20170397 Ver 1_Riverbend Intake Fill_20190111

CERTIFICATE OF COMPLETION
NCDWR Project No.: � W�# 17 0397 cou„ri: �qS�Dti
Applicant:
Project Name:
I ��i� � �
c.+ r; /,
Date of Issuance of 401 Water Quality Certi£cation: �/���� /
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 Divisj�n of Water Resources, 1650 MailService Center,
Raleigh, NC, 27699-1650. 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.
Applirnnt's Certification
I, �On/�l �G�/n�/�. , 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 sp ' ications, and other supporting materials.
Signature.—���� Date: // a?// %
AgenYs Ce►tification
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 Cluality Certification and Buffer
Rules, the approved plans and specifications, and other supporting materials.
Signature:
Engineers Certificatlon
Partial Final
Date:
I, /V �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
Registration No.
StateofNorthCarofina i FnNronmentalQuality I Water Resources
SR N. Satlsbiay Street I �6ll MailService Centm I Ra�ei9h NC 276941611
919.707.9000