20090076 Ver 1_Certification of Completion_20090911

An IF °q- oo7t,
Certification of Completion L9
E @P= 0:
DWQ Project No.: 09-00-7(p County: 1 y e W ? Jono V er SN=P 1 i 2009
Applicant: Ale Q Farb ?1Cr Cash }y jar e+&, ?w i' WETLANDS AND TOR WATER BRANCH
Project Name: 2'vi" ?o-.l Tar k
Date of Issuance of Wetland Permit: re Le"', 2m Ci
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to retum this certificate to the 401 Oversight/Express Permitting Unit,
North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. 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
1, , 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 G`et?ification and Buffer Rules, the approved plans and specifications,
and other supporting materials, c1F ? ftf- _
Signature: - Nte:
y... r•:
Agents Certification
hereby state that, to the beat br}ty„fiilities, due care and diligence was
used in the observation of`the construction such that the construction was'obsterved 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
as a duly registered Professional L u e ( (i.e., E ,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorize t?rve iodicall ,
weekly, full time) the construction of the project, for the Permittee hereby state that, to the best of my ,
abilities
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, o er supporting materials.
Signature: Registration No. a 6 d
l Date ??