20151247 Ver 1_Certification of Completion_20170119

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Water Resources
ENVINONMENTAL �UALITY
NCDWR Project No.:
Applicant: /VC,�
Project Name: s� 2/ 3
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PAT MCCRORY
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DONALD R. VAN DER VAART
County: WaKG
Dste of lssuance of 401 Water Quality Certifica[ion: O/ OS//(p
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Secrcrnrv
S. JAY ZIMMERMAN
Ulfeclnr
Certificate of Completion
Upon completion of all work approved within the 401 Water Qualiry Certification or applicable Buffer Rules, and
any subsequent modifications, [he applicant is required to return Ihis certificate ro the 401 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1617 Meil Service Center, Raleigh, NC, 27699-1617. This form •
may be retumed to NCDWR by the applicant, the applicenPs authorized agent, or the project cngineer. It is not
necessary to send certificates from ell of these.
Applicanl's CeriiJlcotlon
l, T� /�o�O�.�✓/5 �%� E , hereby state that, to the best of my abilities, due care and diligence
was used in the observadon 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
specification� ther supp rting materials.
Signature: �F( ' �ete: �Z�'����
AgrnPs Cerlifrca!!
�� , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such that the consVuction 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 materiels.
Signature: Date:
Engtneer's Cerf�catlon
Partial Final
�, , as a duly registered Professional Engineer in the State of North
Carolina, heving been authorized to observe (periodically, weekly, full rime) the construction of the project for the
Permittee hereby state that, to the best of my abilities, due care snd diligence was used ia the observation of the
construction such that the construction was observed to be built within substantial compliance and in[ent of the 40I
Water Quality Certification and 6uffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No.
Date
Slam nt North Cualina �Envimnmmlal Qunlity I N'a1a Resavices
1617 Mal Service Cenler, RaleigR Notlh Carplina 176941617
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JANi9�Ui/ �
T���AA7ER REgp��ES
T�1 PERh4f1TING UNfT