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Home My WebLink AboutE-ELEVATION CERTIFICATE - 721 WATERGLEN DRIVE BUILDING E - COOPER SLOUGH (3)FtULKAL LMtKULNUY MANAULMLNI AULNt:Y NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires December 31, 2005 Read the instructions on paces 1.7. SECTION A - PROPERTY OWNER KEN CRUMB Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 721 WATERGLEN DRIVE CITY STATE ZIP CODE FORT COLLINS CO 80525 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TRACT O, WATERGLEN P.U.D. BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) MULTI -FAMILY RESIDENTIAL LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):_ ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION St. NFIP COMMUNITY NAME& COMMUNITY NUMBER B2. COUNTY NAME B3. STATE CITY OF FORT COLLINS 080102 LARIMER COLORADO B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5.SUFFIX B6.FIRM INDEXDATE EFFECTIVEIREVISED DATE B8.FLOODZONE(S) (Zone AO, use depth of flooding) 080 102 0008 / SHT. 22 C 3/18196 3/1856&00/03 YJ100-YR 4957.0 B10. Indicate the soutce of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑FISProBIe ❑FIRM ❑ Community Determined ® Other (Describe):BOXELDERCREEK/COOPERSLOUGH MASTER PLAN B11. Indicate theelev9on datum used for the BFE in B9: ® 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 Designation Dale_ SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction DraMngs' ❑ Building UnderConstiuctlon` ® Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number l (Select the building diagram most similarto the building forwhich this cartfcale is being completed -seepages 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, AR/AO Complete Items C3.-ai below according to the building diagram specified in Item C2. State the datum used. 9the 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. Datum NGVD 1929 Conversion/Comments Elevation reference mark used ACBM #2-92 Does the elevation reference mark used appear on the FIRM? iii Yes 71 No oa) Top ofbottom floor (including basement orenclosure) 4959. 11 ft.(m) o b) Top of next higher floor 4969.71 ft.(m) oc) Bottom oflowest horizontal structural member (Vzones only) WA._ft.(m) o d) Attached garage (top of slab) 4959. 11 fL(m) o e) Lowest elevation of machinery and/or equipment servicing the building (Desaibe in a Comments area) 4959.11 ft.(m) o1) Lowest adjacent (finished)grade (LAG) 490 40(m) o g) Highest adjacent (finished) grade (HAG) 4958, 80 ft.(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 sq. in. (sq. cm) OR ARCHITECT CERTIFICATION `°f�k�v �SS/ONAIE�GX 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Section 1001. CERTIFIERS NAME LICENSE NUMBER JAMES B. WRIGHT 34809 SENIOR P J CTMANAGER JRENGINEERING ADDRESS CITY STATE ZIP CODE 2620 . PR PECT ROAD, STE.190 FORT COLLINS CO 80525 Form rl-31, January 2003 See reverse side for continuation. Replaces all previous editions s A ( -i/ ////S ('?Y n IMPORTANT: In these spaces, copy the corresponding information from Section A Forlmurance Company Use. ,BUILDINGMTREErADDRESS (Indudq Apt, Unit Suite, anNorBldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 721 WATERGLEN DRIVE BLDG. E CITY STATE LP CODE Company MC Number FORT COLLINS CO 805 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Cerificatefor (1) community official, (2) insurance agenticompany, and (3) building owner. COMMENTS - BENCH MARKACBM #2-92 AT INK CORNER OF VINE DRIVE AND SUMMIT VIEW RD. TOP STEP OF THE OLD PI-UMMER SCHOOL EL.=4958.91 - C3.e) INCLUDES HVAC & WATER HEATER Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A WHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 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 _SeJect the building diagram most similar to the building forwhich this certificate is being completed — see pages 6and 7. tnodiagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ft.(m)_in.(cm)❑above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (seepage 7, the next higherfloor or elevated floor (elevation b) of the building is _ft.(m)_im(cm)above the highest adjacent grade. Complete items C3.h and C3.1 on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ fl.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, I 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 oommunitys 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 owneror owners authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are comectto the bestofmyknowiedge. PROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME KEN CRUMB ADDRESS CITY STATE ZIPCODE 540011THSTREET RO.BOX337600 GREELEY CO 80632 SIGNATURE DATE TELEPHONE ❑ Check here 9 attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is autho zed by law or ordinance to administer the mmmunitys floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Ceddlcate. 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 catty 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 AO. G3. A The following information (Items G4-G9) is provided for community floodplain management purposes. ia�6� �P o4oyla 1 �/v/oy �P� s Icy to Iz� �04 G7. This permit has been issued for. X New Construction ElSubstantialimprovement G8. Elevator of as -built lowest floor (including basement) of the building is: G9. BFE or (in Zane AO) depth of flooding at the building site is: f/ yf:�Yeft (m) Datum:.A&VJ1 f 6eft.0) Datum;U�yV2-f i✓1 FEMA Fo m 81-31, JaYivary 2003 - Replaces all previous editions