HomeMy WebLinkAbout20140431 Ver 1_DWR Certificates of Completion 2014_20161128e��
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
NCDWR Project No.: 26(�{- Q�i3�
Applicant:
;5;�� r3
County: �li�cLjr
John E. Skvaria, III
Secretary
ProjectName: /7l3f�. l3.2• /ay L�r'fc�qc 235/A3rusG Crcc� SR �3/7 �y i��usG Grc�lC
(2o c cp
Date of Issuance of 401 Water Quality Certification: /�fi,� Z Z� �0/y
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be returned to NCDWR by Ihe applicant, the applicanYs authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicant's Certifica�ion
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 and intent of [he 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: //�LL�XR--c— Date: zg �oJ /6
Ageirt's Certificatiar
I, , hereby state that, to the best of my abilities, due care and diligence
was ased in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of Ihe 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signawre:
Engineer's Certifrcntion
Partial Final
1, , as a duly registered Professional Engineer in the State of North
Carolina, havi�g been authorized to observe (periodically, weekly, full [ime) the construction of the projec[ for the
Permittee hereby state that, [o [he 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 Regis[ration No.
Date
Transportation and Permitting Unit
1617 Mail Service Center, Raleigh, NoAh Carolina 276994617
Loca�on: 512 N. Salisbury St. Ralegh, NoAh Carolina 27604
Phone:919907-63001FAX:919-733-1290
In�emet: www.ncwateraualiN.orq
An Equal OODotlunity \ ARumative Aclion Employer
NorthCarolina
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NCDENR
North Carolina Department of Environment antl Natural Resources
Pat McCrory
Governor
NCDWRProjectNo.: Z�/3-0633
Applicant: A�G JOT �: � t s: o.� �3
John E. Skvarla, III
Secretary
County: /`'�������
Project Name: 17 $�. t 3- R. ! I( t3�; 4.yc Nf/G�F F�ForK Ca»� Cfz�.i Sn i2U6 S�a j y c.�— W«� ��
Date of Issuance of 401 Water Quality Certification: Tu �y �t Z C7/�/
Certificate of Completion
Upon comple[ion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to rewrn this certificate Yo the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This forn�
may be returned to NCDWR by the applicant, the applicanYs authorized agent, or the project engineer. [t is not
necessary to send certificates from all of these.
ApplicanYs Certificatian
I, ���'�5 ��1�"� , hereby state that, to the best of my abilities, due care and diligence
was osed i� 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 a�d Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: /��Ge('.�-�-- Date: Z 8 ,t%o �/6
AgenYs Certificalion
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 and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other sapporting materials.
Signature:
Eugineer's Cerlificatio�t
Partial Final
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee hereby state that, to the best of my abilities, d�e care and diligence was used in the observation of the
construction such that the construction was observed to be built within substantia] compliance and intent of the 40]
Water Qaaliry Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Regishation No.
Date
Transpotlation and Permit6ng Unit
1617 Mail Service Center, Ralegh, Nodh Carolina 27699-1617
Location: 512 N. Salisbury Sl. Raleigh, Notlh Carolina 27604
Phone:919A07-63001FAX:919-733-1290
Intemet www.ncwatemualiN.ora
An Equal Oppotluniry 1 Affrmative Aclion Employer
NorthCarolina
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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
NCDWR Project No.: 2(�(��' 67W�
Applicant: /L5C- D6Y �:�;sid" 13
County: IG�GL�
John E. Skvarla, III
Secretary
Project Name: (� af .13. R• (10 (3r:QYC ���/I��� �� Crw6: SQ (333 u�� �'y!'"'� 2O`"�
Date of Issuance of 401 Water Quality Certification: /�u� �Z � 2a/y
Certificate of Completion
Upon completion of all work approved wi[hin the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be returned to NCDWR by Ihe applican[, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicant's Certifrcation
I, lu� /�l��� , hereby state that, to the best of my abilities, due care and diligence
was used in [he 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.
Signa[ure: r2'/�Y�'Q-!/ /,�e.r��— Date: Zg it%oJ
Age�tYs Certificaliou
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 and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Engineer's Certijicntion
Partial Fina]
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee 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 Registration No.
