20061962 Ver 1_Certification of Completion_20090610

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
D WQ Project No.: U O ( - 9 G , County: Q A o L.3 c- vt
Applicant: I ) om ws 1, a , ?! h J .
JUN 1 0 20`9
Project Name: Taos
Date of Issuance of 401 Water Quality Certification: Feb- 9 , Z J o 7
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, 1650 Mail Service Center, Raleigh, NC, 27699-1650. 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, ( or2?s F, A, A J t- 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 m ills. ?f
Signature: Date: ?1w•?? 2 ew
Agent's Certification
I, hereby state that, to the best of my abilities, due dau
190M LE was used in the observation of the construction such that the construction was observed to be built I
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved pland specifications, and other supporting materials. JUN j 5 2009
Signature:
Date:
If this project was designed by a Certified Professional
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ME1lJ1ig6NOS??
1, , 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.
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Phone: [phone] FAX: [phone]
Internet: www.ncwaterquality.orq
An Equal Opportunity 1 Affirmative Action Employer
North Carohna
Naturally
Thomas F Austin Jr
220 Heritage Point Drive
Edenton, NC 27932
NC DENR
Washington Regional Office
DWQ Surface Water Protection
943 Washington Square Mall
Washington, NC 27889
June 9, 2009
JUN 1 0 20G9
Dear Mr. Scarbraugh,
I spoke with Mr. Hodge today, and he suggested I forward the enclosed certificate of
completion to you. I appreciate your sending it to me, as I had misplaced the one I was
sent with the original waiver.
If you have any questions about the way I filled out the form please feel free to give me a
call. My phone number is: 252-482-4041.
Sincerely,
Thomas F Austin Jr