20061031 Ver 1_Staff Comments_20080429

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division o Vater Quality

DWQ Project No.: _
Applicant: N C -C
Project Name:
N5 - To" Q. Nan
County: w o,
- - 5R 3725 (FevA 2J) - ?w?ti?nc,G rePA;r
Date of Issuance of 401 Water Quality Certification: Ob 12(, o

Certificate of Completion
Upon completion of all work approved within the 401 Wa/orized ertification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to rtificate to the 401 Transportation Permitting
Unit, North Carolina Division of Water Quality, 1650 Mater, Raleigh, NC, 27699-1650. This form
may be returned to DWQ by the applicant, the applicant's ent, or the project engineer. It is n ot
necessary to send certificates from all of these.
Applicant's Certification
I, TON G. Nance /sh y state that, to the best of my abilities, due care and diligence
was used in the observation of the constructit the construction wa s observed to be built within substantial
compliance and intent of the 401 Water Quaation and Buffer Rules, the approved plans and
specifications, and other supporting material Signature:

Agent's Certification
Date:
I, , hereby state that, to the best of my abilities, due care and diligence
was used in the observation oft construction such that the construction was observed to be built within substantial
compliance and intent of the 1 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: Date:
Engineer's Certifleation
Partial Final
L- 7 as a duly registered Professional Engineer in the State of North
Carolina, hOng been authorized to observe (periodically, weekly, full time) the construction of the project,for the
Permittee ereby state that, to the best of my abilities, due care and diligence was used in the observation of the
constru ion such that the construction was observed to be built within substantial compliance and intent of the 401
Wate uality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature _
Date
nbT
Registration No.
6[ ,,, J, Vt Ole`( n, no (; 04 el S4N4wA (.lta??°ti.? 6zs1??
I A 110
NorthCarolina
Transportation Permitting Unit Natura!!y
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone]/ FAX [phone] Internet: htto://h2o.enr.state.nc.us/ncwetiands
as OT LtI2-9109
200(, 10311
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