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HomeMy WebLinkAbout20071143 Ver 1_Certification of Completion_20080201Certification of Completion DWQ Project No ~7~~~~3 County: C~t~-~ c~.) E. Lt- Applicant: ~~~ J~~ c S ~ ~~s ~ q~ f Project Name: ~~o c ~' l~'V'~~E~ F~~S w ~~ri Slto~e~~.~C ~ ~'~/L~t ~~ ~,~,.J Date of Issuance of Certification or Authorization: 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 Oversight/Express Permitting Unit, North Carolina 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 r-- J~~ f~5~/or~ ~~~r~ ~ ~yt1~j-rc~(-/Zi I, J ~c E S `S ~~"" s`-~'~-' ,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: ° ~ ~oZ g/~-~~ Agent's Certification I, used in the observation of the compliance and intent of the 401 and other supporting materials. Signature: Date: If this project was designed by a Certified Professional 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 Permiee 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: hereby state that, to the best of my abilities, due care and diligence was construction such that the construction was observed to be built within substantial Water Quality Certification and Buffer Rules, the approved plans and specifications, Registration No. Q~c~~o~~Q FEB 1 ZOQ8 Date ~~~C~Q) ,~~~1R - WATEMt QUALit'~f ;,ryn<:: ~:~ ~TORMYVATEk ~Pt~H