20071417 Ver 1_Certification of Completion_20081117

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Certificate of Completion
DWQ Project No. b `7- NO County: I? p?Q
Applicant: NC Do T D I 'V. I ;L'
Project Name: 62 133(a , Aol-p- 4n p?
Date of Issuance of 401 Water Quality Certification: ?D ? rYl h? t' ol,
Upon completion of all work approved ?,Nrthin the 401 Water Quality Certification and Buffer Rules,
and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Di\ision of Water Quality, 1621 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
1. M. L. Qt/"" , 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 \Nas observed to
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the approved laps and specifications and other supporting materials
X
; 60-POW
Signature '® ° _ 6401tz?
Agent's Certification
Date //-JO -0e
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 \\as observed to
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
If this project was designed bj, a Certified Professional
Date
. as a duly registered Professional
(i e , Engineer, Landscape Architect Survey or, etc ) in the State of North Carolina having been
authorized to observe (periodically, xN eekly, 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 i the
observation of the construction such that the construction vtas obserN ed to built xN 11thm I
compliance and intent of the 401 Water Quality Certification and Buffer Rules the a N 5dw
and specifications, and other supporting materials N D?
0? 1
Signature Registration No Date 7 2008
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Alexander County Pipe Replacement
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Alexander County Pipe Replacement
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