20170412 Ver 1_Certification of Completion_20190104

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.,. �.:
Envfronmental
Quality
NCDWRProjectNo.: ��%' ���Z
Applicant: /� �- ao r- D�J 13
ProjectName: ���d,ql Zys On .SQ
Date of Issuance of 401 Water Quality Certification: _
ROY COOPER
Governor
MICHAEL S. REGAN
SecretnrV
S. JAY ZIMMERMAN
o,.e�ro.
County: Mc.�d`�c��
llz9 t7t3A. 13. i2, tz
�:1 L S, 2017
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applican[ 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 applicanYs authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
ApplicanNs Certifrcntion
I, ��aTt S�{ i� tr� , hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the construction such tha[ the construction was observed to be buil[ within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signa[ure: ,.f�GcrG-+— Date: TaK �� l��k
Agenl's Ceslifrcnlian
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 Water Quality Cenification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Eirgiueer's Certificnlion
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 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature
Regishation No.
Date
" �'Nothi�g Compares '.- �
State o(North Carolina I Environmzntal Qualiry
�617 Mail Service Center � Raleigh, North Carolina 27699-1617