20171131 Ver 1_Certification of Completion_20190104

ROY COOPER
(iorrrnor
� � �
MICHAEL 5. REGAN
� .Seorrrarr
Envlronmenluf S. JAY ZIMMERMAN
Qteality D1P1i
NCDWR Project No.: ZO(i- /� 3/ � ►/
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_. County: --G�nc.G
Applicant: /VC. tiOT - 17+J 13
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Project Name: ��:c� �i� of ,5� �3Z3 /� {3 �? (3 � 7?� /LL
Date of Issuance of a01 Watcr Quality Certification: ___sc�_ ____�p1_ ZG 17___
Certificate of Completion
Upon completion o(all work approved wi�hin ihe 401 Water Quality Cerlification or applicab�e Buffer Rules, and
any subsequent moditications, the applicant is required to re�um this cerlificate ro ihe 401 Transporlation Pertnitting
Unit, North Carolina Division of Wacer Resources, I617 Mail Service Center, Raleigh, NC, 27699-1617. This fonn
may be returned to NCDWR 6y lhe applican�, the applicanCs au[horized agent, or the project engineer. It is nol
necessary to send certificates Bom all of these.
�
App/lcanf(cCertlf7calla� '
I 7�TCS ���� � , hereby state that, to lhe besl of my abililies, due care and diligence
was used in the observation of ihe construction such that the construction was observed to be built within substantial
compliance and intent ofthe 401 Water Quality Cenification and 6ut7er Rules, �he approved plans and
specifications, and other supponing materials.
Signature: GY.KG��e.- Date: _ra"� �% Z 6� f
Age�N's CerU,ncaNau
I, __ , hereby s�ate that, ro the best of my abilities, due care and diligence
was used in the observation of ihe construc�ion such that the constniction was observed to be buill within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supponing materials.
Signa[ure: _ _ Date:
Engh�eer's Cerllfieatloi�
Partial Final
I, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) �he construction of the project for the
Permittee hereby slate that, to the best of my abilities, due care and diligence was used in the observa�ion of the
construction such tha� the construclion was obscrved to be built within substantiai compliance and inlenl of the 401
Wa�er Quality Cehifcation and Huffer Rules, the approved plans and specifications, and other supporting materials.
Signawre
Date
Registration No.
' SlalcolNorthCarolina�FmironmenlalOuahry
1617 Mnil Scnice Cenler I Ralri�li. Nonh Carohna 276m1-1617