20021385 Ver 1_Certification of Completion_20021122

Michael F. Easley, Governor
~QF WA7F,~, William G. Ross Jr., Secretary
~ ~~ ~ ~ North Carolina Departmont of Environment and Natural Resources
`J Alan W. Klimek, P.E., Director
^i Division of Water Quality
DWQ ProjectNo.: C2 - 1 ~ `~5 County: ~t2~ ~E~~-
Applicant: l~C ~-c ~-~ _ )~ ~ ' ~ , `
~~ c ~l ~ '~ L..~. ~ ~ e \Z ~c>. ~-• i ~ t ~3 l {"'i 0.r b~1C C ~. ~ ~ (~ .
Project Name: ,~~r ~1;^~. S} ab; Z
Date of Issuance of 401 Water Quality Certification: °1- ~ - a ~ ~' ~-
Certificate of Completion
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, K t ~T ~., ) n ~ "~ ~ ~ ~ ,hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the constructton 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 mate ' s.
Signature: Date: \I - 2. t - ~-o
_"""--r---..-.
Agent's Certification i +
~ .~ ~
~~,;
I hereby state that, to th~a ;be~t~i~f ~y~ ' ' 'es, ~k
was used in the observation of the construction such that the constructio was observ be 1Iu
compliance and intent of the 401 Water Quality Certification and Buffer u ~ ~ d lap
and other supporting materials. - -
Signature:
If this project was designed by a Certified Professional
Date:
care and diligence
t within substantial
and specifications,
1, 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 Cert~cation 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