20050234 Ver 2_Information Letter_20080410

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DWQ Project No.: 0 S 0 2 34
Applicant: N C-OOT D ? d 5
Project Name: 5
Date of Issuance of 401 Water Quality Certification: 024,1110
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certificati or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certifica to the 401/Wetlands Unit, North
Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, N , 27699-1621. This form may be
returned to DWQ by the applicant, the applicant's authorized agent, or project engineer. It is not necessary to
send certificates from all of these.
Applicant's Certification
I, , hereby state
was used in the observation of the construction such that the
compliance and intent of the 401 Water Quality Certifica ' n
specifications, and other supporting materials.
Signature:
,? r County:
nh G. rV ance
Date:
r/ , as a duly registered Professional Engineer in the State of North
authorized to observe (periodically, weekly, full time) the construction of the project, for the
that, to the best of my abilities, due care and diligence was used in the observation of the
the construction was observed to be built within substantial compliance and intent of the 401
atior, and Buffer Rules, the approved plans and specifications, and other supporting materials.

Agent's Certification
1.
was used in the observation of the a
compliance and intent of the 401 W
specifications, and other supporting
Signature:
Engineer's Certification
Partial Final
I,
Carolina, having
Permittee hereby
construction suc
Water Quality 'e
Signature
Date 11
Registration No.

Date:
-, hereby state that, to the best of my abilities, due care and diligence
such that the construction was observed to be built within substantial
Certification and Buffer Rules, the approved plans and
t1fat. to the best of my abilities, due care and diligence
onstruction was observed to be built within substantial
and Buffer Rules, the approved plans and