20060324 Ver 1_Certification of Completion_20070112

Coulter I Jewell I ThamesP~
212 SOUTH LAMAR STREET
PO BOX t066
ROXBORO NORTH CAROLINA 27573
p. 336.330.Q368 ~'
Planning for the future-
January 10, 2007
401 Oversight/Express Permitting Unit
N.C. Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699-1650
Re: City of Roxboro Sewer Improvements -Depot Street
DWQ Project # 06-0324
Certificate of Completion
Please find enclosed a Certificate of Completion for the City of Roxboro Sewer Improvements -Depot Street
project.
Should you need additional information about this Project, please do not hesitate to give me a call.
Sincerely,
Coulter Jewell Thames P.A.
G~-~
Steven P. Bailey, P.E.
Project Engineer
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Certification of Completion
DWQ Project No.: '~ ab - c73 2 `~ .County:
Applicant: C- ~~ tr
Project Name: G ~k
Date ~of Issuance of Isolated Wetland Permit:
P~-5
s~q~~an6
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality .Certification -and Buffer Rules, and an3
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carolinf
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. 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, ~ •~ ~ ;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 anti intent of the 401 Water Quality Certification and Suffer Rules, the approved plans and specifications,
and other supporting rnaxerials. .
Signature: Date,
Agent's Certi,~cation
1, ~ ,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:
Date:
If this project was designed by a Certified Professional
I, S% e u~en P ~t i~t~ as a . duly registered Professional.. ~S ~~« ~ (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 Penmittee 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.
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Signature: - ~~~~~ Registration No. ~ ~• Z7~R2 • ~•«'°~g}~~~~t7~b 7~
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