PAL AGREEMENT, SCENARIO A1: LEVEE NOT IN FEDERAL SYSTEM Letter of Agreement and Request for Provisionally Accredited Levee (PAL) Designation and Agreement to Provide Adequate Compliance With the Code of Federal Regulations, Title 44, Section 65.10 (44 CFR 65.10). We, the undersigned, have received the letter from FEMA dated (Month of Scenario A Letter) (Day of Scenario A Letter), (Year of Scenario A Letter), and the enclosed document entitled “Requirements of 44 CFR 65.10.” We understand that the Federal Emergency Management Agency (FEMA) is in the process of providing an updated flood map, termed a Digital Flood Insurance Rate Map (DFIRM), for (County or Community Name) and that the area behind the levee known as (Name of Levee) will be remapped to reflect that the levee has been designated as a PAL. To the best of our knowledge, the levee known as (Name of Levee) meets the requirements of 44 CFR 65.10 and has been maintained in accordance with an adopted operation and maintenance plan as evidenced by the attached plan and records of levee maintenance and operation, as well as tests of the mechanized interior drainage systems, if applicable. We hereby submit to FEMA, within 90 days (before (Month of 91st Day Following Date of Scenario A Letter) (Day of 91st Day Following Date of Scenario A Letter), (Year of 91st Day Following Date of Scenario A Letter)) our agreement to provide FEMA with necessary data and documentation to show that the levee known as (Name of Levee) complies with 44 CFR 65.10. We understand that this data and documentation will be required before (Month of Second Anniversary of 91st Day Following Scenario A Letter) (Day of Second Anniversary of 91st Day Following Scenario A Letter), (Year of Second Anniversary of 91st Day Following Scenario A Letter). This information will allow FEMA to move forward with the DFIRM for (County or Community Name). We fully understand that if complete data and documentation that show compliance with 44 CFR 65.10 are not provided within the designated timeframe of 24 months, FEMA will initiate a revision to the DFIRM to redesignate the area as Special Flood Hazard Area, the area subject to inundation by the base (1-percent-annual-chance) flood. Levee Owner Representative ____________________________ (signature) ____________________________ (print) Date: ___________________ Community CEO ____________________________ (signature) ____________________________ (print) Date: ___________________ Other (if applicable) ____________________________ (signature) ____________________________ (print) Date: ___________________ Attachments – Operation and Maintenance Plan and Records Test Records of Mechanized Interior Drainage System