20160229 Ver 1_Certification of Completion_20170327

Water R esources
ENVIRONMENTAL QUALITY
PAT MCCRORY
Govemor
DONALD R. VAN DER VAART
Secretary
S, JAY ZIMMERMAN
Dlrecrar
WR Project No.: 16-0229 County; Henderson
Applicant: Jordan Street, LLC, Manager - David Spence
Project Name: Wash Creek Stream Stabilization - Spence Property
Date of Issuance of 401 Water Quality Certification: March 16, 2016 / ` / 201)
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 and
Buffer Permitting Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh,
NC, 27699-1650. This form may be returned to DWR 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
1, Jordan Street, LLC, Manager - Davi 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 Duffer Rules, the
approved plans and specifications, and other supporting materials.
Signature. Date: 03/13/2017
Agent's Certification
1, Rachel E. Smith , 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 sumi 1 compliance and intent the 401 Water Quality Certification and Buffer Rules, the
approve ¢ pl and eci lc tions d o r supporting materials.
Signature: Date; 03/13/2017
If this projec was designed by a Certified Professional
1, 'as a duly registered Professional _ (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 Permitee hereby state that, to
the best of my abilities, due care and diligence was used in the observation ofthe 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: Registration No.
Date 03/13/2017
@C�@OMC
IN MAR 2 7 2017.
State of Notch Carolina I Enviromental Quality I Wa;erRewurcea
1611 Mai] service Center I RaleiXS, North Carolina 27699-1611
919 707 900D