20151251 Ver 1_401_Certificate of Completion_146_20171017

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PAT MCCRORl'
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DONALD R. VAN DER VAAR'I'
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WaterResources S. JAY �IMMGRMAN
ENVIRONMENTAL OUPLITY
Uil'e[Inl'
NCDWRProjectNo.: �(QIJ12S � � County: �L/-IMAnICF
Applicant: /UL DOT �iv 7—/�t �e. b-1 1 k� I-t ��L�
Project Name: �� {� ��-1(.P bi.l �(L •? 3G� � R �ALG �1� )
W0�5 � �7 8P 7 R. (o� �
Date of Issuance of 401 Water Quality Certificatioo: / Z// 7 �_J �/5
Certificate of Completion �
Upon completion of all work approved within Ihe 401 Water QualiTy Cerlification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate lo [he 401 Transporta[ion Pcrmitting
Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be rc[umed to NCDWR by [he applicant, the applicant's autliorized agent, or [he pro,ject engineec It is not
necessary to send certificates from all of these.
App/icnnPs Cert)fica[lon
1, �-��/ •�l/j ���5 , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such [hat the construction was observed to be built within substantial
compliance and intenl of the 401 Water Quality Cer[ification and Buffer Rules, the approved plans �nd
specifications, and other supporting iiiaterials.
Signatw�e: " �'%'� r�� Daie: /D �/3 —�J� %
Agen1's � frrnliun
I, , hereby sta[e that, to the best of my abili[ies, due care and diligence
was used in [he o6servation ofthe construction such that the consVuction was observed to be built wi[hin subs[antial
compliance and intent of ihe 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: Date:
E�igiueer's Certifirntron
Partial Final
I, , as a duly registered Professional Engineer in the Sta[e ofNorth
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee hereby sta[e tha[, to the bes[ of my abilities, due care and diligence was used in Ihe observation of the
construction such [hat the construction was ohserved to be built within substan[ial compliance and in[ent of the 401
Water Quality Certification and Buffer Rul2s, the approved plans and specifications, and o[hzr supporting materials.
Signa[ure
Date
Registration No.
Slale of Notlh Camlina �Gnvironmenlal Qualiry � Water Resources
16i7 Mail Service Cenler, Ra!aiyh, tJotlh Carolina 27599-16❑