20071906 Ver 1_Certification of Completion_20081208

4"!-M STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
December 3, 2008
CONTRACT NO C201481
WBS NO 333883 1
TIP No B-4021
COUNTY BEAUFORT
DESCRIPTION Bridge over Latham Creek & Approaches on SR 1410
AM'EMORANDUM TO Alan W Klimek, P E
Division of Water Quality
1638 Mail Service Center
Raleigh, NC 27699-1638
FROM Shawn Mebane, P E
I Resident Engineer
SUBJECT Project Completion
Please see the attached form
Please feel free to call me at 252-792-0347 if you need more information
CC Garcy Ward
Jay Johnson
RECEIVED E WQ
AQUIFFR PROTF_ ON SECTION
082
19210 U S Hwy 64 East, Williamston, NC 27892 [phone] Fax [phone]
S Michael F Easley Governor
+ WATEhj 115 Witham G Ross Jr Secretary
\O QG F North Carolina Department of Environment and Natural Resources
? Coleen H Sullins Director
Division of Water Quality
o < ,
DWQ Project No.• Z007 / O0 p 1
Applicant- I Vot4i-t Cc.r-nil nrDe p-rLY
Project Name TIP 6- 4D'L i A r- i da r C
Date of Issuance of 401 Water Quality Certification
County 8 ea L, FO r-"
I?uni?a-?i -I 2oo1;
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 /Wetlands Unit, North
Carolina Division 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
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
Agent's Certification
1, 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 mtent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials
Signature
Date
Engineer's Certification
Partial X_ Final
I, C kcA -1es ?1nc u M r b cv?z , as a duly registered Professional Engineer in the State of North
Carolina, havmg been authorized to observe (periodically, weekly, full tune) the construction of the project, for the
Permittee 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 Rulles,. the approved plans and specifications, and other supportmg materials
Signature C 11,e A65) Registration No DZ?4 o t.,
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NorthCaroli

Transportation PeffnM g Unit
1650 Mail Service Center, Ralegh, North Carolina 27699-1650
2321 Crabtree Boulevard Suite 250 Raleigh, North Carofne 27604
Phone [phone] FAX [phone] / Internet http //h2o enr state nc us/ncwettands
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