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Home My WebLink AboutE-ELEVATION CERTIFICATE - 1221 EAST PROSPECT ROAD BUILDING C - SPRING CREEK (10)v, FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. SECTION A- PROPERTY OWNER INFORMATION O.M.B. No.3067-0077 Expires December 31, 2005 BUILDING STREET ADDRESS (Inducing Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I. Company NAIC Number 1221 East Prospect Road Building C (Building 3 in Utility Plans) CITY STATE ZIP CODE Fort Collins CO 80525 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 3, Block 1, The Lofts at Park Central Subdivision, City of Fort Collins, County of Larimer, State of Colorado BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, K necessary.) Residential LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):— ( ##°- ##'-##.##' or ##.ttt7k') ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B • FLOOD INSURANCE RATE MAP (FIRM) INFORMATION City of Fort Collins 080102 I Lmmer I Colorado 34. MAP AND PANEL BT FIRM PANEL B9, BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6, FIRM INDEX DATE EFFECTIVEIREVISED DATE 38. FLOOD ZONE(S) (Zone AO, use depth of Wing) 0801020012�ityACEPg.4 C 3-1886 318-96-CifyACE2-15-02 X-City100Year Cly4940.2 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined ® Other (Describe): Hydraulic Model Spring Ck-ACE-2-15-02 811. Indicate the elevation datum used for the BFE in 89: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Bamer 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 UnderConstmctiorr ® Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2. Buid9ng Diagram Number 1(Selec(the building diagram most simflartothe building for which this certificate is being completed -see pages 6 and 7. Il 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, AR/AE, AR/A1-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 forthe 8FE. 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 U 402 Does the elevation reference mark used appearon the FIRM? ❑ Yes ® No ► a) Top of bottom floor (including basement or enclosure) 4942.56fL(m) ► b) Top of next higher floor 4952.3ft.(m) a ► c) Bottom of lowest horizontal structural member (V zones only) NA ft.(m) S •.•• "' ' ' ► d) Attached garage (top of slab) 4942.56 ft,(m) E a v ► e) Lowest elevation of machinery and/or equipment w servicing the building (Describe in a Comments area) 4941.8 k(m) a ► f) Lowest adjacent (finished) grade (LAG) 4942.1 ft (m) z' m (p ID ► g) Highest adjacent (finished) grade (HAG) 4942.8 tt.(m) . n •'••••••••••• ► h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 AL 1 ► i) Total area of all permanent openings (flood vents) in C3.h 0 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, 8, 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- Michael Paul Obedander LICENSE NUMBER - CO 34288 TITLE - Civil Engineer COMPANY NAME -North Star Design, Inc. ADDRESS CITY STATE ZIP CODE 700 Automation Drive, Unit I Windsor CO 80550 SIGNATURE///' / 1,4 ;5 DATE 7,n /O % `t TELEPHONE 970-686-6939 Form 81-31, January See reverse side for continuation. Replaces all previous editions � 7/zz/oy NIMPORTAN R 4n these spaces, copy the corresponding information from Section A For Insurance Company use: BUILDING STREET ADDRESS (Including Apt, Unit, Suit, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 1221 East Prospect Road Building C (Building 3 in Utility Plans) CITY STATE ZIP CODE Company NAICNumber ' Fon Collins CO 80525 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance aggenUcompany, and (3) building owner. COMMENTS Benchmark U 402 = 4944.98 C3.a — HVAC Units Located between driveways (adjacent to garage side of building). ❑ 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. ti the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. 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 flog (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 68 with openings (seepage 7), the next higherfloor or elevated floor (elevation b) of the building is _ ft.(m) _in.(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 _ft.(m)_in.(cm)❑above or ❑ below (check one) the highest adjacentgrade. (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 owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.1 only), and E for Zone A (without a FEMA-ssued or community - issued BFE) orZone AOmust sign here, The statements inSections A,B,C,ardEare correcttothe besfofmyknowfedge. PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys 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 orlocal 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 ZoneA (without a FEMA-issued orcommunityassued BFE) orZone AO. G3. Ci he following information (Items G4-G9) is provided for community floodplain management purposes. l j'P /oy&13P So?,6Q6 -- ] FP 7/3�03 r3�� /6 0 G7. This permit has been issued for.'XNew Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (Including basement) ofthe building is: �f%YZ. t(m) Datum:aczyjl / G9. BFE or (in Zone AO) depth of flooding at the building site is: f `f'�Q �ft.(m) Datum:A/3Olq Check Form 81-31, January 2003 Replaces all previous N Z N 7 W O Y T 7 E PROSPECT RD J V G F