HomeMy WebLinkAbout20061015 Ver 1_Staff Comments_20080429a
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DWQ Project No.: Z��O 1�1 5
Applicant: NCDoT ��J S
Project Name: 52 139 0� o,P�"�''`'�'S�' FA�� Q��'� -
� Date of Issuance of 401 Water Quality Certi�cation: Ol�
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CertiCcate of Completion
Upon completion of all work approved within the 401 Wat Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required t return this certificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Quality, 1650 ail Service Center, Raleigh, NC, 27699-1650. This form
may be returned to DWQ by the applicant, the appl' ant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicant's Certification
I.
was used in the observation of the c
compliance and intent of the 401 W
specifications, and other supportin�
Signature:
Agent's Certification
I,
was used in the obsery
compliance and inte
specifications, an th
S i gnature:
Engineer' Certificat
artial
Fina(
I� , as a duly registered Professional Engineer in the State of North
Caro ' a, having been authorized to observe (periodically, weekly, full time) the construction of the project,for the
Per ittee hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
c struction such that the construction was observed to be built within substantial compliance and intent of the 401
ater Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No.
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Transportation Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: 919-733-1786 / FAX 919-733-6893 / Internet: http://h2o.enr.state.nc.us/ncwetlands
Michael F. Easley, Governor
William G. Ross Jr., ecretary
North Carolina Department of Environment and Natur esources
Alan W. Kli , P.E. Director
Divis' n of Water Quality
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County: li a
on► G. Nanc.� �
hereby state that, to the best of my abilities, due care and diligence
ction such that the construction was observed to be built within substantial
Quality Certification and Buffer Rules, the approved plans and
erials.
Date:
, hereby state that, to the best of my abilities, due care and diligence
tion of the construction such that the construction was observed to be built within substantial
of the 401 Water Quality Certification and Buffer Rules, the approved ptans and
er supporting materials.
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