FLOOD05178

• County: Jefferson
• Community: Lakewood
• Stream Name: Weaver Creek
• Basin: South Platte
• Title: CLOMR Report for Preserve at Weaver Creek HEC-2 Cross Sections 24+30 to 42+95
• Date: 12/26/2000
• Prepared For: Fairfield Homes
• Prepared By: David Evans & Associates
• Floodplain - Doc Type: Floodplain Report/Masterplan

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4. ENCROACHMENT INFORMATION

1. Does the Slate have jurisdiction over the floodway or its adoption by communities participating in the NFIP?
181 Yes 0 No

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If Yes, attach a copy of a letter notifying the appropriate State agency of the floodway revision and documentation of the
approval of the revised floodway by the appropriate State agency.

2. Does the development in the floodway cause the 1 % annual chance (base) elevation to increase at any location by more than
0.000 feet? 181 Yes 0 No 0 N/A

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3. Does the cumulative effect of all development that has occurred since the effective SFHA was originally identified cause the base
flood elevation to increase at any location by more than one foot (or other increase limillf community or state has adopted more
stringent criteria - even if a floodway has not been delineated by FEMA)? 0 Yes 181 No

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If the answer to either Items Is Yes, please attach documentation that all requirements of Section 65.12 of the NFIP
regulations have been met, regarding evaluation of alternatives, notice to Individual legal property ownel$, concurrence of
CEO, and certification that no insurable structures are impacted.

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5. MAINTENANCE RESPONSIBILITY
perfonning

overseeing compliance with the maintenance

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The community is willing to assume responsibility for
and operation plans of the Low Flow Culvert Crossino
(Name)
flood control structure. If not perfonned promptly by an owner other than the community, the community will provide the necessary
services without cost to the Federal govemment.

I 0 ration and maintenance lans are attached.

DYes 0 No
6. REVIEW FEE

181 NJA

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The review fee for the appropriate request category has been included. 181 Yes Fee amount: $3.100
OR
This request is based on a federally sponsored flood-control project where 50 percent or more of the project's cost is federally
sponsored, or the request is based on detailed hydrologic and hydraulic studies conducted by Federal, State, or local agencies to
replace approximate studies conducted by FEMA and shown on the effective FIRM; thus the project is fee exempt.
DYes

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I Please see Instructions for Fee Amounts

7. SIGNATURE

Note: I understand that my signature indicates that all information
I submitted in support ofthis request is correct

Signature of Revision Requester

Printed Name and Title of Revision Requester

Date:
CERTIFICATION BY REGISTERED PROFESSIONAL
ENGINEER AND/OR LAND SURVEYOR
This certification is In acoordance with 44 CFR Ch. 1, Sect 65.2

Signature

Printed Name and Title of Revision Requester

Regislr No. _ Expires (Date) _ State
Type of LicenselExpertise:

I FEMA Fonn 81-89

Nole: Signature Indicates tIlat the community understands, from the
revision requester, the Impacts of the revision on flooding
conditions in the community.

Signalure of Community Official

Printed Name and Tille of Community Official

Community Name

Tele hone No.: Dale:
Check which forms have been Included with this request

Form Name and (Number) Reouired If ......
o Hydrologic (3) new or revised discharges
181 Hydraulic (4) new or revised water-surface elevations
181 Mapping (5) ftoodplainllloodway changes
181 Channelization (6) channel is modified
181 Bridge/Culvert (7) addition/revision of bridge/allvert
o Levoe/Floodwall (8) addition/revision of leveeJftoodwall
o Coastal (9) new or revised coastal elevations
o Coastal Structures (10) addition/revision of coastal structure
o Dam (11) addition/revision of dam
o Alluvial Fan (12) structures proposed on alluvial fan

Revision Requester and Community Official Form

MT-2 Form 1 Page 2 of 2