20180888 Ver 1_Certification of Completion_20180821

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
DWQ Project No.
Applicant:
Project Name
NORTH CAROLINA
Environmental Quality
lol t . o b fs County
TW � oc S.,ow N:11
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Date of Issuance of Wetland Permit: � . o I 20 iy
Upon completion of all work approved within the 401 Water Quality Certification and/or Buffer Rules, and any subsequent
modifications, the applicant is required to return this certificate to the 401 & Buffer Permitting Unit, North Carolina Division of
Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. 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.
Applicant's Certification
I, Jan. lxnk '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/or Buffer Rules, the approved plans and specifications, and other supporting
materials.
Signature: Date: IL A%-9," Zotf�
Agent's Certification
I, D-.-- u :11 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 /or Buffer Rules, the approved plans and specifications, and other supporting
materials.
Signature:
If this project was designed by a Certified Professional
Date: I AuJ, ,J 10, Y
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 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/or Buffer Rules, the approved plans and specifications, and other supporting
materials.
Signature:
Registration No.
D_E
ncflrN I Ar.r_Ymw Ql�
DWh—t of EnWamKnW WYttr�
Date
North Carolina Department of Environmental Quality I Division of Water Resources
Washington Regional Office 1 943 Washington Square Mall I Washington, North Carolina 27889
252.946.6481