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y�oprs oeFNp <br /> CERTIFICATE OF COMPLIANCE y��a <br /> Army Corps <br /> of Engineers a WITH DEPARTMENT OF THE ARMY PERMIT <br /> of <br /> Seattle District �k470p''""`PP <br /> Permit Number: NWS- <br /> Name of Permittee: <br /> Date of Issuance: <br /> Upon completion of the activity authorized by this permit, please check the applicable boxes below, date <br /> and sign this certification, and return it to the following email or mailing address: <br /> Department of the Army <br /> U.S. Army Corps of Engineers Seattle <br /> NWS.Compliance@usace.army.miI OR District, Regulatory Branch <br /> 4735 E. Marginal Way S, Bldg 1202 <br /> Seattle, Washington 98134-2388 <br /> Please note that your permitted activity is subject to a compliance inspection by a U.S. Army Corps of <br /> Engineers representative. If you fail to comply with the terms and conditions of your authorization, your <br /> permit may be subject to suspension, modification, or revocation. <br /> The work authorized by the above-referenced permit has been completed in accordance with the terms <br /> and conditions of this permit. <br /> El <br /> Date work complete: <br /> ❑ Photographs and as-built drawings of the authorized work (OPTIONAL, unless required as a <br /> Special Condition of the permit). <br /> If applicable, the mitigation required (e.g., construction and plantings) in the above-referenced permit has <br /> been completed in accordance with the terms and conditions of this permit (not including future <br /> monitoring). <br /> Date work complete: ❑N/A <br /> ❑ Photographs and as-built drawings of the mitigation (OPTIONAL, unless required as a <br /> Special Condition of the permit). <br /> Provide phone number/email for scheduling site visits (must have legal authority to grant property access). <br /> El <br /> Printed Name: <br /> Phone Number: Email: <br /> Printed Name: <br /> Signature: <br /> Date: <br />