20141056 Ver 1_401_Certificate of Completion_248_20171017

Pat McCrory
Governor
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IdCDE1dR
North Carolina Department of Environment and Natural Resources
Donald van der Vaarf
Secrelary
NCDWR Project No.: Z(�1�� I�5� County: �Ait4�C�,--- .
nppr�,:,�,f: �IGAor_u_v_�_ -_Mr2. F-tlk� A.�i(���— —
ProjectNTme: P>12tt � jj nnl_.�2_��SZ-i �QVk1Ck"n��USiF IZIJ
Wrbs�: i� i3R� 7 2 5�
Datc of Issuancc of 401 Wa�cr Qualit,y Cerlific�tiai: l� � � L(e /�
CertiPicale of Complelion
Upon contplelion of all u�urk approved wifhin the <401 Wtrter Qualiry Cenification or applicable f3ulTer R�des, <uid
any subsequent moditications, the �pplicant is required fo return this cenilica[e to ihe 401 Transporlaiion Permittiug
Unit, North C�rolina Division ol Water Resources, I(SO Mnil Service Center, Raleigh, NC, 27699-I(�0. This fm�m
mny be returned lo NCDWR by Ihc �pplicant, thc applicant's �mthorized ;igcnl, nr Ihe Fa�ojeci enginecr. I� is not
necess�ry [o send certificates froin �II of �hese.
rlpplicrml's CerllJ7cnlion
I, �� .��� •��/ ��S , hcrcby stale fhal, to thc besL of my a6ilities, due cnre aud diligence
was used in tlie observetion of die wnstruciion such �hai die consiruc�ion �vas observed to be built �vidiin substantial
compliance and inteirt of thz 401 Waler Quality Cerlitic�tion nnd Ruffer Rules, the approved pl�ms and
specitications, and ntl�er supporting materinls.
Signature: / ` p(� Dalc: �O '—/,3 ' �/ %
ilgeul's iflcnllo�i
I, , hereby state th�t, to the best of my abili[ies, due care and diligencc
tvas used in the observ�[ion of Ihe emistruction such that the conshuction w�s observed ro be built �vithin subst�ntiTl
compliance and intent of the d01 W�ter Qualily Certification aincl I3id'I'er Rules, �he approved plans �nd
speciticntions, and other supporting in�terials.
Signature:
Lugineer's Cerllfrcalinn
P�rtial �intil
I, , as a duly regislered ProFessionnl Enginezr in the St�te oFNorlh
Carolina, having 6een authorized to obscrve (periodically, wcekly, full tinte) �he construction of the prqject for Ihe
Permittee hereby s�ate that, io Ihe best of my abiliiics, duc care nnd diligence w�s uscd in ihe observ�uion oFihe
construction such that the cons[ruction was observed to be built within substantial compiiance and intem of ihe 401
Water Qu�liq� Certifcation and Huffer Kules, Che approved plans sind specificadons, �nd other supporling me�erials.
Signa�ure
Dnle
Regislr�lion No.
iG17 Mail Service Cenler, Ralelgh, Norlh Carollna 27699-1617
Phone:[phone]nterneC www.ncdenr.gov
An Equal Opporlunlly 1 Alfumalivo Acllon Employer