Date
Transpor�ation and Permitting Uni�
16ll Mail Service Center, Ralegh, North Carolina 27699-0617
Localion: 512 N. Salisbury St Ralegh, NOAh Carolina 27604
Phone: 919�07-63001 FAX� 919-733�1290
IntemeC www.navatemualiN.orq
An Equal OODo�unity 1 AKrmalive ACtion Employer
NorthCarolina
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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
NCDWR Project No.: ZU�°l- �� 8y
Applicant: _iUC. (,7aT �,J�s�o�n 13
County: ��lin�c�/
John E. Skvarla, III
Secretary
ProjectName: (% 13P. (3, fZ� lD�f f3r;cQyS 3>i r3�uS� Grz�k S12 /3!i �`Y :�n'`S�` �i�'�'
,Za �<A
Date of Issuance of 401 Water Qoality Certification: /-{w y �Z, Z
CertiGcate of Completion
Upon comple[ion of all work approved within the 401 Water Qualiry Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be returned to NCDWR by the applicant, the applicanYs authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applrcant's Certifrcntion
I, ��47vS f�li�-� , 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
specifica[ions, and other supporting materials.
Signature: �Z�� Cee�V L Date: zg �%oJ
AgeuPs Certificalion
I, , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of [he 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:
E�igirteer's CertiJtcation
Partial Final
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee hereby state that, [o 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 Registration No.
Date
Transporlation and Permi�Ung Unit
1617 Mail Service Center, Ralegh, NoM1h Carolina 27699-1617
Location: 512 N. Salisbury St. Raleigh, North Carolina 27604
Phone:919�07-63001 FAX: 919-733-1290
Internet wvnv.ncwatemualiN.ora
An Equal ODPotlunity 1 Affirmative Aclion Employer
NorthCarolina
�atura!!r�
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NCDENR
North Carolina Department of Environment antl Natural Resources
Pat McCrory
Governor
NCDWR Project No.: y0(L�-07�$
Applicant: NG DoT �;.1; s:o.� �3
County: f4acQ:so�
John E. Skvarla, III
Secretary
ProjectName: �'TR�• �3• �• ��� L�t-�cQ.yc 3J�(/Cc.lv�� Cr�"E 5Q l.�3Z C4IJti-i CK iZ�P
Date of Issuance of 401 Water Quality Certification: �yuh �N� ZUly
Certificate of Completion
Upon comple[ion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 401 Transporta[ion Permitting
Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be rewrned to NCDWR 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 Certifrcatio�r
I, ��G�ics 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 and intent of the 401 Water Qualiry Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signamre: ��G(d�.�^�— Date: 25' �t%o� /6
AgeuYs CertiJlcallon
I, , hereby state that, to the best of my abilities, due care and diligence
was ased in the observation of the construction such that the construction was observed to be built within substantial
compliance and intent ofthe 401 Water Qualiry Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: Date:
Engineer's Cerlification
Partial Fina]
I, , as a duly registered Professiona] Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee 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 [he 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No.
Date
TranspoAation and Permitling Unit
1617 Mail Service Center, Ralegh, North Carolina 276994617
Location: 512 N. Sa�isbury SL Ralegh, North Carolina 27604
Phone:919A07-63001FAX:919-733-1290
InterneC www.ncwatemualiN.oro
An Equal Oppoaunity 1 Affirmalive Adion Employer
NorthCarolina
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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
NCDWRProjectNo.: ZU��`'O�%
Applicant: N C D o
County: {�i`�GL`%
ProjectName: 5�� 1208 ,✓?C1�awc,ll Zoc�Q
Date of Issuance of 401 Water Quality Certification: �uy i 4
John E. Skvarla, III
Secretary
Certificate of Completion
Upon completion of all work approved within the 401 Water Qoaliry Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to rewrn this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Resouroes, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be returned to NCDWR by the applicant, the applicanYs authorized agent, or the project engineec It is not
necessary to send certificates from all of these.
Applicant's Certificallon
I, '�4-t�5 /��io.-� , hereby state that, to the best of my abili[ies, due care and diligence
was used in the observation of the constraction 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, a�d other supporting materials.
Signature: �'i,t�.��e��c_ Date: 28 ,(JoJ /�
AgenPs Certificatioi:
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 bailt within substantial
compliance and intent of the 401 Water Qualiry Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
E�egineer's Cerlificatiou
Partial Fina]
�, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Perminee hereby state that, to the best of my abilities, due care and diligence was ased 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 Registration No.
