20140842 Ver 2_Certification of Completion_20170606

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
DWR Project No
Applicant:
Project Name:
14-0842v2
Town of Apex -David Hughes
White Oak Creek Infrastructure
401 Water Quality Certification Issued Date
County: Wake
March 30,2016
Donald R. van der Vaart
Secretary
Certificate of Completion p [9 @ �� C
p 6 2017
Upon completion of all work approved within the 401 Water Quality Certification or applic bl B �4N e
Rules, and any subsequent modifications, the applicant is required to return this certificat to he DW
401 &Buffer Permitting Unit, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This forUF11'FER P R
returned to DWR by the applicant, the applicant's authorized agent, or the project engine e . Is not
necessary to send certificates from all of these.
Applicant's Certification
I, 7De1110 lla,4 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.
Signatue: Qj Date: j / `J / 7
Agent'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:
If this project was designed by a Certified Professional
I, , 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 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:
Division of Water Resources — 401 & Buffer Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N Salisbury St, Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquality.org
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