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Home My WebLink AboutE-ELEVATION CERTIFICATE - 721 WATERGLEN DRIVE BUILDING D - COOPER SLOUGH (3)FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 Expires December 31, 200E ELEVATION CERTIFICATE on pages I.7. SECTION A- PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 721 WATERGLEN DR. BUILDING D 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 LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):_ ( ##°-##-##.##' or ##.tom) ❑ NAD 1927 ❑ NAD 19a3 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME B COMMUNITY NUMBER B2. COUNTY NAME B3.STATE CITY OF FORT COLUNS 080102 LARIMER CO B4. MAP AND PANEL 87. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEREVISED DATE B8. FLOOD ZONES) (Zone AO, use depth of flooding) 0801020008/5kr7Z. C 318-96 3-18-96 x/imYfQR 4957 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑PIS Profile El FIRM ❑ Community Determined ® Other (Describe): Box Elder/ Cooper Slough Master Plan B11. Indicate the elevation datum used for the BFE in 39: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ®No Desi nation Date_ SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Dravdnge ❑ 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 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, ARIA, ARIAE, AR/A1-A30, ARIAH, AR/AD Complete Items C3: a� below according to the building diagram specified in Item C2. State the datum used. B the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show 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. Datum1929 Conversion/Commentsna Elevation reference mark used 92-2 Does the elevation reference mark used appear on the FIRM? ❑ Yes ®No o a) Top of bottom floor (including basement or enclosure) 4959. 30ft.(m) o b) Top of next higher floor 4968.25 ft.(m) d a o c) Bottom of lowest haizonlal structural member (V zones only) na . _ft.(m) o o d) Attached garage (top of slab) 4959. 00 ft.(m) rj E a o e) Lowest elevation of machinery and/or equipment w d servicing the building (Describe in a Comments area) 4958.78 ft.(m) E o f) Lowest adjacent (finished) grade (LAG) 4959.10 ft.(m) d h o g) Highest adjacent (fnished)grade (HAG) 4959. 0.(m) 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_O sq. in. (sq, cm) 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 in Sections A, B, 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, CERTIFIERS NAME Chad R. Washburn LICENSE NUMBER CO -37963 TITLEPrcject Surveyor COMPANY NAME JR Engineering AUURESS CITY STATE ZIPCODE 2620 East Prospect Rd., Ste 190 Fort Collins CO 80525 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions rC'41 1iuIrr IMPORTANT: In these spaces, copy the corresponding information from Section A BUILDING STREET ADDRESS (Including Apt, Unit Suite, anNor Bldg. No.) OR P.O. ROUTE AND BOX NO. 721 Waterglen Dr. Building D CRY STATE ZIP C( FortCollins CO 80524 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (C( Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenYccmpany, and (3) building owner. COMMENTS Sedion C3e. servicing equipment is an AC unit. BM92-2isdescibedas"NORTHWEST COR. VINE DR. AND SUMMIT VIEW, IN THE TOP STEP OF THE OLD PLUMMER SCHOOL.-_ �q�-0 Qr ❑ Cheri( 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 E1 through E4. ff 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 —(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.) E2. The top of the bottom floor (including basement or endosure) of the building is _ fl.(m) _in.(om) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade,'rf available). E3. For Building Diagrams 6 8 with openings (seepage 7), the next higherfloor or elevated floor (elevation b) of the building is _ f (m) _in.(cn) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ fl.(m) _ia(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, 9 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 floodpVn management ordinance? ❑ Yes ❑ No ❑ Unknown. The local offidal must cedy this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who canoetes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMAissued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best ofmyknoWedge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME STATE ZIP CODE TELEPHONE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized bylaw or ordinance to administer the communitiys floor plain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. 31. ❑ 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 cedfy, 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 communityissued BFE) or Zone A0, G3. RE The following information (Items G4-G9) is provided for community floodplain management purposes. /G4�..�an P� PERMITNUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF pOMPLIANCEIOCCUPANCY ISSUED E0`l70I, R/i, I II 1� ICE 37. This permit has been issued for. 7X New Construction ❑ Substantial Improvement ` G8. Elevation of as -built lowest floor (inducting basement) of the building is: 1659 . T (m) Datum: z VD29 G9. BFE or(inZone AO) depth offlooding atthe building site is: z/9�CL0—a.(m) Datum:IJ6 VX—f -✓o7D0 FEMA Form 8*031, January 2003 Replaces all previ . outs editions n �