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<br /> FEDERAL EMERGENCY MANAGEMENT AGENCY D.M.B. Burden NO. 3067.0148 FEMA IISE DNL Y <br /> CERn FICA nON BY REGISTERED PROFESSIONAL ENGINEER Ex".resJulyJI.1997 <br /> AND/OR LAND SURVEYOR FORM <br /> PUBLIC BURDEN DISCLOSURE NonCE <br />Public reporting burden ror this rorm is estimated to average. 23 hour per response. The burden estimate includes tl <br />time ror reviewing instructions, searching existing data sources, gathering and maintaining the needed data, al <br />completing and reviewing the rorm. Send comments regarding the accuracy of the burden estimate and ar <br />suggestions for reducing this burden, to: Information Collections Management, Federal Emergency Manageme <br />Agency, 500 C Street, S.W., Washington, DC 20472; and to the Office or Management and Budget, Paperwol <br />Reduction Project (3067- 0148), Washington, DC 20503. . <br />1. This certification is in accordance with 44 CFR Ch. I, Section 65.2 <br />2. 1 am licensed with an expertise in Civil Engineering/HYdraulics <br /> (example: water resources (hydrology, hydraulics. sediment IraMport, interior drainage)" structural, -. <br /> geotechnical,land surveying. I <br />3. I have 8 years experience in the expertise listed above. <br />4. I have 0lI prepared 0 reviewed the attached supporting data and analyses related to my expertise. <br />5. 1 Ii1I have 0 have not visited and physically viewed the project. <br />6. In my opinion, the following analyses and/or designs, is/are being certified: <br />7. Base upon the following review, the modifications in place have been constructed in general accordance with plan <br /> and specifications. <br /> Basis for above statement: (check all that apply) <br /> a.O Viewed all phases of actual construction. <br /> b.O Compared plans and specifications with as-built survey information. <br /> c.O Examined plans and specifications and compared with completed projects. <br /> d. (] Other Proiect under construction, reviewed initial site pill, <br />8. All information submitted in support of this request is correct to the best or my knowledge. I understand that any <br /> false sta~ment may be punishable by fine or imprisonment under Title 18 of the United States Code, Section 100 <br />Name: Eric L. Krch <br /> (plene priolo or typtt) <br />Title: Civil Engineer <br /> (pi.... prin\.or type) <br />Registration No. 28583 Expiration Date: June 30, 1997 <br />State Colorado <br />Type of License Professional Engineer <br /> Sicnature <br /> Da'" <br /> - Selll <br />'Specify Subdiscipline cOp""...t) <br />Note: Insert not applicable (N/A) when statement does not apply. <br /> <br />FIMA Form ""9". OCTM <br /> <br />CertifICAtion by Reglft.rod Prolo,,_1 <br />lngilleer and/or Laild Surveyor form <br /> <br />MY.a Form a <br /> <br />