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FEDERAL EMERGENCY MANAGEMENT A EN O.M.B. Burden No.3067-0148 FEMAUSEONLY <br />CERTIFICATION :ATION BY REGISTERED PROFESSIONAL ENGINEER Expiresiuly37,1997 <br />AND/OR LAND SURVEYOR FORM <br />PUBLIC BURDEN DISCLOSURE NOTICE <br />Public reporting burden for this form is estimated to average. 23 hour per response. The burden estimate includes the <br />Lime ror reviewing- instrucLions, searching existing data sources, gathering and maintaining the needed data, and <br />completing and reviewing the form. Send comments regarding the accuracy of the burden estimate and any <br />suggestions for reducing this burden, to: Information Collections Management, /Federal Emergency Management <br />Agency, 500 C Street, S.W., Washington, DC 20472; and to the Office of Management and Budget, Paperwork <br />I edu ion Project (3067- 0148), Washington, DC 20503. <br />1. This certification is in accordance with 44 CFR h,1, Section 65.2 <br />2. I am licensed with an expertise ire lRydraulles and Flood Control <br />[example: wai,er resources (hydrology, hydraulics, sedtment transport, f nierior drainage)* structural, <br />geoteehnieal, land surveying.) <br />3. 1 have _ <br />reams experience in Lhe expertise listed above. <br />4. 1 have ED prepared IM reviewed the attached supporting data and analyses related to my expertise. <br />5. I IM. have 1:1 have not visited and physically viewed the projed. <br />6. In my api nion, the following anAly es gu% lsl� -being cerLified: <br />Report on the Flood Control Levee Protecting the Uni versi-t y of Colorado's <br />Pro-pertv at south Boulder Crege daLg� <br />7. Base upon the following review, the modificaLlons in place have been eanstruded in general accordance with plans <br />and specifications. <br />aszs for above statement: (check all that apply) <br />a. El Viewed all phases of actual consLruction. <br />b. M Compared plans and specirications wiLh as-built survey information. <br />c. 0 Examined plans and specifications and compared with completed projects. <br />d. 0 Other <br />3. All information ion submitLed in support. of i.hls request is correct to the best. of mfr knowledge. 1 under trand that any <br />false statement an y be punishable by fine or imprisonment under Title 18 of the UnRed States Code, Section 10D1. <br />Marne: Leslie '. Botha <br />(please print. or type) <br />TiLle: Principal <br />(please priaL or type) ` <br />Registration �o. <br />14387' <br />Expiration Date: 12/31/2000 <br />p . . <br />tae <br />Colorado <br />Type License <br />Professlonal Engineer <br />+•"•',k #J + _,l i +..'•{.' . <br />?' <br />y1 <br />+ice# <br />i � LLi <br />+".� �N' r'y ,. : ►' a <br />+ <br />'i' ..i t + 1'" _ •n«.� ,.. tF ' +1„4-1 t' .ti. +� <br />a <br />-DateVl <br />'ry '..r } <br />Seat i <br />f� <br />(opho l) <br />*Specify Subdiscipline <br />Note: Insert riot applicable (N/A) when statement does not apply. <br />FEMA Form 81 -89A, OCT 94 Certification by Registered Professional <br />Engineer and/or Land Surveyor Farm <br />MT-2 Form <br />