The URL can be used to link to this page

Home My WebLink AboutE-ELEVATION CERTIFICATE - 233 NORTH SHERWOOD STREET - OLD TOWN0MB No . 1660-0008 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency Exp iration Date: November 30, 2022 National Flood Insurance Program ELEVATIO N CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community officia l, (2) insurance agent/company, and (3) build ing owner. SECTION A -PROPERTY INFORMATION FOR INSURANCE COMPANY USE A 1. Building Owner's Name Policy Number: JAMESSCOTI A2 . Building Street Address (includ ing Apt., Un it , Suite , and /or Bldg . No.) or P .O . Route and Box No . Company NAIC Number: 233 NORTH SHERWOOD STREET C ity State ZIP Code FORT COLLINS Colorado 80521 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description , etc.) NORTH 1/2 OF LOT 4 , BLOCK 62 , FORT COLLINS A4. Bu i ld ing Use (e .g ., Res identia l, Non-Res idential , Addition , Accessory, etc .) ACCESSORY AS . Latitude/Longitude : Lat. 40.590355 Long . -105.085097 Horizontal Datum : 0 NAO 1927 [8J NAO 1983 A6 . Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance . A7. Bu il d ing Diagram Number 1A AS . For a bu ilding w ith a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s ) N/A sq ft b) Number of permanent flood open ings in the crawlspace or enclosure(s) w ithin 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8 .b N/A sq i n d) Engineered flood open ings? 0Yes [8J No . A9. For a build i ng with an attached garage : a) Square footage of attached garage tilLA sq ft b) Number of permanent f lood open ings in the attached garage w ithin 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9 .b tilLA sq in d) Engineered flood openin gs? 0Yes [8J No SECTION B-FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1 . NFIP Community Name & Community Number B2 . County Name B3 . State CITY OF FORT COLLINS 080102 LARIMER Colorado 84. Map/Panel BS . Suffix B6 . FIRM Index 87 . FIRM Panel BS . Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO , use Base Flood Depth ) Revised Date 08069C0979 #6 H 02-06-2013 os-02-12n-15-03 X/100 YEAR 4994.4 B10 . Indicate the source of the Base Flood Elevation (BFE) data or base flood depth en tered in Item B9 : D FIS Profile D FIRM D Community Determi ned [8J Other/Source : ol.t) ..,._,,.., ,,w.,(.W.. /JiArJ B 11. Indicate elevation datum used for BFE in Item 89: D NGVD 1929 [8J NA VD 1988 D Other/Source : B12 . Is the build ing located in a Coasta l Barrie r Resources Syst em (CBRS) area or Otherwise Protected Area (OPA)? D Yes [8J No Designati on Date: D CBRS DOPA FEMA Form 086-0-33 (12/19) Replaces a ll previous editions . Form Page 1 of 6 ELEVATION CERTIFICATE 0MB No . 1660-0008 Exp iration Date: November 30 , 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Bu ild ing Street Address (includ ing Apt., Un it , Su ite , and/or Bldg . No.) or P .O . Ro ute and Box No . Policy Number: 233 NORTH SHERWOOD STREET City State ZIP Code Company NAIC Number FORT COLLINS Colorado 80521 SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevati ons are based on : D Construction Drawings* D Bu il ding Under Construction* [:gJ Finished Construction *A new Elevation Certificate will be required when construction of the bu ild ing is complete. C2 . Elevations -Zones A1-A30, AE , AH , A (with BFE), VE , V1-V30 , V (with BFE), AR , AR/A, AR/AE, AR/A 1-A30, AR/AH , AR/AO . Complete Items C2.a-h below according to t he building diagram specified in Item A7 . In Puerto Rico on ly, enter meters . Benchmark Utilized : FORT COLLINS 1-13 Vertical Datum : NAVO 88 Indicate elevation datu m used for the elevations in items a) through h ) below . 0 NGVD 1929 [:gj NAVO 1988 0 Other/Source : Datum used for bu il ding elevations must be the same as that used for the BFE . Check the measurement used . a) Top of bottom floor (includ ing basement , crawlspace, or enclosure floor) 4996.1 [:gJ feet D meters b) Top of the next higher floor NIA D feet D meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA D feet D meters d) Attached garage (top of slab) NIA D feet D meters e) Lowest elevation of machinery or equipment servicing the bu il ding (Describe type of equ ipment and location in Comments) NIA D feet D meters f) Lowest adj acent (finished) grade next to bu il ding (LAG) 4995.5 [:gJ feet D meters g) Highest adjacent (fin ished) grade next to build ing (HAG) 4996.0 [:gJ fee t D meters h) Lowest adjacent grade at lowest elevation of deck or stairs , includ ing structura l support NIA D fee t D meters SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information . I certify that the information on th is Certificate represents my best efforts to interpret the data available. I understand that any false statement may be pun ishable by fine or imprisonment under 18 U.S. Code, Section 1001 . Were latitude and long itude in Section A provided by a licensed land surveyor? [:gJ Yes 0No [8] Check here if attachments . Certifier's Name License Number STEVEN PARKS 38348 ~OOL~ Title ······· ~. CO-OWNER ~auil ... -·. • ., . r.y~ Company Name ( ,,,,,,--:.,.,a,: -. '----- MAJESTIC SURVEYING, LLC .A • -·:39 : -0 • • « ;D • • 0 Address o ·.1zi:-f~2gz.,O: J.: 1111 DIAMOND VALLEY DRIVE, SUITE 104 ~ ·.· ''. •· ,t,• J'., •••••••••• ~~ City State ZIP Code I01t,4L L~ .. ~ ~ WINDSOR Colorado 80550 Signature d Date Telephone Ext. r-<...,.