20180263 Ver 1_Certification of Completion_20181113

CERTIFICATE OF COMPLETION
NCDWR Project No.: County: e K C+i/i cl Pr Coup 47Y
Applicant: _ 'Tri Life -r .�r ZIGeS Gm.OUfly
Project Name: ��.5 iM�1 G -o l F
Date of Issuance of 401 Water Quality Certification: _3
Certificate of Completion
Upon completion of all work (and planting of trees) 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 Wetland & Buffer Permitting Unit, North Carolina Division of Water Resources, 1617 Mail Service
Center, Raleigh, NC, 27699-1617. This form may be returned to NCDWR 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, 0) 146 3 r;'6-nhereby 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: /0 ' o�
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:
Engineer's Certification
Partial Final
Date:
I, , as a duly registered Professional Engineer 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 Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature Registration No. Date,

Within sixty (60) calendar days of receipt of this notice, a petition must be filed with the OAH. A
petition is considered filed when the original and one (1) copy along with any applicable OAH filing fee
is received in the OAH during normal office hours (Monday through Friday, 8:00 am to 5:00 pm,
excluding state holidays).
The petitions may be faxed to the OAH at [phone], provided the original and one (1)
copy of the petition along with any applicable OAH filing fee is received by the OAH within five (5)
business days following the faxed transmission. Mailing address for the OAH:
If sending via US Postal Service.
Office of Administrative Hearings
6714 Mail Service Center
Raleigh, NC 27699-6714
If sending via delivery service (UPS, FedEx, etc)
Office of Administrative Hearings
1711 New Hope Church Rd.
Raleigh, NC 27609-6285
One (1) copy of the petition must also be served on DEQ as follows:
Mr. William F. Lane, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh, NC 27699-1601
This letter completes the review by the Division under Section 401 of the Clean Water Act. If
you have any questions, please telephone Mr. Alan Johnson in the Mooresville Regional Office at 704-
663-1699.
Sincerely,
W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Mooresville Regional Office, DEQ
Attachments
cc: William Elliot, Army Corps of Engineers, email
Megan Jolly, Wetlands and Waters, Inc., [e-mail]
DWR 401 & Buffer Permitting Branch file
MRO, Land Quality