20171135 Ver 1_Certification of Completion_20190104

-`:�7 s•
��� �� . .�' .
£nvironmental
QUQ�Ii}�
NCDWRProjectNo.: Z�li' �I3S
Applicant: �tiL f�UT.- 17i� 13
ROY COOPER
Covernar
MICHAEL S. REGAN
Secrelary
S. JAY ZIMMERMAN
Direcror
County: ��"«cy
Project Name: ��"�kL �� 7 p� S IZ !3 z 3
Date of Issuance of 401 Water Quality Certification: s
I�P �3, Z• �2>
20 (�
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 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be returned to NCDWR by [he applicant, the applicanPs authorized agent, or the project engineec It is not
necessa�y to send certificates from all of these.
ApplicnnYs Cerlifrcnlioir
I, ��G'�'GS iQ��oh , 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 40l Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: �.��(,�-Yc� Date: �q� �� 26�f
AgenYs Cerlificntiox
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 oFthe 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Eiigineer's Certificnliar
Partial Final
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 s[ate 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, [he approved plans and specifications, and other supporting materials.
Signature
Date
Registration No.
State of North Carolina I Enviromnemal Qualiry
1617 Mail Service Center � Raleigh, Nonh Carolinz 27699-1617