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<br />C. REVIEW FEE <br /> <br />Has the review fee for the BPProprfala requeal category been Included? <br /> <br />G Yea Fee l1/TIounl: $~ <br />CJ No, A1tI.loh ExplanaUon <br /> <br />PleSIIII. the FEMA Web Ille lit ht <br /> <br /> <br />D. SIGNATURE <br /> <br />AlIklC\ll1enl8 submItted In support of this request ara oorract to the beat of my knowledgl, I undel'llllnd that any falas 'tatlment may be punlshable <br />by fine or lmpr/8onment lIIl1er T1Ue 18 of the United Slates Code, Section 1001. <br /> <br />Name: BeauDry J, Koch <br /> <br />Company: Anderson COnuulllno Enalneers. lno. <br /> <br />MelillO Addl'8.!ls: <br />172 WhBlarl Way. Sutte 200 <br />Fort Cotllns1 co 80625 <br /> <br /> <br />Dayl\mll Telephone No,: <br />91'0426-0120 <br /> <br />Fax No.: <br />970-226.0121 <br /> <br />Slgnalure of Requasltlr (reqW'ed): <br /> <br />Dale: <br /> <br />/z./, I ~G. <br /> <br />As tM community omotel respDl\9lbte Corlkl m nagemsnt,l hereby Bcknowledgelhetwa have rell8lved and re'llawed lhl81.l1Uer of Map <br />RevlaIon (LOMR) or condlltolllll LOMR req . SB8d upon tho communlo/tl review. wa Rnd Ute completed or proposed P1'oJaclll'18Bt8 Dr Is deSlgrul4 <br />to meet all of the aoml11unJty ftoodp/aln menagement requlrettlllnfs, including the requlrem8l'lllhal no flll be pJaDBd In the regulatory f100dway, (1I'1i1 Ihlit <br />ell necoseary Federal, Stull', Emd local permll8 have bill", or In the cue of 8 condlllonsl LOMA, WIll bll obtaIned. In addItion, we have dotermInQd that <br />Oteland and eny eldsl/ng Dr proposed sln1cll1l'8ll to be removed from lhe SFHA are or will be rllB8Or1abty sare from flooding B8 defined In <44CFR <br />66.2(0), end thai we hBve available upon requBst by FEMA, all anBly8llll and dOllUmenlallon used to make UtIli debmnlnatlon. <br /> <br />Cllmn1unHy OfBclal'a Name and TIt!&: Becky DavIdson. Town Menager <br /> <br />TelephOne No.: <br />970-224-3211 <br /> <br />Comtnunlly Name: Town t1fTlml'1lllh <br /> <br /> <br />qulred.: <br /> <br />Dale: <br /> <br /> <br />'-- <br />( <br /> <br />CERTIfICATION BY REGISTERED PROFESSIONAL ENGINEER AND/OR LAND SURVEYOR <br /> <br />ThIs cortIRcaUon 18 10 belllgned and sealed by II licensed land llUlV8YD', rsglstarsd proflll!lllonel anglnBBl'. Dr architect aulhorlzad by law 10 csrtIfy <br />elevalon InlOmlDUon. All doownonl8 Ilubmltted In support of \his raqusat are cotracl 10 the baal of my knowlsdge. I understand theleny fals9 <br />stamment may be punlshabfe by fillS or Imprlsonmenl under Tille 1 B of Ute Unlled SlatB8 COdB, SooUon 1001. . <br /> <br />C8lt1flBr'1I' Name: Gregory J. Kooll UoonB8 No.: 26387 <br /> <br />EJcpII8Uon Date: <br />01131/01 <br /> <br />Cl:impany Name: Andel8Ol1 CensuRIng EnglneElfll, Telephone No.: 970-226-0120 <br />Ine. <br /> <br />Pax No.: <br />. S70-228-0121 <br /> <br /> <br />Slgnalure: <br /> <br />Dale: <br /> <br />1'2. ~ I~ <br /> <br />ReQulmd If ... <br />181 Atverlna Hydrology Illld Hydraulics Form (Form 2) New Dr revlsed dlsdTarges or waler-llutfaoo eJev81101\1l <br /> <br />181 Riverine Slruoturaa Form (Fonn 3) <br /> <br />Chennells modIfied, addlUonlrevlslon 0' brldge/culverlll, <br />addlUonIrevlslon of levee/lloodwan, addlllonfravlaJcn of dam <br /> <br />New or revlaad coastal elevallons <br /> <br />Addl1lcnlrevlslan of coastal structure <br /> <br />Sesl (OpUonan <br /> <br />o Coaslel AnBlyele Form (Fonn 4) <br />o Coasllll structures Form (Form 5) <br />o Alluvial Fan AoDdIng Fonn (FDI'nl 6) <br /> <br />Roolf wlltrot meaeurell on alluvial fans <br /> <br />FEMA Form 81-69, SSP 02 <br /> <br />Overview & Conourrenoo Form <br /> <br />MT-2 Form 1 Pege 2 of 2 <br /> <br />cOd <br /> <br />Ll2Z17220L61 :01 <br /> <br />b12817LL80~1 d~O~ ~NI~33NI9N3 8I:WO~j d9[:80 L002-S1-83j <br />