20170432 Ver 1_Certification of Completion_20190104

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Environmental
QUR�Ify
NCDWR Project No.:
Applicant: �/L
Project Name:
ROY COOPER
covernor
MICHAEL S. REGAN
SecretnrY
S. JAY ZIMMERMAN
� Direclor
co�nry: ur�e
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Date of Issuance of 401 Water Quality Certitication: ��25�'�(1 /'�
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 the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
App(icnnYs Certifrcntion
1, ROqPr � Il�PV6N , hereby state that, to the best ofmy abilities, due care and diligence
was us 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 supponing materials.
Signature: �� Q a� Date: ,2d
AgenYs Certifrcnlion
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 Wa[er Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Engineer's Cerlification
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 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 40 ]
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Date
Registration No.
%'Nothing Compares .- �
Stare of North Carolina � Environmental Quality
1617 Mail Service Center � Raleigh. North Camlina 27699-1617