20170083 Ver 1_Certification of Completion_20170310

RECEIVED
sour
OlNsono WaesPece�
ROY COOPER
N-C
G"".'MpY - 1 2017 MICHAEL S, REGAN
Secretory
Water Resources S. JAY ZIMMERMAN
Ercironmmml QaaL..
' Water Duality Regional l7pnrationa oimetm
00 pshovilo se Zonal Office
WR Project No. V o County: 0
Applicant: ':5�5eP 6 N i1'I Q 141—
Project Name: (n Q21n4!" S6fes. 1Se+M 6111 7 ti�-1 1�
Date of Issuance of 401 Water Quality Certification: 2 - d 1-
Certifcate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and my subsequent modifications, the applicant is required to return this certificate to the 401 and
Buffer Permitting Unit, North Carolina Division of Water Resources, 1650 Mai( Service Center, Raleigh,
NC, 27699-1650. This form may be retained m DWR by the applicant, the applicant's authorized agent, or
the project engineer. It is not necessary to send certificates from all of these.
ca
Applicant's tC�erhfrcatwn
I, ---� h 4 - Md-)-uy , 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 in 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.
Signa ae: 3-10- 1-7
Agent's Cert Alli..
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 substmUs' 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 Professi.aal
11 , as a duly registered Professional
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 Pemtitm 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: Registration No.
Date
-^Nothtn9 Comparest,
Sete or NoM Cmoaaa i Envi mnmealal Quality 1 w&or Reaomcea
'-090 U.S. Highway 70, Swam,moa, North Camam 18778
828-2W 45W