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HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 2500 EAST PROSPECT ROAD - POUDRE RIVER (13)l CcmS'\' A 101 SM ELEVATION CERTIFICATE O.M.B. No. 3067.0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires Ju)y 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide at waiver of the flood insurance purchase requirement, This form is used only to pro" vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of Information unless a valid OMB control number is displayed In the upper right corner of this form. Instructions for completing this form can be found on the following pages. BUILDING OWNER'S NAME SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite end/or Bldg. Numhar) OR P.O, ROUTE AND BOX NUMBER I COMPANY NAIC NUMBER I 2500 East Prospect Road TI OTHER DESCRIPTION ILot and Block Numbere, eto.) Cavan j,akpc P-it_17-, Phase II Subdivision CITY STATE ZIP CODE Fort Collins, Colorado 80525 SECTION S FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4, DATE OF FIRM INDEX S. FIRM ZONE e. BABE FLOOD ELEVATION 1 1 (In AO Zones, use deptA) 080102 0012 C March 18,1996 AE & X 4900 7, Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑NGVD'29 ❑Other (describe on back) 0, For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, Indicate the community:s BFE: I I I I I , L 1 feet NGVD (or other FIRM datum —see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 1 . 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 elevation of 1 1419 P, 11 .2 feet NGVD (or other FIRM datum —see Section B, Item 7), (b)" FIRM Zones V1-V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, Is at an elevation of IJIw,u feet NGVD (or other FiRM datum —see Section B, Item 7). (c). FIRM Zone A (without FIFE). The floor used as the reference level from the selected diagram is I I .LI feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO, The floor used as the reference level from the selected diagram Is Li-J. LI feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated In accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used In determining the above reference level elevations: ® NGVD'29 ❑ Other (describe under Comments on Page 2). (NOTE: if the elevation datum used in measuring the elevations Is different than that used on the FIRM (see Section 8, Item 71,, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: IR Yes ❑ No (See Instructions on Page 4) S. The reference level elevation is based on: 91 actual construction ❑ construction drawings (NOTE. • Use of construction drawings is only valid N the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction, A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: I I 1910 PJ .IJ feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1, It the community official responsible for verifying building elevations specifies that the reference level Indicated in Section C, Item 1 is not the "lowest floor" as defined In the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I LL feet NGVD (or other FIRM datum —see Section B, Item 7). 2. Date of the Stan of construction or substantial Improvement Approx. February 1 999 FEMA Form e1-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUA11CN SECTION E CERTIFICATION This certification Is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),Vt—V30,VE, and V (with BFE) is required, Community officials who are authorized by local law or ordinance to provide floodplaln management Information, may also sign the certification, In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification, Reference level diagrams 6, 7 and 8 - Distinguishing Features —If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not Included in the Certification under Comments below. The diagram number, Section C, Item 1, must still be entered, e�ol t s:u;rsr<r I certify that the information in Sections 6 and C on this Certificate represents my best efforts to interpret !h I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sf:�tJiy=dal James T. Knostman : NAME CITY NUMBER (or Affix 59El) 970) 482-5922 copies shodfd be made of this Certificate for;1) community official, 2) Insurance agenUcompany, and 3) building owner. COMMENTS: Benchmark W402,- Elevation = 4892.84' Please see attached descri tion of benchmark. ZIP ON WITH SLAB ON PILES, BASEMENT PIERS, OR COLUMNS A V A ZONES ZONES ZONES A V ZONES ZONES REFERENOE A[IERENCE LEVEL EASE LIVIL REFEA Net FLooG LEV L EAVEntti FLOOD LINT :I•.' •`�, REiERE