20041420 Ver 1_Certification of Completion_20080401

~ ~~~i~~~
I p
!~ ~~ ~ ~ ~~ 2 ~r~
Cer-~ificate of Cc~r~:plet~on
WE1UNge NVD SrTEQ(J~
DWQ Project ?`o-: Qy ^ ~ ~{ ~~ _ Countl-: ~Y'2~ ~ I
Applicant:
Frojecl Dame: ~Y1C(':m~ru 5~-4,C~ ~ J r~l nr~ LD~ ~ ~~~ ~Tc - ~ ~~S~l~
Date of Issuance of 401 Rater QuaIit}~ Certification: ~51~ n-k .mhP f ~ 7_ a.~Q~
Upon completion of all work approved within the 401 Vi~ater Quati~• Ce: cation and Bum F~ul°s and
any subsequent modifications, the applicant is required to return this certificate to the ~OllWer,.lands Unit,
North Carolina Division of Water Quality, 1621 Mail Sen~ice Center, Raleigh, NC, 2769°-1 QZ 1. i pis form.
may be returned to DWQ by the applicant, the applicant's attthorizetl went or the project ~~in,:.,r_ It is
not ne; essary to send certibcates from all of these_
_~pplicant's Certification
I ,hereby skate than to the first of my abilities. due crre and
aili~ence was used in the obsen~ation of the construction such that the conrst; action was ocs°-trey Io
bunt vrithin substantial compliance and intent of the 4al Water Quality Certincation and Btu- r:..t~uies, the
approved plans and specifications, and other suppordn~ materials.
Simazure:
Date:
4gent's Cerzij-icazion
~ i ~ Y e hereby state that, to the i~st of my abilities, aue rare and
d~iaence used ~~ the obser-vati of *~he constru.;uon such that `one consii action w-as obs....--vex to be
built within substan ' ~Iiance and rent of the 401 Water Quality C„-rzification and Bu~-.;,~ Rules, the
approved plans sp cifications, and other supporting materials.
Signature: Date: ~ ~'
erg Ce-rn~~o
tu~u~~n-~ I~ax-tr,et-
If this project was designed ny a Certified Professional
i- , as a duly re~-i;~ered Professional
i i.e.,
rn~ineer, Landscape Arcritect, Surveyor, etc.) in `she ,.ate of?vorLh Caroiinz, having be°n a~_-moo-mod to
obs.°rve (periodicaIly, weeltly, full time) the construction of the proiec*., for the Pe~iitee h°_ eb~- ;~° that,
to the best of my abilities, due care and diiiQen ~ was tsed in the obs.,;vation of the con<scu.~o~ suc~ that
the construction was obs.°:ved to be bt.itt within substantial compliance and inter of the 40i v-ate_ Quality
Certincation and Bummer Rules, 'she approved plans and speci_ncationc, and oth°r supportizL --=-°r,;~._
S i hnattir~ : *~
h°~T_St•.2tlOn ~10._ D3te.