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Home My WebLink AboutE-ELEVATION CERTIFICATE - 2420 EAST PROSPECT ROAD BUILDING E - SPRING CREEK (3), ELEVATION CERTIFICATE Ohre No y, 19 3 E.pves May y367007 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodpiain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER JMC Company, A Partnership STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 2420 East Prospect Road OTHER DESCRIPTION (Lot and Block Numbers. etc.) Fort Collins MRI Building CITY STATE ZIP CODE Fort Collins Co 80525; SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): - 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATEOF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION 1 (in AO Zones, use depth) 080102 0004 A 7/16/79 A4 4900.1 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ® NGVD'29 ❑ Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the Community has established a BFE for this building site, indicate the community's BFE: I 1 '. !feet NGVD (or other FIRM datum —see Section B, item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 1 , 2(a). FIRM Zones Al-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I91016 .0 feet NGVD (or other FIRM datum —see Section B, Item 7). (b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of' I I I I !,IJ feet NGVO (or other FIRM datum —see Section 8, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is 1.L! feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is 11.L feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Ye; ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: ya�1 NGVD'29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 71, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2J 4. Elevation reference mark used appears on FIRM: ® Yes ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on: ® actual construction ❑ construction drawings (NOTE. Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: 1 140 101 . @J feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I ! I I ,I! feet NGVD (or other FIRM datum —see Section 8, Item 7). 2, Date of the start of construction Cr substantial improvement SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones At—A30, AE, AH, A (with BFE),Vi—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features —If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. l certify that the information in Sections 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. Richard A. Rutherford Colorado 5028 CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal P. E. & L.S. James H. Stewart & Associates, Inc. TITLE COMPANY NAME P.O. Box 429 Fort Collins CO 80522 ADDRESS CITY STATE ZIP io 2/23/93 303/482-9331 .SIGNATURE. // DATE PHONE Copies should be made of this Certificate 'or: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ON WITH - ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A V A A v ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE BASE LEVEL - - ROOO LEVEL PEFEPENCE LEVEL Et AMN rt + y-:. r. BASE AWAGENT .. REFERENCE R000 G� IEVEI MOE BASE R000 ELEVATION � ELEVATION REFERENCE kAACENT LEVEL GRADE 'ry!AWACENT `. The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.