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Home My WebLink AboutFDP202000008 Action Letter 2021-02-02U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY OVERVIEW & CONCURRENCE FORM PAPERWORK BURDEN DISCLOSURE NOTICE O.M.B No. 1660-0016 Expires February 28, 2014 Public reporting burden for this form is estimated to average 1 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form. You are not required to respond to this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20958-3005, Paperwork Reduction Project (1660-0016). Submission of the form is required PRIVACY ACT STATEMENT AUTHORITY: The National Flood Insurance Act of 1968, Public Law 90-448, as amended by the Flood Disaster Protection Act of 1973, Public Law 93- 234. PRINCIPAL PURPOSE(S): This information is being collected for the purpose of determining an applicant's eligibility to request changes to National Flood Insurance Program (NFIP) Flood Insurance Rate Maps (FIRM). ROUTINE USE(S): The information on this form may be disclosed as generalty, permitted under 5 U.S.0 § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by the routine uses published in DHS/FEMA/NFIP/LOMA-1 National Flood Insurance Program (NFIP); Letter of Map Amendment (LOMA) February 15, 2006, 71 FR 7990. DISCLOSURE: The disclosure of information on this form Is voluntary; however, failure to provide the information requested may delay or prevent FEMA from processing a determination regarding a requested change to a (NFIP) Flood Insurance Rate Maps (FIRM). A. REQUESTED RESPONSE FROM DHS-FEMA This request is for a (check one): ❑ CLOMR: A letter from DHS-FEMA commenting on whether a proposed project, if built as proposed, would justify a map revision, or proposed hydrology changes (See 44 CFR Ch. 1, Parts 60, 65 & 72). ® LOMR: A letter from DHS-FEMA officially revising the current NFIP map to show the changes to floodplains, regulatory floodway or flood elevations. (See 44 CFR Ch. 1, Parts 60, 65 & 72) B. OVERVIEW 1. The NFIP map panels) affected for all impacted communities is (are): Community No. Community Name State Map No. Panel No. Effective Date Example: 480301 480287 City of Katy Harris County TX TX 48473C 48201C 0005D 022OG 02/08/83 09/28/90 510006 Albemarle County VA 51003C 0407D 02/04/05 2. a. Flooding Source: Unnamed Tdbutary to Biscuit Run b. Types of Flooding: ® Riverine ❑ Coastal ❑ Shallow Flooding (e.g., Zones AO and AH) ❑ Alluvial fan ❑ Lakes ❑ Other (Attach Description) 3. Project Namelidentifier: Biscuit Run Tributary - Old Lynchburg Rd 4. FEMA zone designations affected: A,AE (choices: A, AH, AO, Al-A30, A99, AE, AR, V, V1430, VE, B, C, D, X) 5. Basis for Request and Type of Revision: a. The basis for this revision request is (check all that apply) ❑ Physical Change ® Improved Methodology/Data ® Regulatory Floodway Revision ❑ Base Map Changes ❑ Coastal Analysis ® Hydraulic Analysis ® Hydrologic Analysis ® Corrections ❑ Weir -Dam Changes ❑ Levee Certification ❑ Alluvial Fan Analysis ❑ Natural Changes ® New Topographic Data ❑ Other (Attach Description) Note: A photograph and narrative description of the area of concern is not required, but is very helpful during review. FEMA Form 086-0-27, (212011) Previously FEMA Forth 81-89 MT-2 Form 1 Page 1 of 3 b. The area of revision encompasses the following structures (check all that apply) Structures: ❑ Channelizatlon ❑ Levee/Floodwall ® Bridge/Culvert ❑ Dam ❑ Fill ❑ Other (Attach Description) 6. ❑ Documentation of ESA compliance Is submitted (required to initiate CLOMR review). Please refer to the instructions for more Information. C. REVIEW FEE Has the review fee for the appropriate request category been included? ❑ Yes Fee amount: $_ ® No, Attach Explanation D. SIGNATURE All documents submitted In support of this request are correct to the best of my knowledge. I understand that any false statement maybe punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Name: Bryan Cichocki Company: Timmons Group Mailing Address: Daytime Telephone No.: (434)327-5380 Fax No.; 608 Preston Ave, Suite 200 E-Mail Address: Bryan. CichoddQTimmons.com Charlottesville, VA 22903 Signature of Requester (required): Date: 02/01/2020 As the community official responsible Cgociplain management, I hereby acknowledge that we have received and reviewed this Letter of Map Revision (LOMR) or conditional LOMR request Based upon the community's review, we find the completed or proposed project meets or Is designed to meet all of the communityfloodplain management requirements, including the requirements for when fill is placed In the regulatory floodway, and that all necessary Federal, State, and local permits have been, or in the case of a conditional LOMR, will be obtained. For Conditional LOMR requests, the applicant has documented Endangered Species Act (ESA) compliance to FEMA prior to FEMA's review of the Conditional LOMR application. For LOMR requests, I acknowledge that compliance with Sections 9 and 10 of the ESA has been achieved independently of FEMA's process. For actions authorized, funded, or being carried out by Federal or State agencies, documentation from the agency showing its compliance with Section 7(a)(2) of the ESA will be submitted. In addition, we have determined that the land and any existing or proposed structures to be removed from the SFHA are asonably safe from flooding as defined In 44CFR 65.2(c), and that we have available upon request by FEMA, all analyses and tion used to make this determination. Official'sName and Title: �pd- /7` 57� �/��`�r�/ �p� Community NameN/t/ -ress: A� _.k Daytime Telephone No.• �3y_Z'9Alftg� Fax No.:/�04 rdommentagon L 2,V / E-Mail Address: o �, Lbr�•u��cOfficial's Signature (required): / Date: Zo Z4Z/ CERTIFICATION BY REGISTERED PROFESSIONAL ENGINEER ANDIOR LAND SURVEYOR tion is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation Information data, hydrologic and hydraulic analysis, and any other supporting information as per NFIP regulations paragraph 65.2(b) and as described in the MT-2 Forms Instructions. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Certifier's Name: Bryan Cichoc ki License No.: 0402053741 Expiration Date: 01-31-2023 Company Name: Timmons Group Telephone No.: (434)327-5380 Fax No.: E-Mail Address: Bryan.Clchockl@Timmons.cam Signature: 02/01Date: /2021 L FEMA Form 086-0-27, (212011) Previously FEMA Form 81-89 MT-2 Form 1 Page 2 of 3 are appropriate to your revision request are included In your Form Name and /Numbed Required if ... ® Riverine Hydrology and Hydraulics Form (Form 2) New or revised discharges or water -surface elevations ® Riverine Structures Form (Form 3) ❑ Coastal Analysis Form (Form 4) ❑ Coastal Structures Form (Form 5) ❑ Alluvial Fan Flooding Form (Form 8) Channel is modified, addition/revision of bridge/culverts, addition/revision of levee/floodwall, addition/revision of dam New or revised coastal elevations Addition/reviston of coastal structure Flood control measures on alluvial fans Seal (Optional) MAN Q. C(CHOCq L4. No. 53741 FEMA Form 086-0-27, (2/2011) Previously FEMA Form 81-89 MT-2 Form 1 Page 3 of 3