20001432_Certification of Completion_20080630

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Certificate of Completeness
Utr V?DWQ Project No.: 001432 County: Lee county Bpi X05
Project Name: TIP R-2417 BB ?kv'q4/
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Date of Issuance of 401 Water Quality Certification: September 17, 2004
Certificate of Completion Y
*Pon 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 Transportation Permitting Unit, North Carolina Division of Water Quality, 1650 Mail
Service Center, Raleigh, NC, 27699-1621. 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
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:
If this project was designed by a Certified Professional
I, .-Jef4u 1P. ?. ?ci?t??,? , as a duly registered Professional E%J& sWeV-
(i.e., Engineer, Landscape Architect, Surveyor, etc.) 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
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 plarnd specifications, and other supporting materials.
Signature Registration No. ZZ 9 79
Date ?? U