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Home My WebLink AboutE-ELEVATION CERTIFICATE - 712 ALTA VISTA STREET - DRY CREEK (3)/03*?? FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE O.M.B. No. 3067-01077 Expires July 31, 2002 Important: Read the instructions on pages 1 -7. SECTION A- PROPERTY OWNER INFORMATION , ' , „Op")�., 0— andlor Bldg. No.) OR P.O. ROUTE AND -rf#'-#MI.rIM or tRrarrrptaM) LJ NAD 1927 LJ NAD 1963' SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION EFFECTIVE/REVISED DATE I ZONE(S) . I gone AO, use depth of 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. LJ FIS Profile LXI FIRM LJ Community Determined LJ Other (Describe): - B11. Indicate the elevation datum used for the BFE In 89: L�j NGVD 1929 L_I NAVD 1988 LJ Other (Describe): 812. Is the building located in a Coastal Barrier Resources system (CBRS) area cr Otherwise Protected Area (OPA)? L Yes LV No Designation Date: SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 'El -,Building elevations are based on: LJConstruction Drawings• "Building Under Construction' KJI-Inisnea Consvpcuon •A new Elevation Certificate will be required when construction of the building Is complete, 02. Building Diagram Number_$_ (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 Al-A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, ARIAO Complete Items C3a-i below according to the building diagram specified in Item t2. State the datum used. If the datum is different from the datum used torthe BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum cohverslon calculation, Use the space provided or the Comments area of 6ection D or Section G, as appropriate, to document the datum conversion. Datum NGVD29 ConversioNComments Elevation reference mirk used 4944.18 Elevation reference mark usedNGS .BM. BJQZ Does the elevation reference mark used appear on the FIRM?. LJ Yes LJ No O a) Top of bottom floor (including basement or enclosure) 494A . ,_Q- fl.(m) O b) Top of next higher floor 4952 •QL fL(m) p0 REq O c) Bottom of lowest hoilzontal structural member (V zones only) N/A _1L(m) OQ P......• /. ❑ d) Attached garage (top of slab) 49gn ,g3 IL(m) g Cl. e) Lowest elevation of machinery and/or equipment servicing the building N/A t(rn �;, ' 31169 ❑ f1 Lowest adjacent grade (LAG) 4950 fL(m) y 1 O g) Highest adjacent grade (HAG) 4950 6 IL(m) 0 ,T_ 0. O h) No. of permanent openings (flood vents) within 11L above adjacent grade 0_ cP•, ` ❑ 1) Total area of ail.permahent openings (flood vents) In C3h N/A aq. In, (sq. em) �'✓/ ""•t) ATZI This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized bylaw to certify elevation Into I certifv that the lnformatlon In Sections A, B, and C on this cerVicate represents my best efforts to Interpret the date available. FFMA Fnr 91.31. AUG 99 SEE REVERSE SIDE FOR CONTINUATION . REPLACES ALL PREVIOUS EDITION: mil SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community dfflcial, (2) Insurance agent/company, and (3) building owner. MI For Zone AO and Zone A (without BFE), complete Hems EI through E3. If the Elevation Certificate Is Intended for use as supporting information for d LOMA or LOMR-F, Sectlon C must be compleled, E1. Bullding Diagram Number_,_ (Select the building diagram most similarto 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.) E2. The top of the bottom floor (including basement or enclosure) of the building Is' I I I IL(m) I f iin.(cm) U above or U below (check one) the highest adjacent grade. E3. For Zone AO only. If no flood depth number Is evalable, Is the top of the bottom floor elevated in accordance with the community's _ floodpiain management ordinance? L( Yes Li No . L( 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 communiy-Issued BFE) or Zone AO must sigh here. PROPERTY OWNER'S OR OWNER'S AUTHORED REPRESENTATIVE'S NAME ., .. - ADDRESS CITY. STATE ZIP CODE _SIGNATURE DATE TELEPHONE ' COMMENTS SECTION G-COMMUNITY INFORMATION (OPTIONAL) . The local oflcial who is authorized by law of ordinance to administer the community's floodplain management ordinance can complete Sections A,'S, C (or E), and G of this Elevation Certificate. Complete the applicable Rem(s) and sign below. G1. U The Information In Section C was taken from other documentation that has been'slgned and embossed by a licensed surveyor, engineer, or architect who is autho ized bKletate: prlocal 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 FEMA-Issued or community -Issued BFE) or ;Zone Ad G3. U The follovnnd fntoxnatiop (Items G4 G9) Is provided for community floodplein management purposes. _ ...0 .- ;,ti ,Z C"141 I. I ISSUED G7, This permit has been issued for. L( New Construction "Substantial Improvement G6.-ETevatidh ofas:bulfttowestflcor(Including basement) of the building is: _ IL(m) Datum G9. BFE or (in Zone AO) depth of flooding at the building site Is: _1L(m)Datum: LOCAL OFFICIAL'S NAME TITLE . COMMUNITY NAME TELEPHONE SIGNATURE DATE FEMA Form St-31, AUG 99 ' REPLACES ALL PREVIOUS EDITIONS