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FLOOD HAZARD DEVELOPMENT PERMIT (FHDP) APPLICATION <br />'. FOR PLANNING DEPARTMENT USE DATE RECEIVED _ __ <br />RECEIPT/AMOUNT # ___ /$ CASE # ASSIGNED ____ _______ - <br />APPLICATION RECEIVED BY_____________ PLANNER ASSIGNED <br />Parcel Number 1313 16 0 - 00 - 010 <br />(12 digd number -louno on Tax I D in/ormation, obtainable at the Weld County Assessor's Oflice, or ~rww co weltl cn usl <br />Legal Descrlphon _NE 1/4 ___________, Section 16, Township _2 North. Range 68West <br />FEE OWNER(S) OF THE PROPERTY <br />Name. IVUneral Ke50UfCES, In_O. (H JUDSIDary OT LaTar9e WBSt• In. <br />work Phone # 303-657-4421 Home Phone # _ 303-829-_6511 Email <br />Address 1400 W. 64th Ave- <br />city/$tate/zP Code __Denv_er, CO 80221_____________ <br />APPLICANT OR AUTHORIZED AGENT (See Below Aulnonrdbon must acompany all appLCaems sgned byAUthonzed Agenp <br />Name Suzanne Janzen <br />work Phone tt 303-657-4421 Home Phone # _303-829=6511 Email Address suzannejanzen(a~lafa~na.com <br />Adorers 1400 W. 64th Ave. _________ _ <br />City/State/Zip Code Denver~CO 80221 __ ___ __ <br />General Descrlphon of Proposed Devebpment (Check when applicable) <br />Residential Non-Residential Manufactured of Mobile Home <br />Ntw Cnn>ini, Lot. New Construction On Single Lot <br />Addition or Improvements Addition or Improvements In Mobile home ParK <br />In Su bdivlsion Fdl Matenal Fill Matenal <br />Fill Matenal Watercourse Alteraton In Mobile Home <br />SubdIViSD^ <br />Ocher Sand and Gravel Mining _____ <br />Brief Narrative Description of Proposed Development Conveyor Crossing of Idaho Creek <br />3 Property located mdesignatedFW (Floodway)Districto Yes No_X (Ifyes, certification shall be <br />provided by a registered professnnal engineer that Ute property use or strucWre, when built, will not cause any <br />increase m fbodwater levels during an m[ermediate regional flood (100-year fbod) or wit limd or restncl the flow <br />capacity of the floodway ) <br />4 ro r I ate designated FP-1 or FP-2 (Floodprone) Distnct~ Yes X No <br />~~~(J ~ ~Jfi --- -- <br />Signature Owner or Authorized Agent Date Signature Owner or Authorized Agent Date <br />(1l an Aulhorizeo Agent sigls, a letter o(authonehon from all fee owners must be induoetl with the application II a corporation is the fee owner, <br />notarized evidence must be mduded showing the signatory has to legal authority to sign fortne corporaum ) <br />-6- <br />