HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 500 EAST VINE DRIVE NORTHWEST BUILDING - POUDRE RIVER (3)ELEVATION CERTIFICATE Epres May 31, 1993
FEDERAL EMERGENCY MANAGEMENT AGENCY '4t/ �„/��
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
provide 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).
Instructions for completing this form can be found on the following pages.
SECTION PROPERTY INFORMATION I FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME - _ - POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Slog. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY NAIC NUMBER
OTHER DESCRIPTION (Lot and Block Numbers. etc.)
CITY �STATE ZIP CODE ovn v��ri�rlyd /1:1/v IfOSZ/
SECTION B 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
6. BASE FLOOD ELEVATION
11--led/e z
Z
B
6is19�4
1
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fin AO Zones, use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): RNGVD '29 Of Other (describe on back)
8. 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: I11 1 1 `! feet NGVD (or other FIRM datum —see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicat the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level .
2(a). FIRM Zones At-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of LJ.I4 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 I I I JJ feet NGVD (or other FIRM datum —see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I I LLJ 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 Imo._ 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: It the elevation datum used in measuring the elevations is different than that used on
the FIRM [see Section B, Item 71 then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 51 1
4. Elevation reference mark used appears on FIRM: Yes _ ;No (See Instructions on Page 4)
5. The reference level elevation is based on: Xactual construction ❑ construction drawings
(NOTE. Use of construction drawings is only valid it 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 1.5 feet NGVD (or other FIRM datum -see
Section B, 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 1 I I._i feet NGVD (or other FIRM datum —see Section B, Item 7).
2. Date of the start of construction or substantial improvement
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 BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain 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.
I certify that the information in Sections 8 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.
STATE
SIGNATURE / DATk PHONE
Copies should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner.
ON - WITH
ON PILES.
SLAB BASEMENT
PIERS. OR COLUMNS
A v A
A v
ZONES ZONES ZONES
ZONES ZONES
DEFERENCE
DEFERENCE C
LEVEL iLC00
LEVEL
REFERENCE
LEVEL
EIEVAMN
j•� i, x!(, r i yYy
BASE
BASE •' PEFEPENCE
FLCOO •AMACENi
ELEVATION G�OE LEVEL
REFEPENCE ADJACENT
FLOOD
ELEVATION
IEVEL GRADE
71
_GP�OE
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.