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Home My WebLink AboutE-ELEVATION CERTIFICATE - 721 WATERGLEN DRIVE BUILDING C - COOPER SLOUGH (3)FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31,2005 ELEVATION CERTIFICATE Read the instructions on paces 1.7. SECTION A- PROPERTY OWNER INFORMATION ) For Insurance Company Use: ) BUILDING OWNER'S NAME I Policy Number ABERDEEN PARTNERS BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 721 WATERGLEN DR. BUILDING C CITY STATE ZIP CODE FORT COLLINS CO 80524 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TRACT O, WATERGLEN BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):— ( #? - ##' - ##.##' or ##.##tt ) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 31. F� MCOLLINS09NAME & COMMUNITY NUMBER BB22RIOUR NAME OSTATE CIT 64. NIAPAND PANEL 67. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE 38. FLOOD ZONES) (Zone AO, use depth ofPooding) 080102MI.SB7ZZ C 3-18-96 3-18-96 X/100 4957 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined 0 Other (Describe): Box Elder/Cooper Slough Master Plan B11. Indicate the elevation datum used for the BFE in 89: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Earner Resources System (CBRS) area or Otherwise Protected Area (OPA)? []Yes ®No Designation Date_ SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. 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 similar to the building for which this cerfificate 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, ARJA1-A30, AR/AH, AR/AO Complete Items C3: a-i 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 Section B, convert the datum to that used for the BFE. Shaw field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum 1929 Conversion/Comments Elevation reference mark used 92-2 Does the elevation reference mark used appear on the FIRM? ❑ Yes 0 No oa) Top ofboflomfloor (including basement orenclosure) 4959.3711(m) ; d o b) Top of next higher floor 4968.32ft.(m) a o c) Bottom of lowest horizontal structural member (V zones only) na . o o d) Attached garage (top of slab) _ft.(m) 4959. 10 ft.(m) E o e) Lowest elevation of machinery and/or equipment w v servidng the building (Desaibe in a Comments area) 4959.10 ft.(m) E Z! o 0 Lowest adjacent (finished) grade (LAG) 4959.17 ft.(m) Z o g) Highest adjacent (finished) grade (HAG) 4959. 328.0) in o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 o I) Total area of all permanent openings (flood vents) in C3.h 0_0 sq. in. (sq. on) 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 Chad R. Washburn LICENSE NUMBER CO -37963 TITLEProject Surveyor COMPANY NAME JR Engineering ADDRESS CITY STATE ZIP CODE 2520 East Prospect Rd., Ste 190 Fort Collins CO 80525 SIGNAT DATE TELEPHONE (970) 491-9886 FEMA 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. For Insurance Company Use: BUILDING STREET ADDRESS (Inducing Apt, Uni. Suite, ardor Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 721 Waterglen Dr. Building C CITY STATE ZIP CODE Company NAlC Number FortCollins CO 80524 SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS Section C3e. servicing equipment is an AC unit. BM 92-2 is described as "NORTHWEST COR. VINE DR. AND SUMMIT VIEW, IN THE TOP STEP OF THE OLD PLUMMER SCHOOL.* ❑ Check here if attachments SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El 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_(Seled 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.) E2. The top of the bottom floor (including basement or endosure) of the building is _ ft.(m) _in.(crm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(am) above the highest adjacent grade. Complete items C3.h and C3.i on front of forth. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(crm) ❑ 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 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 FEMA- ssued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best ofmyknowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME TELEPHONE COMMENTS wall I ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the oammunVs 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 FEMAissued or cormmunity4ssued BFE) or Zone AO. G3. F The following information (Items G4-39) is provided for community floodp ain management purposes. NUMBER I G5. DATE PERMIT ISSUED I G6. G7. This permit has been issued for. New Construdion ❑ Substantial Improvement G8. Elevation of as -built lowest floor (i duding basement) of the building is: /f9 .(m) Datum: AZCI-VI) 2 f G9. BFE or (in Zone AO) depth of flooding at the building site is: Datum:A—/6rVd 29 IIII-Iz ,v /lL.-/17 /�L✓i%L//L/L�Y'/L�--TG,� TELEPHONEC/a�Z� �7b0 DATE �f ,It4 iOZ27 /0?? CGnS�iuG�i�7� /mil r kJ �Gi �, %% ❑ Check here if attachments FEMA FdYm 81-31, January 2003 - Replaces all previous editions