20030084 Ver 2_Certification of Completion_20081208

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleen H Sullins. Director
Division of Water Quafity
DWQProjectNo.: 03-OOPY Val County: _ W4l-a?_.__--_._.__.__._.??_
Applicant: _ faboe f C.?ddy
Project Name: _ los 4e' dw+
_-e2
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon compleion of all work approved within the 441 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401,fWetlands Unit, North Carolina Division of Water Quality, .1650 Mail Service Center, Raleigh, NC,
27699-3650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
tfae prqject ertgine:et It is riot necessary to send certificates from a.ll of these.
Applicant'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
Males, the approved plans and specifications, and other supporting, materials.
Sigr ahtre; _ hate:
Agent's Certification
? _ _ ?_ _ _ , hereby state that, to the best of my abilities, dale 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 (duality Certification and burr
Rules, the approved plans and specifications, and other supporting materials.
Signature: _ Date:
If this prDject was designed by a Certified Professional
1, _ as a duly ret.listered 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 prgject, for [lie Peranitee hereby sta2cthat, to the best of my abilities, due care and diligence was used in the observation of thka cops6.rractior?
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 plats and specifications, and other
supporting materials,
Signature -_Registration No.
Date
k @ 12 Ole 19 D5
DEC 8 Zoos
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH
North Carolina Division of Water duality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
Oct V