Date
Transportation and Permitting Unit
1617 Mail Service Center, Ralegh, Nodh Carolina 27699-1617
Location: 512 N. Salisbury St. Ralegh, Norih Carolina 2�604
Phone: 979�807-63001 FAX: 919-733-1290
Internet: www.ncwatemualiN.om
An Equal ODPorlunity 1 AKrmative Aclion Employer
NorthCarolina
�aturallr�
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I�CDE�IR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
NCDW'R Project No.: 201�� —041�
Applicant: fJ C, 1� 0 T � t J { 3
County: �c �%ow�6l Co •
ProjectName: �� l3�• �3• �• SS i�c-:�9-�� IC7/S�Z �53`(
Date of lssuance of 401 Water Quality Certification: .St-� 1" � r ��`�
John E Skvarla, III
Secrelary
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Bufler Rules, and
any subsequent modifications, the applicant is required to retum this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-16I7. This form
may be retumed to NCDWR by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
AppHcant's CertifrcatJon
�, ��a'i�S K1 j �<-•^ , hereby state that, ro the best of my abilities, due care and diligence
was used in the observation of [he construction such that the construction was observed to be buil[ within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and o[her supporting materials. •
Signature: _/%���� Date: 2� �a�
AgenYs CeRificatlon
�, , 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 Qualiry Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Engineer's Cer[iJlcalion
Partial Final
�, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee 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 specifica[ions, and other supporting materials.
Signa[ure Registretion No.
Date
TranspoAation ard PermA6ng Uml
1611 Mad Servce Center, Rakgh, NoM Camlina 27699-1677
LocaWrc 512 N. Sal'�sbury Sl Ralegh, NoAh Carolina 27604
Phone. 979AO7E3001 FAX: 979-733-1290
Inlemef w�nv.n�wa�emuallN.oru
An Equal OpporWnity \ ARrmahve Aclion Employer
No"rthCarolina
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NCDENR
North Carolina Department of Environment and Natural Resources
Pal McCrory
Govemor
NcnwR P�o�e�� r+o.: Zo/4— 1497
Applicant %1(� l�0'j` �;ViSGo�.
Project Name: �7 ��• 13• R• N6
John E. Skvarla, III
Secrelary
County: /�iu��SU�
�3
.v� yog F,sG<..� �-uti�u sR i�&�
Date of Issuance of 401 Water Quality CertiPcation: s<.p�' gi Z� ��
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the appiicant is required [o retum this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Wa[er Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be re[urned to NCDWR by [he applicant, the applicanPs authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applrcant's Ce�lificatiai
I, �l�'�'zS �/��� , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of tlie cons[ruction such tha[ the construc[ion was observed to be buil[ within substantial
compliance and intent of the 401 Water Quality Cenification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: /(��/�E'.�.-�. _ Da[e:
Age�d's Ce�lifrcalion
2g ,c1o.! /6
I, , hereby state that, to the,best of my abilities, due care and diligence
was used in [he observation of the construc[ion such that the conslruction was observed [o be buil[ wi[hin subs[antial
compliance and intent of [he 401 Water Quality Certifica[ion and Buffer Rules, Ihe approved plans and
specifications, and other supporting materials. '
Signature:
Engineer's Cerlrficarion
Partial Final
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized [o observe (periodically, weekly, full time) [he construction of the project for the
Permittee hereby state that, ro the best of my abili[ies, due care and diligence was used in [he observation of [he
constr�ction such that the construction was observed to be built within substantial compliance and intent of the 401
Wa[er Quality Certification and Buffer Rules, [he approved plans and specifica[ions, and other supporting materials.
Signamre � _ Registration No.
Date
Transportation antl Permining Unil
1617 Mail Service Cenier, Raleigh, North Carolina 27699�1617
Locafio¢ 512 N Salisbury St Raleigh, Nodh Garolina 27604
Phone:919b07-63001 FAX�. 919-733-1290
intemeC www.ncwate uau .o
An Edual Oppotlunity 1 Af(uma:ive Aclion Employer
NorthCarolina
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NCDENR
North Carolina Ueparlment of Environment and Natural Resources
Division ot Water Resources
Water Qualily Progrems
Pal McCrory Thomas A. Reeder John E. Skvarla, III
Governor Direclor Secrelary
NCDWN Project No.: ZU���- 6566
Applicant: NC. f�OT �i;J 13
Coun1Y: _._✓°(,�t.l+.c.i�.._.__.
