HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 1243 ALAMEDA STREET - WEST VINE (3)0.,r4.9..vo 067-00?�
ELEVATION CERTIFICATE t �p.res,uay3r, r9s
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOCO INSURANCE PROGRAM
AT? ELATION: Use at this csrtficate does not provide a wsiver cf the flood insurance purchase requirement. T`fs form is used only to
ances, to
provide elevation information necessa-oai2sp ormo lsupper' 3 r-cuestfoir a Letter oaf Mty ap Apmendmenlain t or Revision n(LOMA or LOMR),
determine the proper Insurance premium
instructions for completing this term can be found on the following pages.
SECTION A PROPERTY INFCRMATION
'ILDING OwNEF3 NAME
S , E_-- ADORESS i OUCing ApL, Unlc Sude V'C;or 31c;. Nu=er) OR P.C- ACuTE •av0 BOX ,yU-1EEy
1243 Alameda Street
FGR INSURANCE CCMPANY USE
PCLIcY NUM$Er7
cvMPAW NAIC NUMBER
07AER CESCRIFTICN (Lot and'?Io Numcers. z:a,
Lot 8, Granada Heights STATE ZIPGCGE
G �'Y
Fort Collins
S2CTICN 8 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
/ram . ,$><� �J � � � ►�" -�.
Provide the foilowing from the proper FiF.M (See Insuuc ons): 9
2. PANEL i L;MSEa J. SUFFIX :ATE OF EiRM INDEX 5. F18m ZONE 6. AO 7 �� 58EL.dap oN
I. COMMUNITY NUM9E� 147�lw� i Q
o on the FIRM for Base Flood Elevations (eFE):
NGVD 'Z9 40ther (describe on back)
7. indicate the elevarion da:Um system use
8. For Zones A or V, where noB�FEE is provided on the FIRM, and the community has established a BFE far this build
tng Site, indicate
the community's BF=: t feet NGVD (or other FIRM datum —see Section S. item 7). V;--e_
ScCTION C BUILDING ELFVA70N INFORMATION
t. Using the Elevation Canficate lnstruc ons, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level A4
2(a). FIRM Zones Al-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an a►ovation
of 15i (a i Vi.ftl feet NGVD (or other FIRM datum -see Section B, Item 7).
oi the FIRM Zones V1-V30, VE, and V (with BFE). 1Thelbottom If the lowest horizontal
her FIRM datum -see Sec' do 8, tem 7) rence (eve! from
ram, is at an elevation of '�_� feet NG
the selected ding I � feet above ❑ or
FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is •� -
below r (check one) the highest grade adjacent to the building. I I ❑ or below ❑ (check
ram is- t�____j ..J feet above
Zone AO, The loor used as the reference level from the selected
numbe ails available, is the building's lowest floor (reference
one) the highest grade adjacent to the building. {f no flood depth No 0 Unknown
level) elevated in accordance with the community's floodpiain management rdina elevationas: Yes 0 C] NGVO `29 51 Other (describe
3. Indicate the elevation datum system used in determining the above rethan that uSed Orl
under Comments on Page 2). (NOTE: If the ele at eledations to he datum sy tOm sm used in measuring the tedgon he FIRM and show the conversion
the FIRM (see section 8, Item 77, then convert the
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes ,' No (See Instructions on ?age a)
5. The reference level elevation is based on: X. valid actual
lit tco constbuildruction
does [lot yet have en the reference level floor in PCertificate
(NOTE: Use of cone, if' which
struction drawings is only
card this certificate will only be valid far the building during the course of construction. A post-constructtonElevation
will be required once construction is complete.)
6, The elevation of the lowest grade immediately adjacent to the building is: � 1�1�1 � (� ,�] feet NGVD (or other FIRM datum -see Section B, Item 7).
SECTION D CONIMUNITY INFORMATION
1. If the community official responsible for verifying building elevations Specifies that the reference level indithe cated in Section C, Item t
is not the "lowest floor" as defined in the community's I fe,dt C management eIRM datum -di see Section gon f item b7jlding's "lowest
I I I ie„ �C !D (c
floor' as defined by the ordinance
2. Date of the start of construction or substantial improver Fnt
= r;SE SiDE FGR GO,NTINUATIO`J
a a_�CES _�a:v1oUS Folr.o :5
SEC7ICN E CER-nF1CAY1Ct'
state or'ccai law to certify elevation
AH, A (with aUtl Vt—V30,VE, and V ,with SFE) is required.
This certification is to be Signed by a land surveyor, engineer, or arc7ited who is authoriz Y
local law of ordinance to provide floodplain management information, may also sign the
information when ine elevation information for Zones Al—A30, AE, a Owner, or an
Community officials who are authorized by
certification. In the case of Zones AO an A (without alien a FaMA or community issued 8Fc), d building official, a Prof
owner's representative may also sign
nonce Eevei diagrams 5, 7 and 8 Cis Features —if the certifier is unable to Certify t0 bra thanY s U1e F Feature(s) e(s) not
Aefe wail Openings s or unnnished area Feature(s),
enciosur8 size, location of servicing equipment, area use, g
�`Ro
Eincluded in the Cer ificaticn underComments below. The diagram number.Section C, ltem 1, must s'�Ilrest efforts to'nO! hable by fine or imprisCnment under i8 U.S• - n i 'J+�in
! certify that the inrom'atlon in SaCtfens B dnd C on this cerrificate represents my tz
7�((rr
I understand that ary false statement may puns 94ftdi
Kevin W. Patterson P.E.
CEg7FIER'S NAME
Professional. Engineer
�frLe
100 East Third Street
ADDRESS
SiGNATU
Copies
COMMENTS.,
for AMY
CCMPANY VAME
cm
PHONE
80537
STATE zip
and 3) building Owner.
this Certificate for: 1) community official, 2) insurance agenticampany,
1
ON
ON
9LA9
A V
ZONES ZONES
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A
itr ZONES
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ON P+Ls.
p,Ei18. OR COIUTANS
A
The diagrams abc"e illustrate the points at which the elevations should be level lood in A Zones and V Zones.
T 9 of the referent
r.
Elevations for all A Zones Should he measured at the toe
Elevaticns for all V Zones should be measured at the bc,, Om cr the lowest horizontal Stn;cturai member.
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