WE FFLOOD—� ELEVAA711 a REFt11lNCE Ap�AGEN! SAE •. �. LEVELL IaVATIG LEVEL Guor X The diagrams above Illustrate the points at which the elevations should be measured In A Zones and V Zones, Elevations for all A Zones should be measured at the top of the level reference floor. Elevations for BUY Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 a ELEVATION CERTIFICATE °P,esmay3t,,1992 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PRCGRAM ATTENTION: Use of this certificate does not provide a waiverof the flood insurance curchase requirement. This form is used only to provide elevation information necessary to ensure compliance with acolicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Mao Amendment or Revision (LOMA or LOMR). Instructions for completing this form can be found on the following pages. SECTION PROPERTY INFORMATION I FCR INSURANCE: COMPANY USE BUIL3INg3 OWNER'S NAME I PdudY NUMBER STREET AOCRESS pn000,19 Act. Unit. Suite alfC/or 3!cQ0.rNumoeq CA P.O. ROUTE ANO 8CX NUMBER I COMPANY NAIC NUMBER tL-t and 31da /V.9% C:p/r%%vrey 0+: 1:oy g/paiyJ V,0 8 I ,i%1 7/ do 7jw-+ A✓hiCACCnry S� SECTION 8 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the foilcwing ?rcm the proper FiRM (See Instructions): 1. COMMUNITY NUMBER 2 PANEL NUMBER a. SUFMIX 4. DATE CF F!RM INCEX S. FIRM ZONE 6. SASE F LCCD =.-/ATICN ©8alo2 0011a G 3 ifs/9G &F_ (in AO 7. Indicate the elevation catun system used on the FIRM for Base Ficod Elevations (BFE): )LNGVD'24 Other (describe on back) 8. For Zones A or V, where nc EFE is provided on the FIRM, and the community has astaciished a SFEfor this building site, indicate the community's SFE: '' ' ._ feet NGVD (or other FIRM datum -see Secdcn B. Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions. indicate the diagram number from the ciagrams found on Pages 5 and o" that best describes the subject building's reference level _J_ . 2(a). FIRM Zones A I-A30. AE, AH, and A (with SFE). The top of the reference level lcor rrcm the selected diagram is Stan elevation of! I'll ql0laI.L0 feet NGVD (or other FIRM datum -see Section B, Item 7). (b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of ' ' ' I ! 1 i feet NGVD (or other FIRM datum -see Section 8, Item 7). (c). FIRM Zone A (without SFE). The floor used as the reference level from the selected diagram is I —._I feet above r or below [ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is I I II. feet above ` or below C1 (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: X NGVO '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used an the FIRM (see Section 8, Item 4 then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: [9 Yes ❑ No (See Instructions an Page 4) 5. The reference level elevation is based on: r actual construction ix construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: l I9-01.9 feet NGVD (or other FIRM datum -see Section 8, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: ! ' ' I I I .'—I feet NGVD (cr other pFIRM datun-see Section 6, Item 7). 2. Date of the start of construction or substantial improvement FE MA Form 81-31r MAY 90 REP!ACES ALL PREVIOUS e71r!C�1S SEEREVERSE SICE FOR CCNTINU'AT!CN SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized. by state or local law to certify elevation information when the elevation information for Zones At—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFEE is required. Community officals who are authorized by local law or ordinance to provide fioodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued EFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features —If the certifier is unable to certify to breakaway/non-breakaway wall, endosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that !he information in Sections 8 and C on this certificate represents my best efforts to interpret the data available. I understand that false statement may be punishable by fine or imprisonment under 18 U.S. Code, Secdon 1001. � l/ nt 6 Ii'-7-„ /?/ CERTIFIER'S NAME L10E.NSE Copies should be made of this Certificate for:1) community official, 2) insurance agenUcompany, and 3) building owner. COMMENTS: ON - WRH - ON PILES, SLAB BASEMENT PIERS. OR COLUMNS A V A A v ZONES ZONES ZONES ZONES ZONES PFfEPFNLE REFWENCE ySE LEVEL PEFEaFNCE IEVEI ELEV�iICN - h ^. a�` -...: -s,�; .g. •.G EKE '•.:.�••v. RFEEPENCE HD00 P.000 LAVEL ELEV�IICn fl_"/�T:CN PEFEPENCE AGi u e GMOE LEVEL G�OE WADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2