20020742 Ver 1_Certification of Completion_20021211

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Michael F. Easley, Governor
17ji William G. Ross Jr., Secretary
(2 fZ North Carolina Department of Environment and Natural Resources
~/ Alan W. Klimek, P.E., Director
Division of Water Quality

DWQ Project No.: ~ ~ ~`7 ~ County:
Applicant:
Project Name: ~o ~ rf~
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Date of Issuance of Isolated Wetland Permit:
C,1 / '
Certificate of Completion
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Upon 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 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, =~ ~~ G-~J"< !~~'~" ,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: ~-~--Z-~ Date: (~~ - ~ - ~ -~
t'o..~tL7~-t ~+-~
Agen;r~ Certification
I, ft~a ~~o(~ k- S'i.r~ / 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 supporting materi
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Signature: i Date: /~ `" 7 ` a~
If this project was designed by a Certified Professional ~ ~ " l' r~'"5 ~ ~ ~~ , ~- ~ ~ ~(~I ~
I, 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 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
N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/ncwetlands