiTY SECTIC
Upon completion ofi ail work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
subsequent modifications, t~~e applicant is required to re#urn this certificate to the 4011VIfetlands Unit, North Carolina Division
of ~Nater Quaiity,1621 Mail Service Center, Raleigh, NC, 27699-1621.This form maybe 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.
ApR(icant's Certificafion
1, ~uN15 V. L.yvcr~ ,hereby state that, to the best of my abilities, due care and diligence was used in
the observation of the cansfiruction such that the construction was observed to be built within substantial compliance and
intent of the 401 Water Quality Certification and Suffer Rules, the approved plans and specifications, and other supporting
materials. I 1
Cinn~fi ~~a• 1 I .. a .~. 1 / ~ . _ ~ ' 11..x... !.~ / - 7i~~ r1
Age is Certification _ __
1, ~tiNN L S V. ~7~ c /-(\` ,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 Suffer Rules, the approved plans and specifications, and other supporting
materials.
Signature: ~ Date: ~/- ~-o~oo ~.
If this project was designed by a Certified Professional
1, as a duly registered Professional (i.e., Engineer, Landscape
Architect, Surveyor, ect.) in the State of North Carolina, 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 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
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