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Home My WebLink AboutE-ELEVATION CERTIFICATE - 1171 MULBERRY STREET - POUDRE RIVER (3)U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency I Expires February 28.2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/ar Bldg. No.) or P.O. Route and Box No. Company NAIC Number / / lyeI6 E city State ZIP Code G02Y CpLLyfvS GD Bas.Z¢ A3. Property Descripti�oh (lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Cor.t HGA/E�f/ eAFA,I sN P74Rcc�G 23 <8.Z-�}S-teal A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) o - tS 17C'HT/RL A5. Latitude/Longitude: Lat. Long. /OS ° 03 '.ZZ•.2 ` W Horizontal Datum: ❑ NAD 1927 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 0/ A8. For a building with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) d sq it a) Square footage of attached garage sq ft b) No. of permanent Road openings in the crawl space or b) No. of permanent flood openings in the attached_g arage enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade! c) Total net area of flood openings in A8,b O sq in e) Total net area of flood openings In A9.b CD sq In SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION St. NFIP Community Name & Community Number 62. County Name B3. Sta[e Cir oc >�u A/S e&6Af), G/IR0976 L c� B4. Map/Panel Number 86. Suffix B6. FIRM Index B7. FIRM Panel 88. Flood B9. Base Flood Elevation(s) (Zone Date 1 Effective/Revised Date Zone(s) 1 AO, use base flood depth) 08G69CG983 /a /9�7c�6 /211912W4 4xr 4V.? A eo' B10. B11. B12. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile RF1RM ❑ Community Determined ❑ Other (Describe) Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ,HNAVD 1988 ❑ Other (Describe) Is the building located in a Coastal Banner Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date ❑ CBRS ❑ OPA NOWUM. Ci. Building elevations are based on: ❑ Construction Drawings- ❑ Building Under Construction' CK Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones At-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item AT f7 /� Benchmark Utilized &1A/C�YrJ�.QK R d.2. Vertical Datum C/7y 6P Foe> (,OGL/AyJ �!�/i Z /� ConversionlComments /31DO -Z6 ' To &e'r TO AIA1/0 &b '=-V M Check the measurement used. a) Top of bottom Floor (including basement, crawl space, or enclosure floor) �9.3� , �j feyf ❑ meters (Puerto Rico only) b) Top of the next higherfloor._❑ feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) IZ�X _❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) y�A ._❑ ❑ feet meters (Puerto Rico only) / e) Lowest elevation of machinery or equipment servicing the building S�ia feet ❑ meters (Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) ��^�6•.c%YU fe t ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) ¢9&,6 feet ❑ meters (Puerto Rico only) 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 this Certificate represents my best efforts to interpret the data available. I and rstand that any false sfatament may he Punishable by fine or imprisonment under 18 U.S. Code, Section 1001. heck here if comments are provided on back of form. Certifier's Name License Number Clop R. a/iisNBv2N P[s3 �963r1WAL1 Title Company Name Sv¢�EyAddressCity / Sta[e ZIP Cade S nate r_ Telenhnne _ _ _ _ FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding 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. i Policy Number 1 City State ZIP Code Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. �ammenrs ELL,IifYT/Ul!/S D'0SL'?7 on/ l3CIUGi///1.6�W.0 8-6Z WITN 4,y C2671,47/GN OF aF 764%A2N X *A/ /A/ 7-lWN' /al7Le dF rNC 8Z,/40s.t/4 !S �'930( 7D - C1144UO2t3) Signature SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT'REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFEI For Zones AO and A (without BFE), complete Items Et-E5. if the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items El-E4, use natural grade, if available. Check the measurement used. in Puerto Rico only, enter meters. El. 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, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see Page 8 of instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ ❑feet ❑ meters ❑ above oc �,J below the HAG. E3. Attached garage (top of slab) is _ _E] feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplam 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 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, B, and E are correct to the best of my knowledge. or Address City State ZIP Code Signature Date Telephone and G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8. and G9. G1. FGr The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who �l is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) GZ ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AD. G3. The following information (Itemy G4.-Gg.) is provided for community floodplain management purposes. Ga. Permit Number 'bp 10 � .- G5. Date Permit Issued G6. R to Certificate Of Cc pliance/Occupancy Issued Vo ii I-ce9 aP CO L-IQ_n-) RP 5-((--o"7 Ih�, (t14111 i G7. This permit has been issued for: ®'New construction ❑ Substantial Improvement Ga. Elevation of as -built lowest floor (including basement) of the building: AA 37 . 77 lKfeet ❑ meters (PR) Datum NAV Q M G9. BFE or (in Zone AO) depth of flooding at the building site: 44 %y -. `'60 ❑ feet ❑ meters(PR) Datum 11`3A4�4 %I Local Official's wmnimnr Name iete none u of- Ford-C)nl�i✓l� [fl A70- 231-1o7O'o Signature +, ,,II /I '' .r/r. �'�/� n Date LW,6(A�/AA M� /0 — a— 0% Comments ❑ Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions ll 1�511� TZ C y - TO i _ 1 No Text