20041083 Ver 1_Staff Comments_20080410

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DWQ Project No.• °411083
Michael F. Easley, Governor
William G. Ross J k, Secretary
North Carolina Department of Environment and Natwfil Resources
Alan W. Kli k, P.E. Director
Divi i n of Water Quality
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County: ?rQh //`e
Na 4/1 010g
Toni G: ive
. A.ppliamt: Af,' DO r d l ?
Project Name: SR / l O
on J74t1/iort RD) , 7hw0
Date ofUsuance of 401 Water Quality Certification; /lot iSS
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c ?c .lr?f 6? j?rian 1•?,?2n?
Certificate of Cotnvl"etion
Upon completion of all work approved within the 40.1 Water ality Certification or applicable Buffer Rules, and
any subsequent mudi6cations, the applicant is required to r n this certificate to the401/Wet.lands Unit, North
Carolina Division of Water Quality, 1621 Mail Service C ter, Raleigh, NC, 27699,1621, This form may be
returned to DWQ by the applicant, the applicant's auth 2zed agent, or the project engineer, It is not necessary to
send certificates from all of these.
Applicant's Ccrtifiteation
T. o G- NaN e ,hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construe n sucb tbat the construction was observed to be built within substantial
compliance and intent of the 401 Water itality Certification and Buffer Rules, the approved plans and
specifications, and other supporting makriala.
Signature:
Agent's Certification
z,
was used in the obser
compliance and inten
specifications, and 9(
Signature:
Date:
artial Final
Z, , as a duly registered Professional Engineer in the State of North
Car ina, having beef) authorized to observe (periodically, weekly, full time) the construction of the project, for the
P ittce hereby state that, to the best of my abilities, due care and diligence was used in the observation of the
onstruction 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
Date
Registration No,
14-r hCarolma
Transponatlon Perrnltting Unit AIAMQ4
1654 Mall SArvioa Center, Raleigh, North Carolina 27699-1650
2321 Crebtma Uulaverd, Suite 250, Releigh, North Carolina 27604
Phone: [phone] /FAX [phone]/ Intemet httoJ/h2o.enr.state.ne.us/ncwetlands
Date:
hereby state that, to the best of my abilities, due care and diligence
n of the construction such that the construction was observed to be built within substantial
the 401 Watcr Quality Certification and Buffer Rules, the approved plans and
supporting materials.