-12-9-2020 (970) 833-5698 Copy all pages df'th is Elevation Certificate and all attachments for (1) community official , (2) insurance agent/company , and (3) build ing owner . Comments (including type of equipment and location, per C2(e), if applicable) FORT COLLINS BENCHMARK 1-13 ELEVATION=4979 .75 (NAVD88) FEMA Form 086-0-33 (12/19) Replaces all previous editions . Form Page 2 of 6 ELEVATION CERTIFICATE 0MB No. 1660-0008 Expiration Date : November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR IN SURANCE COMPANY USE Bu ilding Street Address (including Apt., Unit, Su ite , and /or Bldg . No.) or P.O. Route and Box No. Policy Number: 233 NORTH SHERWOOD STREET City State ZIP Code Company NAIC Number FORT COLLINS Colorado 80521 SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B ,and C. For Items E1-E4, use natural grade, if available . Check the measurement used . In Pue rto Rico only , enter meters . E1 . Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is Ofeet 0 meters 0 above or O below the HAG . b) Top of bottom floor (including basement, crawlspace , or enclosure) is 0feet 0 meters 0 above or O below the LAG . E2 . For Bu ilding Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2 .b in Ofeet 0 meters 0 above or O below the HAG . the diagrams) of the building is E3 . Attached garage (top of slab) is Ofeet 0 meters 0 above or O below the HAG . E4 . Top of platform of machinery and/or equipment 0feet 0 meters 0 above or O below the HAG . servicing the building is ES . Zone AO only : If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No 0 Unknown . The local official must certify this inform at ion in Section G. SECTION F-PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERT IFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here . The statements in Sections A , 8 , and E are correct t o the best of my knowledge . Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments . FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE 0MB No. 1660-0008 Expiration Date : November 30, 2022 IMPORTANT: In these spaces, copy the correspond ing information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P .O . Route and Box No . Policy Number: 233 NORTH SHERWOOD STREET City State ZIP Code Company NAIC Number FORT COLLINS Colorado 80521 SECTION G-COMMUNITY INFORMATION (OPTIONAL) The local officia l who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate . Complete the applicable item(s) and sign below . Check the measurement used in Items G8-G10. In Puerto Rico only, enter meters . G1. D The information in Section C was taken from other documentation that has been s igned and sealed by a licensed surveyo r , engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. D A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3 . D The following information (Items G4-G10) is provided for community floodplain management purposes. G4 . Perm it Number GS . Date Permit Issued G6 . Date Certificate of Compliance/Occupancy Issued G7 . Th is permit has been issued for: 0 New Construction O Substantia l Improvement GB . Elevation of as-built lowest floor (including basement) O feet 0 meters of the building : Datum G9 . BFE or (in Zone AO) depth of flooding at the building site : 0 feet O meters Datum G10 . Community's design flood elevation : D teet 0 meters Datum Local Official 's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location , per C2(e), if applicable) O Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous ed itions. Form Page 4 of 6 BU ILD IN G PHOTOGRAPHS EL EV ATION CERTI FICATE See Instructions for Item A6 . IM PORTANT: In these spaces, copy the corres ponding information f rom Section A . Building Street Address (including Apt., Unit, Suite , and /or Bldg . No .) or P.O . Route and Box No . 233 NORTH SHERWOOD STREET City FORT COLLINS State Co lorado ZIP Code 80521 0MB No. 1660-0008 Expiration Date : November 30 , 2022 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 bu il ding photographs below according to the instructions for Item A6 . Identify all photographs with date taken ; "Front View" and "Rear View"; and , if required , "Right Side V iew" and "Left Side View." When applicable, photographs must show the foundat ion with representative examples of the flood openings or vents, as indicated in Section AB . If submitting more photographs than will fit on th is page , use the Continuation Page . Photo One Photo One Caption LOOKING NORTH 11-1 6-2020 Clear Photo One Photo Two Photo Two Caption LOOKING WEST 11-16-2020 Clear Photo Two FEMA Form 086-0-33 (12/19) Replaces all previous ed itions . Form Page 5 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. Bu ilding Street Address (including Apt., Un it, Suite , and /or Bld g. No .) or P .O. Route and Box No . 233 NORTH SHERWOOD STREET City FORT COLLINS State Colorado ZIP Code 80521 0MB No . 1660-0008 Expiration Date : November 30 , 2022 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number If subm itting more photographs than will fit on the preced ing page , affix the additional photographs below. Iden tify all photographs with: date taken; "Front V iew" and "Rear View"; and , if required, "Rig ht Side V iew" and "Left Side View." When applicab le, photographs must show the foundation with representative examp les of the flood open ings or vents , as indicated in Section A8 . Photo Three Photo Three Caption LOOKING EAST 11-16-2020 Clear Photo Three Photo Four Photo Four Photo Four Caption Clear Photo Four FEMA Form 086-0-33 (12/19) Replaces all previous ed itions. Form Page 6 of 6