20050235 Ver 1_Staff Comments_20080410

,xVQ Nm. 0 56 Z 3
DWQ Project No.: 05'0?- 3 5
,Applicant: Alaor Irv 5
Project Name: 52 / (v Zy (a A- I &2S
Date of Issuance of 401 Water Quality Certification: 02 ? it 10S
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or pplicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certific/to e 401/Wetlands Unit, North
Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC1621. This form may be
returned to DWQ by the applicant, the applicant's authorized agent, or the pngineer. It is not necessary to
send certificates from all of these.
Applicant's Certification
I, , hereby state that, to a best of my abilities, due care and diligence
was used in the observation of the construction such that the const ction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification an uffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Agent's Certification
I,
was used in the observation of the construction
compliance and intent of the 401 Water Qualit
specifications, and other supporting materials
Signature:
Engineer's Certification
Partial _
I,
Carolina, having been
Permittee hereby state
construction such that
Water Quality Certific
Date:
as a duly registered Professional Engineer in the State of North
7r' ed to observe (periodically, weekly, full time) the construction of the project, for the
o the e best of my abilities, due care and diligence was used in the observation of the
)nstruction was observed to be built within substantial compliance and intent of the 401
and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No. _
Date
v?? ?? ?G?A 1v\?V1
County:
??•? C Nance
b a rre4
Date:
lreby state that, to the best of my abilities, due care and diligence
h that the construction was observed to be built within substantial
rtification and Buffer Rules, the approved plans and