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Summit County Engineering Division Flood Plain Request 60 North Main ~ P.O. Box 128 Coalville, UT 84017 Coalville line (435) 336-3250 ~ Kamas line (435) 783-4351 x 3250 ~ Park City line (435) 615-3250 Fax (435) 336-3043 APPLICANT Name: Phone Company: Fax Mailing Address: City: State: Zip: INQUIRY ADDRESS Owner Name: Street Address: City: Serial # (Tax ID Subdivision: Lot Section(s): Township(s): Range(s): APPLICATION FEES $20 per Flood Plain Request Requests can be sent to: Summit County Engineering Flood Plain Requests P.O. Box 128 Coalville, Utah 84017 Please make checks and / or money orders payable to: Summit County Engineering. Requests will not be processed until the Engineering Department has received payment. Processing may take 2-3 business days. For Office Use Only: Zone Designation: % Effective Date: 03/16/06 Community Panel: 49043C C Date Received: Completion Date: By: Notification Date: By: $50