HomeMy WebLinkAboutFDP202200001 Correspondence 2021-12-27 (3)PAPERWORK BURDEN DISCLOSURE NOTICE
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
Managament Amencv. 1800 South Bell Street, Adineton, 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 generally 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
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 panel(s) affected for all impacted communities Is (are):
Community No.
Community Name
State
Map No.
Panel No.
Effective Date
Example: 480301
480287
City of Katy
Hams County
TX
TX
48473C
48201C
0005D
0220G
02/08/83
09/28/90
510033
Albemarle County
VA
51003C
0289D
02/04/05
2. a. Flooding Source: Moores Creek
b. Types of Flooding: ® Riverine ❑ Coastal ❑ Shallow Flooding (e.g., Zones AO and AH)
❑ Alluvial fan ❑ Lakes ❑ Other (Attach Description)
3. Project Name/identifier: Woolen Mills Redevelopment
4. FEMA zone designations affected: AE (choices: A. AH, AO, At-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 F000dway 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, (2/2011) Previously FEMA Form 81-89 MT-2 Form 1 Page 1 of 3
b. The area of revision encompasses the following structures (check all that apply)
Structures: ❑ Channelization ❑ Levee/Floodwall ® Bridge/Culvert
❑ Dam ® FIII ❑ 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: $8000
❑ No, Attach Explanation
Please see the DHS•FEMA Web site at htto:ftwww.fema.gov/plan/prevenUfhm/frm fees.shtm for Fee Amounts and Exem tions.
D. SIGNATURE
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 Tide 18 of the United States Code, Section 1001.
Name: Brian Roy
Company: Woolen Mills LLC
Mailing Address:
Daytime Telephone No.: 434.996.3904
Fax No.:
P.O. Box 1099
Charlottesville, VA 22932
E-Mail Address: brianhroy@gmail.com
Signature of Requester (requir
Date:
As the community official responsible for floodplain 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 community floodplain 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
or will be reasonably safe from flooding, as defined In 44CFR 65.2(c), and that we have available upon request by FEMA, all analyses and
documentation used to make this determination.
Community Official's Name and Title:
Community Name:
Mailing Address:
Daytime Telephone No.:
Fax No.:
E-Mall Address:
Community Official's Signature (required):
Date:
CERTIFICATION BY REGISTERED PROFESSIONAL ENGINEER AND/OR LAND SURVEYOR
This certification 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,
Certifiers Name: Bryan Cichocki
License No.: 053741
Explratlon Date: 01/31/2023
Company Name: Timmons Group
Telephone No.: 434-327-5380
Fax No.:
Signature:
Date: 6118/21
E-Mail Address: bryan.cichocki@timmons.com
FEMA Form 086-0-27, (212011) Previously FEMA Form 81-89 MT-2 Form 1 Page 2 of 3
Ensure the forms that are appropriate to your revision request are included in your submittal.
Form Name and (Number)
Required If ...
® Rivedne Hydrology and Hydraulics Form (Form 2)
New or revised discharges or water -surface elevations
® Riverine Structures Form (Form 3)
Channel is modified, addition/revision of bridge/culverts,
addition/revision of levee/floodwall, addition/revision of dam
❑ Coastal Analysis Form (Form 4)
New or revised coastal elevations
❑ Coastal Structures Form (Form 5)
Addition/revision of coastal structure
❑ Alluvial Fan Flooding Form (Form 6)
Flood control measures on alluvial fans
Seal (Optional)
FEMA Form 086-0-27, (2/2011) Previously FEMA Forth 81-89 MT-2 Form 1 Page 3 of 3