20160629 Ver 1_Certification of Completion_20190108

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fnvironmental
Quality
NCDWR Project No.:
ApplicanL• ��C- I
ROY COOPER
Gocrnuu
MICHAEL S. REGAN
&cr�nm;r
S. JAY 'LIMMERMAN
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�-U�� Counly: �a[l�'1Pr-1'pi-�
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Project Name� _ IJ= �-3 I_.%,_ {��,�� S
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Date of Issuancc of A01 Watcr Quality Certification: __�% _ 1� .ZU/ p _
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifica[ions, the applicant is required to retum this certificate to the 401 Transporlation Permitting
Unit, North Carolina Divisiai of Water Resources, 16I7 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be returned to NCDWR by the applicant, ihe applicant's aud�orized agent, or the project engineer. It is not
necessary to send cenificates from all of these.
AppllcanYs CerlificaHo�r
�y�t/��_______ , hereby s�ate that, [o Ihe best of my abili[ies, due care and diligence
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was u d in the observ3lion of Ihe construction such Ihat the construction was observed [o be buil� within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting malerials.
Signature: _ �� __ _ ____ Date: (/�/10/ �_ _
Agen!'s Cerlifrcation � �
�, _, hereby state that, to Ihe best of my abilities, due care and diligence
H�as used in the obsetvation of the construc[ion such ihat �he construction was observed to be built wilhin substantial
compliance and intent of the 401 Water Quality Certification and BufTer Rules, the approved plans and
specifications, and o[her supporting materials.
Signature:
Engineer's Cer�lJlcatioi�
Partial final
�� , as a duly registered Professional C:ngineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full [ime) the construction of Ihe projec� for [he
Perminee hereby state ihat, to the best of my abilities, due care and diligence was used in the observation of the
construc�ion such that the construction was observed to be built within substantial compliance and intent of the 401
Water Quality Certification and f3uffer Rules, �he approved plans and specifications, and other supporling materials.
Signature
Date
Registration No.
.. �'Nothing Compares - ,
titate of Nonh Cnmhna � Emironmem�d Qunli���
1617 Mnil Service Ccmer I Raleiyh, North Carolina 27699-1617