20070222 Ver 1_Certification of Completion_20070829

~ 14.
~erti~cation of Completion
1 ~i~-._~~~~~ Cotrnty: f-/« /r"~t~ L ~iiil~i
Applicant:
Project I~Iar~ie
Date o!`Issuancc oI` Wetland Permit: --~'c'~r~:~lP~--~~_I~
Certificate of C:umpleticrn
Upon completion of all work approved within the 401 'e'ater Quality Certification and Buffer Mules, and any
subsequent modifications, the applicant is required to return this certificate to the X01 OversightlExpress Permitting Unit,
'~~cartlr Carolina Division of Water Quality, 1650 14Ia! Service Center, 12aleigh, NC, 27699-1650. This form may be
returned to DWQ by the applicant, the applicant's authorized agent, ar the project engineer. It is not necessary to send
certificates from all of these.
Applicrc~t's Certf c~rtr©n
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
co;npliance and irrtent of the 401 Water Quality Certification and Buffer Kates, the approved plans and specifications,
and other supporting materit-Is.
Signature; _~~ ____~_-- I?ate:
A~e~xt's Certifiecrtiol:
1, ,hereby state that, tea the best of my abilities, due care and diligence vas
used irr the observation of the construction such that the construction eras 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.
S i,gnature: .~._...~ l:)ate:
If this ~YQject rvrrs de~ign~d by a f'~nr~~fre~t Prdfessanal
I, ~-ANw~-~Ca ~ , W~L.see-'~ , as a duty registered 1'rofessionai ENy~e?~(i.e., L;ngineer,
Landscape Architect, Surveyor, etc.} in the State of North Carolina, having been authorized to observe (periodically,
weekly, full tithe} the construction of the project, for fhe Permtttee hereby state that, to the hest of my abilities, due care
and dili;~ence was used in the observation of the construction such that the cartsttuctian was observed to be built within
substantial campliarrce and intern of the 401 ~'Vater Quality Certification and Buffer Kules, the approved plains and
specifications, and tither sulaportng materials.
5ignairue: egistratiorr No. i~C- 2+o•'ti-~~ Date e~8- 06 --- O~
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