20061139 Ver 2_Certification of Completion_20080421

F \ NA T? Michael F. Easley, Governor
\O?0 q?G William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
-H Division of Water Quality
O 'C
Applicant: GC-% -7i V,)F;LcPMrc
Project Name: 1+h¢ \-do cD.>
Date of Issuance of 401 Water Quality
DWQ Project No.: lE-GP -* 0 to -x%39vaCounty: \,,JA-4,1?:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
the project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, , hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction 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:
Agent's Certification
I, `JAcr- t_.?t1r[a F(L , hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction such that the construction was observed to
be built within subs antia c mpliance and intent of the 401 Water Quality Certification and Buffer
ly registered Professional (i.e.,
of the project, for the Permitee hereby state
used in the observation of the construction
ubstantial compliance and intent of the 401
plans and specifications, and other
Rules, the approve pl ns d specifications, and other suppo to materials.
Signatur Date: ?
If this project was d ed by a Certified Professional
I, , as a du
Landscape Architect, Surveyor, etc.) in the State
Engineer, of North Carolina, having been authorized
to observe (periodically, weekly, full time) the construction
that, to the best of my abilities, due care and diligence was
such that the construction was observed to be built within s
Water Quality Certification and Buffer Rules, the approved
supporting materials.
Signature Registration No.
Date
APR 2 1 2008

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North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/