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FLOOD HAZARD DEVELOPMENT PERMIT (FHDP) APPLICATION <br /> rrDEPARTMENT OF PLANNING SERVICES* 1555 N. 17TH AVENUE <br /> www.weldgov.com GREELEY, CO 80631 * 970-353-6100 EXT 3540 * FAX 970-304-6498 <br /> FOR PLANNING DEPARTMENT USE: DATE RECEIVED: <br /> AMOUNT $ _ CASE#ASSIGNED: <br /> APPLICATION RECEIVED BY PLANNER ASSIGNED: <br /> Parcel Number: 0 9 5 9 - 3 4 - 4 - 0 0 - 0 1 0 AND 0959-34-4-00-034 <br /> (12 digit number-found on Tax I.D.information,obtainable at the Weld County Assessor's Office www. weldgov.com). <br /> Legal Description Pt.South Half , Section 34,Township 5 N, Range 66 w <br /> Waterway Name: Big Thompson River Flood Insurance Rate Map (FIRM) Panel #: 08123C- 1707 E <br /> p-� https.//msc.fema.gov/portal <br /> Floodzone: A 1 AE_D AH LL AO ElParcel size: 72 acres <br /> Project located in designated floodway? Yes® No 0 If yes, a "No Rise" certificate is required. <br /> FEE OWNER(S) OF THE PROPERTY: <br /> Name: Allely Family-Joyce Allely <br /> Company: <br /> Phone#: 307-344-2560 Email: zach_allely@hotmai I.com <br /> Street Address : 17 Dos Rios _ <br /> City/State/Zip Code: Greeley, CO 80634 <br /> APPLICANT OR AUTHORIZED AGENT: (See Below*.-Authorization must accompany all applications signed by Authorized Agent) <br /> Name: Lucy Harrington <br /> Company: Westervelt Ecological Services <br /> Phone#: 720-955-3029 Email: Iarrington@westervelt.com <br /> Street Address : 7348 S.Alton Way,STE 9-D <br /> City/State/Zip Code: Centennial,CO 80112 <br /> Type of Proposed Development: (Please check all that apply) <br /> Residential Home Non-Residential Manufactured of Mobile <br /> ❑ New Construction ❑ New Construction ❑ On Single Lot <br /> ❑ Addition or Improvements ❑ Addition or Improvements ❑ In Mobile Home Park <br /> ❑ In Subdivision F±1 Fill Material ❑ Fill Material <br /> ❑ Fill Material Subdivision F±1 Watercourse Alteration ❑ In Mobile Home <br /> ❑ Other <br /> Description of Proposed Development**: Wetland Restoration/Mitigation Bank. See attached report. <br /> **Attach a detailed narrative of the project to this application. <br /> 7/22/19 <br /> Signature: Owner or Authorized Agent Date Signature: Owner or Authorized Agent Date <br /> Lucy Harrington <br /> Print: Owner or Authorized Agent Print: Owner or Authorized Agent Rev 1/2016 <br /> *If an Authorized Agent signs, a letter of authorization from all fee owners must be included with the application. If a corporation <br /> is the fee owner, notarized evidence must be included showing the signatory has to legal authority to sign for the corporation. <br />