20170174 Ver 1_Certification of Completion_20180605

Water Resources
I:nv ironmental Qualitp
DWR Project No.
Applicant:
Project Name:
/ 017 County
Date of Issuance of 401 Water Quality Certification: /�2vu) (�, 2oll
Certificate of Completion
ROY COOPER
iio vel'11 UI"
MICHAEL S. REGAN
5'erretcnr
S. JAY ZIMMERMAN
Uireclor
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 DWR Central Office –
Wetlands and Buffers Permitting Unit at 1650 Mail Service Center, Raleigh, NC 27699-1650. This form may be
returned to DWR by the applicant, the applicant's authorized agent, or the project engineer. It is not necessary
to send certificates from all of these.
Applicanfs Certificatio7/ 1
I, �/ r�J—✓ 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: 7x::e� Date:dr-
Agent'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:
If this project was designed by a Certified Professional
I, , as a duly registered 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 project, for the Permitee 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
Registration No.
v- 'Nothing Compares _k .
State of North Carolina I Environmental Qualit,.-
1611 Mail Service Center I Raleigh_ North Carolina 27699-1611
919-707-9000