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r <br />M <br />ltBiE(I!�.e <br />°� =- <br />i <br />Lawson Chiles <br />Governor <br />@'1 <br />k <br />k <br />k <br />Department of <br />Environmental Protection <br />Central District <br />3314 Maguire Boulevard. Suite 232 <br />Orlando. Florida 32603.3767 <br />ENVIR[]isIl IENTAL RESOURCE I'%WIT <br />AS-F3UtLT CERTIFICATION BY A REGISTERED PROFESSIC14AL <br />Virginia B. Wetherell <br />Secretary <br />permit Number•. <br />project Name: <br />I hereby certify that all components of this surrace water management system have been built substantially in accordance <br />with the approved plans and specifitations and are ready for inspection. Any substantial deviations (noted below) From the <br />approved plans and speclficatior's will not prevent rhe system from Functioning as desitne3 when properly maintained and <br />operated. These determinations are based upon on-site observation of the system conducted by me or by my designee under <br />my direct supervision andior my review of as -built plans cern Pied by a regi stared professional or other appropriate individual <br />as authorized by law. <br />Name (please print) <br />Company Name <br />Company Address <br />City, State, Zip Code <br />Tel Number <br />Substantial deviations From the approved plans and specifications: <br />Signature of Professional <br />Florida Registration Number <br />Date <br />(Affix. Seal) <br />(dote: anach rsvo copies of as -built plans when there are substantial deviations) <br />Within 34 days of completion of the system, submit two copies of the form to: <br />OEPARTLIENT OF ENVIRONMENTAL PROTECTiCN <br />CENTRAL01STRICT SUE -MERG E:) (ANDS AND <br />ENVIRONMENTAL RESOURCES PROGRAM <br />$319 MAGUIRE ELVD STE 7.32 <br />ORLANDO FL 32803 <br />"Protect. Conserve Qnd p.1vnar rlooda,s F:tviroruneat and INatoral Res41+r.e's­ <br />pratled on ecnW paper. <br />