20160628 Ver 1_Certification of Completion_20190108

ROY COOPER
o„ronmr
MICHAEL S. REGAN
.Cerre�m,�
Environittenfa! r S. JAY 7.IMMERMAN
QuQ�ity / Uirrriar
NCDWR Project No.: �� IO �=��25� County: _1�N� �2____ _ , __
Applicant: __.�L_�G� _- n�A---- — ----
ProjeciName: _�r���ry_�� _GYI._SIL�B.U.�_._.V 'S
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon completion o(all work approved wilhin the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modilica�ions, tlie applican� is required to return lhis certificate to the 401 Transponation Permiuing
Unit, North Caroline Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-16 1 7. This form
may be returned to NCDWR by ihe applicant, the applicaN's authorized agent, or the project engineer. I� is not
necessary to send certificates from all of these.
App(ican!'s Certificalion
1, _y��j n��jt,/ , hereby sla�e Ihal, to the best of my abililies, due care and diligence
was us m ihe observati n of the conslruction such that the construction was observed to be built within substantial
compliance and iNent of the 401 Water Quality Certifica�ion and Buffer R�les, ihe approved plans and
specifications, and other supporting materials.
Signa[ure: ��Z' Q _____ _ Date: � � alq
- �---�� _- � -
Ageii!'s Cerllfica/ion
I, , hereby s�ate �hat, to the best of my abilities, due care and diligence
was used in the observation of Ihe construc�ion such ihat the construction was observed to be built within substantial
compliance and intenl of the 401 Water Quali�y Certificalion and Dut7er Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Ei�gineei's CerHJlcntla�
Parlial Pinal
I, , as a duly registered Professional Enginecr in the State of Nonh
Carolina, having been authorized io observe (periodically, �veekly, full time) the construction o(the project for the
Penniuee hereby state �haL to Ihe best of my abilities, due care and diligence was used in �he observation of the
construction such that the construction was observeJ to be built wi�hin substaNial compliance and intent of the 401
Water Qualiry Cenification and 13ufter Rules, �he approved plans and specifications, and other supponing materials.
Signature
Date
Registralion No.
51mo ol Nonh C�aiohna I F.mironineNzl QuaL�y
IGI7 A1aJ tierrmt Centrr I Raleigh. Nurth Caruhna 27699�1617