20160346 Ver 1_Certification of Completion_20170119

}'A'I' MCCRORY
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F` � UONALD R. VAN I)F.R VAART
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WoterResources S. J�Y J1MMP.RMAN
ENVIRONMENT/1L OUl�IITY
NCDWRProjectNo.: Z���n03�((v County: G1'0.HV� i�t
Applicant: /�CDOT DIV �S
Project Name: 52 I�F07 �lelt�(�lll /TA►"� Ie��
Date of Issuance of 401 Water Quality Certification: �5� J/(p
Certificate of Completlon
Upon completion of aIl work approved within the 401 Water Qualiry Certification or applicable Buffer Rules, and
eny subsequent modifications, the applicant is required to retum this certificete to the 401 Transportation Pertnitting
Unit, North Carolina Division of Water Resouroes, 1617 Mail Service Center, Raleigh, NC, 27699•1617. This form
may bc rewrned to NCDWR by the appGcnnt, the applicanYs authorized agent, or thc project engineer. It is not
necessary to send certificates from all of these.
Applicant's CeniJlcallon
I, 7- ��o/��n * P E , hereby state that, ro the best of my abilities, due care and diligence
was used in the obse ation of the construction such thet the consWction was observed to be built within substantial
compliance and intent of the 401 Water Qualiry Certificafion and Buffer Rules, the approved plans and
specifications n ther suppo i�y materials.
Signature: �' I Date: I Z��� ��
Agen!'s CcrtiJicali
�. , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the conshvction 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.
Signamre:
Engirteer's CerttJTcaBon
Partial Final
�, , as a duty registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observetion of the
constrvction such that the construcaon wes observed to be built within substantial compliance end intent of the 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No.
Date
$Ute of Notlh Cemlinx IF.nvirommemxl ljyality I Wa1er Resnn¢es
1617 Ma'I S�rte Cenkr. Rprnqh. Mxllt Carolina 2769&16ll
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JAN 1 9 i��� �
DENR . WATER qESGURCES
t�SPOR7AT10N PERMIT7�I�IG UNR