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HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 902 BUCKINGHAM STREET - POUDRE RIVER (5)t'tUtKAL lzMIzKUtNUY MANAUtMLNI AUtNUY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE SECTION A - PROPERTY OWNER BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 902 Buckingham Street CITY STATE ZIP CODE Fort Collins CO 80524 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 1, New Belgium Brewery Third Filing, (Rec. No. 2001076186) BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Chemical Storage Room in Proccess Building LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):_ ( #1P-#W-##.##' or ##.*WW) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1.NFIPCOMMUNrrYNAME&COMMUNITY NUMBER B2. COUNTY NAME B3. STATE LadmerCounty 80102 Latimer CO B1. MAP AND PANEL B7. FIRM PANEL 89. BASE FLOOD ELEVATION(S) NUMBER 0801020004 BS.SUFFIX C B6. FIRM INDEX DATE 3/18119% EFFECTIVE/REVISEDDATE 3/18/1996 BB.FLOODZONE(S) X (Zo%AO,use derbofllo Vg) Sbo yR . 4953 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89. ® FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe): Bl 1. Indicate the elevation datum used forthe BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): 1312. Is the buildinq located in a Coastal Banter Resources System (CBRS) area or Otherwise Protected Area (OPAL? n Yes M No Desionation Date SECTION C - BUILDING Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2 Building Diagram Number 1(Select the building diagram most s nmlarto the building for which this certificate is being completed -see pages 6 and 7. If nodiagram accurately represents the building, provide a sketch or photograph.) C3. Elevations —Zones Al-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, APJAE, AR/A1-A30, ARIAH, AR/AO Complete Items C3.-a4 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in SectionB,convertthedatumtothatusedfortheBFE.Shavfieldmeasurementsanddatumconversioncalculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 1929 Conversion/Comments Elevation reference mark used FC BM Does the elevation reference mark used appear on the FIRM? ❑ Yes ®No o a) Top of bottom floor (including basement or enclosure) NIA. o b) Top of next higher floor NIA. _ft.(m) ti o c) Bottom of lowest horizontal structural member (V zones only) WA. o d) Attached garage (top of slab) WA. _fit(m) E o e) Lowest elevation ofmachinery and/or equipment w servicing the building (Describe in a Comments area) 4954.34 ft(m) E o 1) Lowest adjacent (finished) grade (LAG) WA. _ft.(m) z' o g) Highest adjacent (finished) grade (RAG) WA. o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 J o i) Total area of all permanent openings (flood vents) In C3.h 0 sq. In. (sq. an) 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. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Section 1001 CERTIFIERS NAME GERALD D. GIWLAND LICENSE NUMBER 14823 TITLE LAND SURVEYOR COMPANY NAME NORTHERN ENGINEERING SERVICES ADDRESS CITY STATE ZIP CODE 420 S HOWES FORT COLUNS CO 80521 SIGN URE DATE TELEPHONE Jr B A 5/ n _f 970-2214158 FE A Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A ForinsuranceCompanyUse UILDRG STREETADDRESS (Indudmg Apt, Unit Suite, and/orBkIg. No.) OR P.O. ROUTE AND BOX NO. PolicyNumber CrrY STATE ZIP CODE I Company NAIC Number Fort Collins CO 80524 SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community offidal, (2) insurance agenticompany, and (3) building owner. Finish floor elevation for the chemical room located on the east side of the Process SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFEI For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. Et. Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed —seepages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The lop of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, ff available). E3. For Building Diagrams 68wfth openings (seepage 7), the next hfgherfloororelevatedfloor(elevaffonb)ofthebulildingis_ft.(m)_in.(an)above the highest adjacent grade. Complete Items C3.h and C3.1 on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft,(m) _in,(om) ❑ above or ❑ below (check one) the highest adjacent grade, (Use natural grade, I available). E5. ForZone 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? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community - issued BFE) or Zone AO must sign here. The statements in Sections A,B,C,andEareconecttothe best ofmyknowfedge. PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE TELEPHONE ❑ Check here if attachments SECTION G -COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys 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. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E fora building located in Zone A (without a FEMA4ssued or commun tyissued BFE) or Zone AO. G3. ❑ The following information (Items G4G9) is provided for community floodp ain management purposes. G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the buikling is: _. _Nm) Datum: Gg. BFE or (in Zone AO) depth of flooding at the building site is: _. _ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE [�Ti]IT, IuIIIII CAI/ldld SIGNATURE Check here if FEMA Form 81-31, January 2003 Replaces all previous editions I•LULKAL LMLKULNCY MANAULMLNI AULNCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE SECTION A- PROPERTY OWNER INFORMATION I For Insurance Company Use: I New Belgium Brewing Co BUILDING STREET ADDRESS (Including Apt., Unit Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC:Number 902 Buckingham St CITY STATE ZIP CODE Fort Collins CO 80524 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 1, New Belgium Brewery Third Filing (Rec. No. 2001076186) BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Uses Comments area, if necessary.) Industrial - Water Treatment Plant LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):_ ( #hP-#X-##.