ProjcctNamr. l�_i3.1'..�3_ R•G6__ ��;cQYc-__lly/(j�,dt Grzek_ SIZ �3Z7 _
Datc of Issuancc uf J01 Water Qunlil,y Ccrtificatiun: �c.% �y_ _26/N
CerliGcate of Compiction
Upon wmpletion of �II work tipprovecl wilhin Ihe 401 Water Quali�y Certificnlimi or applicable f3uRer Rides, and
any subsequent modificalions, the applicant is required to relurn �his certificale lo �he 401 'I'rnnsportation Permilling
Unit, North Carolina Uivision of Water Resources, I650 Mail Service Center, Rnlcigh, NC, 27699-I650. This form
may be returned to NCDWR by the applicanl, Ihe applicant's authorized agen�, or the pmject engineer. Il is no�
nceessary to send certificates from all of these.
Applic�inl's Cerliftcnlinn
� �, ! 4'k3 ✓�/ic..� _, hereby state thnt, lo tlie bcsl of my abilities, due care and diligence
--...-------- -- -..___ ....._.--
was used in the observaiion of Ihe cmislniclion such IhTt Ihe consiruction was obseiveA to be built wilhin substantial
compliznce and intem of �he 401 Waler Qualily Cer�ifica�ion and I3ufter Rules, Ihe approved plans and
specificalions, and o�her supporting malerials.
Signature: .__. ,��
�.- _ .
Agenl's Cerliflcnllou
oac�: z it �o �_ /6
i, ...__ _, hereby state ihat, ro the bes� of my abilities, due c�re and diligencc
was used in Ihe obseiva[ion of Ihe construction such that the cons[raction was observed to be built wi[hin substantial
cmnplience and iNent of Ihe 401 Water Qualiry CerlificTlion and f3uffer Rules, Ihe approved plans and
specifications, and olher supporling ma[erials.
Sign�ture: ... ____ ____--- Date:
F.nglueer's CerllJ)callou
Panial PinTl
I, , ns a duly registered Protessional G�gineer in ihe S�ate of Nor�li
Carolina, having been au�horized to observe (periodicnlly, weekly, full time) lhc construc�ion of tl�e projecl for �he
Penni�lee hereby state �hat, to Uie bes� of my abilitics, duc care and diligence u-as used in the observaiion of ihe
construction such �hat the conslruclion was observed to be buill wilhin subs�antial compliance nncl intent of the 401
Water Qualiiy Certification ancl 13uffer R�des, Ihe approved plans and specifications, and olher supporting malerials.
Signahu�e _ Rcgisiration No.
Date
_ ___._.___._-_._..__._.
TranspoAalion and Permi�lirg Unil
1650 Mail Service Cenler, Rategh, Nodh Carolina 276994650
Localion: 512 N. Salis6ury SL Ralegh, Nath C2rolina 27604
Phone:919b07-63001FAX:919�8W�6A97
Intemel: ww�v.ncwalemuali .o
An Equa� Oppotlw�ly 1 AHumabve Aciiun Employer
NorthCarolina
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NCDENR
North Carolina Department of Environment and Natural Resources
Pal McCrory
Governor
NCDWR Project No.: Zd��' /f3d
Applicant: NL i70'j' ,�;J � 5f,a� 13
County: i�
John E. Skvarla, III
Secretary
ProjeclName: /7(3P./3.R. Il0 �r:�lqz �L3�l76cGicy Crc,cK $Q (31� �owcr (�oc�,cy �oG�
Date of Issuance of 401 Water Quality Ccrtification: � oJ 2 �, zor 4 _
Certi�cate of Complelion � �
Upon comple[ion of all work approved wi[hin the 401 Wa[er Quality Certificxtion or applicable Buffer Rules, and
any�subsequent modifica[ions, Ihe applicant is required to remrn this certificatc to'the 401 Transponation Permitting
Unit, North Carolina Division of Water Resources, I650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be retumed to NCDWR by Ihe applicant, [he applicanPs authorized agent, or Ihe project engineer. It is not
necessary [o send certifcates from all ofthese.
AppficanPs Cer/ificalio�r
�, �` �'� �� Lh , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construc[ion such that lhe construction was observed to be buil[ within substantial
compliance and intent of the 401 Water QualiFy Certification and Buffer Rules, the approved plans and
specitications, and other supporting materials.
