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Home My WebLink AboutE-ELEVATION CERTIFICATE - 3074 OVERLAND TRAIL - SPRING CREEK (4)` FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 SECTION A - PROPERTY OWNER INFORMATION Fpr 71nsurance Company Use; PblwyNumbar ' BUILDING OWNER'S NAME city of Fort Collins - Restroom BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO, Company NAIL Number, Cottonwood Glen Park •South Overland Trail ZIP CODE CITY STATE CO 80526 Fort Collins PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, Cottonwood Glen Park BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS USGS Quad Map ❑ Other: ( ##° -##' - ##.w- or ##.#####°) ® NAD 1927 ❑ NAD 1983 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP COMMUNITY NAME &COMMUNITY NUMBER L62, arimOUNTY NAME B3.STATE er CO Larimer County 080101 B4. MAP AND PANEL B5. SUFFIX I B6. FIRM INDEX rsr. ruuw rnrv�� "" "-- Zone AO, use depth of flooding) NUMBER DATE EFFECTIVE/REVISED DATE ZOAE(S) ( ''I'4$)iy y� 0192 C 03 18 96 03 1 E 96 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In B9. Ole_ ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation 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 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 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, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-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. 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 _ Conversion/Comments k d ear on the FIRM? CI Yes ®No Elevation reference mark used 2692 Does the elevation reference mar use app ❑ a) Top of bottom floor (including basement or enclosure) 5118. 03 ft.(m) ❑ b) Top of next higher floor lowest horizontal structural member (V zones only) ,jam-' to . —ft'(m) —ft.(m) o ❑ c) Bottom of ❑ d) Attached garage (top of slab) �' —ft'(m) w ❑ e) Lowest elevation of machinery and/or equipment tJR ft (m) -' servicing the building -- _ 2yN cj;Q ❑ f) Lowest adjacent grade (LAG) 5117.51t.(m) zN L'� 5117.S.(m) ft ❑ g) Highest adjacent grade (HAG) g, si, w...••'`O o ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 ❑ i) Total area of all permanent openings (flood vents) in C31h O sq. in. (sq. cm) ft 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. .k. f —, crarament may be punishable by fine orim risonment under 18 U_S. Code_Sectionn1001. Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS f IMPOPTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Cottonwood Glen Park- Restroom CITY STATE ZIP CODE Fort Collins CO 80526 SECTION D - SURVEYOR, tN(iINCCK, UK HKl r11I Cl 1 �� < ,r • ••- -- Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. COMMENTS �dLf 7 lt% *A Alf"0 i 9.Aek U %Z +C%74 S_ *� Check here it attacnmems SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOU I rtt•t) 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 _(Select the building diagram most similar to the building for which this certificate 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 _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. 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.(cm) above the highest adjacent grade. E4. 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 owner's authorized representative who completes Sections A, B. and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's 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 FEMA-issued or community -issued BFE) or Zone AO. G3. Uerhe following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFI E1:11�OF CC�OMPLIANCE/OCCUPANCY 8 r r 00L( %O /� g9 UbS ISSUED G7. This permit has been issued for: • g New Construction Li antial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: `(� `� .a3ft.(m) Datum: Q'6 (%d G9. BFE or (in Zone AO) depth of flooding at the building site is: // fi .biIt (m) Datum: �f (��(� ❑ Check here if attachments FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pa es 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For Insur2n'oe Comban¢?Use BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. CITY STATE ZIP CODE Fort Collins CO 80526 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Cottonwood Glen Park BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ##°-##'-##.##" or ##.#####0) ® NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Larimer County 080101 I Larimer I CO B4. MAP AND PANEL B5. SUFFIX B6, FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE I I EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding 0192 C 03-18-96 03-18-96 At -54-" $f(4,1( 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. orc ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation 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 Date 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 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, AR/AO Complete Items C3a-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. 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 Conversion/Comments Elevation reference mark used 2692 Does the elevation reference mark used appear on the FIRM? ❑ a) Top of bottom floor (including basement or enclosure) 5118. 43 ft.(m) ❑ b) Top of next higher floor N A. _ft.(m) N ❑ c) Bottom of lowest horizontal structural member (V zones only) -I&LA, _ft.(m) 00 ❑ d) Attached garage (top of slab) Nam. _ft.(m) E g ❑ e) Lowest elevation of machinery and/or equipment u v servicing the building 5118. 43ft.(m) E ❑ 0 Lowest adjacent grade (LAG) 5118 . Tt-(m) Z in ❑ g) Highest adjacent grade (HAG) 6118. Oft.(m) d ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 ❑ i) Total area of all permanent openings (flood vents) in C31h 'D sq. in. (sq. cm) ❑ Yes ® No 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, l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME Mark F Corbridge LICENSE NUMBER PLS 25619 TITLEPresident COMPANY NAME Absolute Surveying, Inc. ADDRESS CITY STATE ZIP CODE SIGNATURE DA I L I tLtl'HUNL %�w r/ �• f=z_�1_4 6 to701201-1552 FEMA Form 81-31. AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS tMPOr'irANT: In these spaces, copy the corresponding information from Section A. ) <Fot Insurance Company Use, , ) CITY STATE ZIP CODE I Company NA.IC Number Fort Collins CO 80526 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. ❑ 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 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_(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 enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the nerd higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(cm) above the highest adjacent grade. E4. 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 owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME STATE ZIP CODE SIGNATURE DATE TELEPHONE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's 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 at building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. �99S-31A rP /0a67 ( W/5-119 "J1g7Jg01 I ISSUED 6/28oa G7. This permit has been issued for: New Construction E] Substantial Improvement I / = G8. Elevation of as -built lowest floor (including basement) of the building is: ,ad oe f. 5t.(m) Datum: A,16 (4D G9. BFE or (in Zone AO) depth of flooding at the building site is: fxIL. loft .(m) Datum: k6uj) LOCAL OFFICIAL'S NAME Cti.t . S _ TITLE COMMUNITY NAME !- t) TELEPHONE C/ i— ~ SIGNATURE - DATE COMMENTS ❑ Check here if attachments FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS