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Home My WebLink AboutE-ELEVATION CERTIFICATE - 1307 EAST PROSPECT ROAD - SPRING CREEK (10)11.S.DEPARTMENT OFHOMELAND SECURITY ELEVATION CERTIFICATE OMB No.1660-0008 Federal Emergency Management Agency I Exofres February 28, 26Q$sr National Flood Insurance Program Important Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Ownees Name TKH Real Estate Holding, LLC Policy Number A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 1307 E. Prospect Rd. City Fort Collins State CO ZIP Code 80525 A3. Property Description Oat and Block Numbers, Tax Parcel Number, Legal Description, etc.) Parcel If 87192-27-001 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Addition to a non-resideas A5. Latitude/Longitude: Lat 40'34'Q(r Long. -105" 03' 15" Horizontal Datum: ❑ NAD 1927 ® NAD 1983 AS. Attach at bast 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT BWkkq Diagram Number 1 A8. For a building with a crawl space or enclosure(s), provide As. For a building with an attached garage, provide: a) Square footage of crawM space or enclosure(s) Na sq it a) Square footage of attached garage n a sq ft b) No. of pemument flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) waft within 1.0 foot above adjacent grade 10 walls within 1.0 foot above adjacent grade ft c) Tefal net area of flood openigs n Allb We sq in o) Total net area of flood openig$ in A9.b ryg sq in C73iATIA Bt. NFIP CannwHy Name & Community Number B2. County Name B3. State Fort Coins, City of-080102le 1 Larimer I CO B4. Map/Panel Number B5. Suffix B6. FIRM Index 87. FIRM Panel B& Flood B9. Base Flood Elevation(s) (Zone Data I Effective/Revised Date 1 Zonei(s) AO, use base flood depth) 0983 F 12/19/2006 12/19/2006 AE 4941.8 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) _ B11. Indicate elevation datum used for BFE in hem B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Descdbe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? oyes ®No Designation Date _ ❑ CBRS ❑ OPA 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. Elevations -Zones Al-A30, AE, AM, A (with BFE), VE, V1430, V (with BFE), AR, ARM, AR/AE, AR(A1,A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized City of Fort Collins - U 402 Vertical Datum 4944.98 NGVD29 Conversion/Comments NAVD88 = NGV029 + 3 Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor)_ 4�43.23 ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 4955.90 ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) n a. ❑ feet ❑ meters (Puerto Rea only) d) Attached garage (top of slab) n/a. ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 4942.9 ® feet ❑ meters (Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) 4942.09 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 4943.15 ® feet ❑ meters (Puerto Rico only) SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or arrhited authorized by law to elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine orimpnsonment under 18 US. Code, Section 1001. ® Check here if comments are provided on back of form. Certifiers Name Jade P. Miller License Number 33885 Title Civil Engineer Company Name DMW Civil Engineers, Ina Address 3400 W 1 St, Bldg 5, Suite Z City Greeley State CO ZIP Code 80634 79 UAA 1�f�t' n� Ban P eH mg lzs/nf .IMPORTANT: In these spaces, copy the corresponding information from Section A. I For Insurance, Comoanv use: :u CO ZIP Code 80525 Copy both sides o(Um ElevaWn Cerbficatefw (1) oommuidy olCirnl, (2) Insurance agenilcanpany, and (3) buildi g owner. Comments Site dah+n is NGVD 1929 datum, project benchmarks are: (1) CRY of Fart Collins benchmark U 402 stainless steel rod in box, located at the lelersectian of Prospect Road and Yount Street Elevation-4944.98 NGVD 1929 unadjusted, (2) City of Fort Collins benchmark 18.97 at soutlnusst corner of south Laney Ave. and Elizabeth St, on a concrete traffic signal base. Elevalwo 4973.21 NGVD 1929 unadjusted. c onnmete pad above base flood elevation and freeboard. 1 /LS/o 43 electncal transformer SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zanea AO and A (wthout BFE), complete Items E1-E5. ifthe Certificate is imanded to support a LOMA or LOW-F request, =Vista Sections A. 8, and C. For hems Et-E4, use natural grade, Mavall". Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation im4orrnaton for the fotlowhg and check the appropriate boxes to show whether the elevation is above or below the highest adjacent Wade (I1AG) and the lowest advert Wade (LAG) a)Top of bottom floor (including basement, crawl space, or enclosure) is—_ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) Is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2 For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 andlor 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment serlcing the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's f oodplain 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 auhhorzed restive who completes Sections A. B. and E for Zone A (wRhoat a FELIAassued or wrcnunRy-issued BFE) orZorre AOmust sign here. The statements in SecborsA A& WE are aonectto gobesto/mylorowledge. Property fawner$orfawnersAuthorized Representative aNanme Address City State ZIP Cade Signature Date Telephone ❑ Check here Rattachments SECTION G -COMMUNITY INFORMATION (OPTIONAL) and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and Gg. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by 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.�!f The following information Meets G4.-G .) is provided for oxnmunity f oodplain management purposes. e�a,Pe t Number - G5. Date Pemdt G8. Dade Gertifieate OF Compliance/Oxupancy Issued i5jil� 46.7,39 0b�9 $O .... `i a 8 [07 iiNo�ggL10161 21l I b$ �t� G7. This permit has been issued for. ), New Construction d Substantial Improvement G8. Elevation of as-buit lowest floor (including basement) of the bu0ding:2W2_O) feet ❑ meters (PR) Datum ZL G9. BFE or (in Zone AD) depth of flooding at the building site., +f 9fL.�(L � feet ❑ meters (PR) Datum � �1 Local Oftars Name 4V A& C/ S roe 6'6� Community Noma r . fJ Telephone D Signature N� Date Building Photographs See Instructions for Item A6. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1307 E. Prospect Rd FortCollins State Co ZIP Code 80525 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken. "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. Figure 1 - East side from south