##' or ##.#####i) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION I City of Fort Collins 080102 I Latimer I CO B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEtREVISEDDATE BB.FLOODZONE(S) (Zone AO, use depth of 0801020004 C 03/18196 0,311856 X 4953 (°SOUyQ) 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. E FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe): 811. Indicate the elevation datum used for the BFE in B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date_ SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* E Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1(Select the building diagram most similar to the building for which this certificate is being completed -see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations —Zones At-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, ARIAO Complete Items C3.-a4 below according to the building diagram specified in Item C2. Slate the datum used. If the datum is different from the datum used forthe BFE in Section B. convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided orthe Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 Conversion/Comments _ Elevation reference mark used NGSBM Z401 Does the elevation reference mark used appear on the FIRM? []Yes E No o a) Top of bottom floor (including basement or enclosure) 4953.25ft.(m) v o b) Top of next higher floor NA. _ft.(m) u, Qp,00 RE o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft.(m) o o Vp��.•O p G o d) Attached garage (top of slab) NA. _ft.(m) E 2 •�; o e) Lowest elevation of machinery and/or equipment w " : • 2825 servicing the building (Describe in a Comments area) 4949.43 it.(m) a a r o f) Lowest adjacent (finished) grade (LAG) 4949.40 ft(m) v N �2H .•',�o o g) Highest adjacent(finished)grade (HAG) 4960. 69ft.(m) SZ "••"" JQ o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 B ONAL LAP J o i) Total area of all permanent openings (flood vents) in C3.h 0 sq. in. (sq. cm) 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 in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME David R Roberts LICENSE NUMBER CO 32825 TITLE Survey Division Manager COMPANY NAME JR Engineering ADDRESS CITY STATE ZIP CODE 2620 E. Prospect Rd., Suite 190 Fort Collins CO 80525 SIGNATURE DATE TELEPHONE 97OA91-9888 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions In information from Section A. CITY STATE ZIP CODE I Company NAiG Number ForlCollins CO 80524 SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of his Elevation Certficate for (I) community official, (2) insuranceagenbWaipany, and (3) building owner. The datum on this form is for the chemical storage building of the water process facility. There is an adjacent facility building and the two are detached but share a common roof. Please see attached drawing for detail. C 3e- Lowest Elevaboin of machinery servidng Bldg. - Elevation of Water Heater base in adjoining Building. BM Elevation = 4959.5T (B on S edne PP N of intersection (a) Vine & AO AND ZONE A For Zone AO and Zone A (w thout BFE), complete Items Et through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. El. Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed —see pages 6 and 7. It no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or endosure) of the building is _ ft.(m) _in.(cm) [:]above or ❑ below (check one) the highest adjacent grade. (Use natural grade, 9 available). E3.ForBuildingDiagrams6-8withopenings(seepage7),thenexthigherfloororelevatedfloor(elevationb)ofthebuildingis_ft.(m)_in.(crn)above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ft.(m)_in.(cm)❑above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the communitys floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the bestofmy knowledge. PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official 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. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMAassued or communityassued BFE) or Zone AD. G3. JX The following information (Items G4-G9) is provided for community floodplain management purposes. /03Sg ISP©I036W I FP 6)]419401 BP0 to G7. This permit has been issued for. 0 New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (ncluding basement) of the building is: 44 S3 ,0.(m) Datum: RJeVb t`t W1 G9. BFE or (in Zone AO) depth of flooding at the building site is: it (m) Datum: i=lV6�tp \qM COMMUNITY NAME SIGNATURE q UA /I J1 14 (a,(),,,— DATE f D -- a — c 3 COMMENTS 1'WJ (Er -PG eck` , r5 Only h be- U_SeJ fleVi Yl/l ✓w CbbrtDhtc CP_ W groove TP& aOC) —YEnr Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions i` ___333____ __--------------------- _------------------------------------------------------------ --_—______ FAcilir/ rtlAivT _______------------------_________.__ CgEMic-gL. Sror�A�E \ 19�0�3 zs L I L-- NORTH ELEVATION T.O. EL.= ____ I __ SECOND_ FLOOR EL.= 11-�0'' STORAGE FLOOR Fqc. • EL.= 1139 WTP ELEVATION DETAIL NEW BELGIUM BREWERY JOB NO. 39067.17 10 SEP 03 SHEET 01 OF 01 J•R ENGINEERING A Subsidiary of Weslrian 20 East Rmpect Rig SA W- Fort CokrA 00 SM