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<br />, <br />DOH FO?..^! 293 <br />. FE5RU.ZXl: 2975 <br /> <br />43 <br />I <br /> <br />. . . <br /> <br />DRIJ.!NAGE STRUCTURE FLOOD SU1'~"Jl.RY <br /> <br />";.1 STREAM NAME <br />-2FLOODING LOCATION /l,fJ.. IV4tY (,,/4 fi/le.. ~a-",Ker 2-o.or <br /> <br />-3DATE OF FLOODING f?-I5-~1-4CAUSE: <br />-5AMOUNT OF RArr;FALL . g ~ OAJc::.... <br />-6DEPTH OF Vi.4TER OVER ROADWAY . ~.~ <br /> <br />Ra i nfa 11 8 Snowme 1 t 0 Other <br />,,'Nc-t, <br /> <br />PI t..r" <br />-7Width '.L...-.t- <br /> <br />-8DEBRIS: Trees 0 Brush 0 Rocks 0 Si 1 t g90ther <br />/.-", \ / ) / <br />-10Amount rr~"1 ~er /u9' 70 eN (:)/1/ Sf-oot/ /de;- <br />/ /r <br />-11STRUCTURE ND. -12CULVERT: Size 2..lf Type 5Tce-/ <br /> <br />-13HIGHWATER REFERENCED TO BRIDGE, CULVERT OR ROADWAY 7C ,,- t>9 H",J q... 4..Ja~r <br /> <br />C7(}el/- fI'()4:dwCl r <br /> <br />-14DAVJl.GE OR SCOUR: Yes 0 No [gJ <br /> <br />If yes, specify <br /> <br />-15 COVu'1ENTS CoAl /IJ~/ HtllrV k/A; /1'"~e;1 cI",a; lVaj?e ~c:. cq",.s;;e.. <br />-f'ql"Her A4S eA/c..;o,,~J. "",./' <'9N '-'0'" 1'11f"4/h)~ <br />-16 SOURCE OF INFORW\TION: <br /> <br />-17 <br />.~ - <br />-. ~ <br /> <br />I <br />-18 Recorder Glen [,J I GI6sW <br />( !lame) <br /> <br />fJ-/d;-8"f Phone '3~5-cPS~%", <br />(Date) <br /> <br />z <br />o <br /> <br />- <br />ro <br />-0 <br />o <br />'" <br />rr <br /> <br />SEND TO: STAFF DESIGN <br />HYDRAULICS UNIT <br />4201 East Arkansas Avenue <br />Denver CO 80222 <br /> <br /> <br />-19 USE back for Instructions and Additional Co:rrJents 0::: Sketch. <br />Attacn any Photos. <br />