Signature: __KG��e� Da[e: Zg �tiU v l�
Ageid',�� Certificalio�r �
�, , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such [hat the construction was observed to be built wi[hin substantial
compliance and intent of the 401 Wa[er Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: Date:
F.pgiueer's Cerlrfrcntion
Partial Final
�, , as a duly registered Professional Engineer in [he State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the construc[ion was observed to be built within subs[antial compliance and in[ent of [he 401
Wa[er Quality Certifica[ion and Buffer Rules, [he approved plans and specifica[ions, and o[her supponing ma[erials.
Signature Registration No.
Date
Transpor�ation and Pertnitling Unit
1617 Mail Senice Center, Ralegh, Nonh Carolina 27699-1617
Loca6ore 512 N. Salisbury St. Rategh, NoM Carolina 27604
Phone:919B07�63001FA%:919�733-1290
Intemet: xvr,�.ncwateroualiN.oro
An Equal ODOo�uniry 1 Affirmafive Adion Employer
None hCarolina
�aturally
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NCDENR
North Carolina Department of Environment and Natural Resources
Pal McCrory
�overnor
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Dnic of Issu�nce ol'a01 Watcr Qnalitr Ccrlific;rtion: � 2� .�-d��
Donald van der Vaart
Secre(ary
Ccr�ifica�cofCnmpletimi � .
Upon cauplc�ion ofall work approvcd wilhin �hc 401 Watcr Qunlity Ccriifirnion or applicable Bu(lir Rulcs. anJ
ony subsequcn� modificalions, �he:ipplicani is rcyuired to return this cer�ilicatc lo Ihe d01 "fransporl�lion Nermilling
Unil, North Carolina Division of Watcr Rcsources, IGSO Mail Scrvicc Ccn[cr, Ralcigh, NC, 27699-IG50. �fhis lunn
ntay bc rclurncd to NCUWR by Ihc applicnn�, (hc npplicam's aWhurizcd �igcnl, or Ihc pnijec� mivinccr. II is no�
nccessary to scnd ccrlilic�ncs Irum �dl ol �hesc.
Applrcnnl's ('er�iJia�lion
I, �UU� �'/ O/-?�y 4�'I/ , hercby s�a�c ihe�, to thc besi ol'my obilitics, duc cnrc and diligcnco
was useeMli �he obseivation of �he construction such tha� tlie consiruciion �vas obsa�ved �o be buil� o�iihin subsicmiial
complianee and intent uf dir 401 Waler Qualily Cerlilicaliun and litdier Rules, �he appru��ed plmis and
spccilicalions, ontl ulher supporlinp mnterials.
Signnlurc: ,�YJ�, Is �iGc�ati I)atc: �� .2� 20/�_ _
�Igen('.s Cerlificn� n
I. . hcrcby s�a�c IhaL �o Ihc bcsl of my obili�ica duc carc and diligcncc
�vtis useJ in the ubsen�ation of Ihe cuns�ruclion such �h�it �ha consh�uc�ion w�s ubserved iu hc huil� �cithin subs�antial
complinncc and intunl of�hc d01 Watm' Quali�y Ccrli�ication and 13idl�cr Rules, the approvcA pinns nnd
specifica�ions, and olhcr suppurling matcrials.
Signaturc:
L7egineer'.s Cerlifirnliar
Parlial final
Dale:
I, , as x didy rugislercd Prufessional Gnginecr in Ihe Si�ile of North
Carolina, having been aulhorized lo obscrvc (poriodically, wcckly. full timc) Ihc conslruction of Ihe prujecl For lhc
Permil�ee heieby st.ile that. w Ihe besl uf nry abilities. Jue etu'c and dili�ence was used in ihe observa�ion oP�lre
conslruclion such Ihnl ihe canslruciion �vns observed �o be buih �eilhin substan�inl mmpli�nee and intent nl ihe d01
Waler Qualily Cenilieation nnd E3ulT�er Kulus. �he approved plans and speeilic.��ivati, wid odier supporling malerials.
Signallu'c
Uaic
Rcgisunlion No.
1611 Mail Service Cenler, Raleigb, Nohh Carolina 27699-1611
Phone: 919-807-63001 Inlernet: www.ncdencgov
An E�ut10DW�uniry 1 Atlrtma6ve Aclbn Empbyer