20060391 Ver 1_Certification of Completion_20090814

Certificate of Completion
DWQ Project No.: 06 - 039 1 County: DAVUSO"
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Applicant:
Project Name: mC,,oDoyl?? GLc) AUG 1 4 2009
DENR - WATER QUALITY
Date of Issuance of 401 Water Quality Certification: /YAWQ Z"7? 2006 WETLANDS AND STORlu1W4TEfF BRANCH
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North
Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be
returned to DWQ by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicant's Certification
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 Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature
Date:
Agent's Certification
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 Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature
Date:
If this project was designed by a Certified Professional
I, _tA?2iS ?? ir07? , as a duly registered Professional _Q ENE& (i.e.,
Engineer, Landscape Architect, Surveyor, etc.) 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 Buff WDQproved plans and specifications, and other supporting materials.
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Signature: Registration No.: 53(0() Date: O / Z
.. Seal
6360
Meadowfield Residential Subdivision
Friedburg Church Road (SR 1520), Davidson County, N.C.
U.S. Army Corps Of Engineers Action ID: 200620549
NCDENR Water Quality Project No.: 06-0391
3 - 10' X 1 l' Culvert Crossing - Upstream

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3 - 10' X 11' Culvert Crossing - Downstream
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Meadowfield Residential Subdivision
Friedburg Church Road (SR 1520), Davidson County, N.C.
U.S. Army Corps Of Engineers Action ID: 200620549
NCDENR Water Quality Project No.: 06-0391

3 - 10' X I I' Culvert Crossing Downstream (Side View)