20170373 Ver 1_Certification of Completion_20190104

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ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
Envlronmental S. JAY ZIMMERMAN
o;.e�m.
Quality
NCDWRProjectNo.: ��!" 0373 County: /KC��6Wc.II
Applicant: /t�<, i70T- ��� 13
ProjectName: �r��,L Z$� Ow $ R ��i�0
Date of Issuance of 401 Water Quality Certification: IQ�r: � ��, Z� ��
Certificate of Completion
Upon completion of all work approved within the 40l Water Qualiry 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.
Applica�iYs Certifrcntion
�, �'C.� /Q��t,�+ , 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 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature: /�i,� Gl.�'�� Date: �G ��, 2 d/ y
AgenYs Certifrcation
I, , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the cons[ruction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certificatio� and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Engineer's Cer(ifrcatiar
Partial Final
[, , 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 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Date
Registration No.
- "�"Nothing Compares'=- ..
S�a[e ofNorth Carolina � Environmental Quality
1617 Mail Service Center � Raleigh, North Carolina 27699-1617