20030527 Ver 1_Certification of Completion_20030612

~~ Ar~c9 Michael F. Easley, Qovernor
William Q. Ross Jr., Secretary
Q. North Carolina Department of Environment and Natural Resources
~ Alan W. Klimek, P.E., Director
~ ,~ Division of Water Quality
n3 ~ ~~,
DWQ Project No.: 4 3 ~ d S2 7
Applicant:
~• /2<~~O.~rfS
county: ~G ~~ wd a >..>
~~` Ci,L t
a. ~
Project Name: SPQ ulQ ~A ~ resic~~a _`~~_
''! .
Date of Issuance of 4D1 Water Quality Certification: ~ ~~ Zl~D3 >> ' °F . •
Certificate of Completion
`,:1
~; ~•.
Upori completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and .any
subsequent modifications, the applicant is required to return this certificate to the 40~/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 Cert~f "ication
I, ~~ S'5~~~ C- ~obeffs ;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 supporti materials. ~~ ~ •
Signature: ~'~' Date:. ~-9-~ 3 ~ .
Agent's Cert4 fication
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
. , . _ eompliar-ee-and -ix><tent of the-401 V~ater Quality Certification andrBufferRtrle~; fihe-~approverl plans° and specifieations,~:: -
_ and other supporting materials: _ _ , . __ ._ _....._ _ ..........._ _...... _ - .
Signature:
If this project was designed by a Cerf~ted Professional
Date: .
h as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe (periodically;
weekly, full time) the construction of the project, for the Per]nittee hereby state that, to the best of my abilities, due
care and diligence was used in the observation of the construction such that the. construetign was observed to be built
within substantial, compliance and intent of ~tfie 401 Water Quality Certification and Buffer Rules, the approved pleas
and specifications, and .other supporting materials. •
Signature:
Registration No.
N. C. Division of Water Quality, 401 Wetlands CerttNcatton UnR,
1850 Mail Serve Center, Raleigh, NC 27899-1850 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27804-2280 (Location)
[phone] (phone), 918.735-8893 (fax), (httpJ/h2o.enr.state.no.us/ncwetlends
Date