HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 2001 SOUTH SHIELDS STREET BUILDING L - SPRING CREEK (3)ELEVATION CERTIFICATE O.h1.e. No May 31,.1993
O.M.8. May 6 007
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 floodplain 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 pan be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER
STREET ADDRESS (Including Apt., Unit, Suite and/or Blog. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
0001 S. Sheds .5f" B L
OTHER DESCRIPTION (Lot and Bloch Numbers. etc.)
Lot IZ SDrirrj Ifrsek Pro ssional Park
CITY STATE ZIP CODE
CollinsForf co OS2
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
I. COMMUNITY NUMBEfl
2. PANEL NUMBER
3. SUFFIX
4, DATE OF FIRM INDEX
S. FIRM ZONE
6. BASE FLOOD ELEVATION
080102
doo i
A
July lit 1171
1
A I
nA!8"Zones, use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (SFE): 9 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: L I i! feet NGVD (or other FIRM datum —see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
I. 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 2
2(a). FIRM Zones At-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
of L.151011131 A feet NGVD (Or other FIRM datum —see Section B, Item 7).
(b). FIRM Zones VI-V30, 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 1 1 1 1 1 I JJ feet NGVD (or other FIRM datum —see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is W .LJ 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 W .LI 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? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: M 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 7J then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
L Elevation reference mark used appears on FIRM: CK Yes 0 No (See Instructions on Page 4)
i. The reference level elevation Is based on: M 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.)
i. The elevation of the lowest grade immediately adjacent to the building is: I IS!O IV 0 ,U feet NGVD (or other FIRM datum -see
. Section B, Item 7).
SECTION D COMMUNITY INFORMATION
If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item
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 1 ` I 1 l:1`1 feet NGVD (or other FIRM datum —see Section B, Item 7).
Date of the start of construction or substantial improvement
i
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),V1-V30,VE, and V (with 8FE) is required.
Community officials who are authorized by local law or ordinance to'provide fleodplain management information, may also sign the
certification. in the case of Zones AO and A (without a FEMA or community issued SFE), 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.
TyQ tiff
I certify that the information in Sections B and C on this certificate represents my
f understand that any false statement may tie punishable by line or imprisonment prisonmentunder18 est efforts
S.t Cod�>t � Gaf a
O
LICENSE NUMBER (or Affix Sean 0 4502
CERTIFIER'S NAME C * • • 7j-C
�` I. got?bM0n Coloracld # 4502
TITLE COMPANY NAME :• q S, ��
V. P S�eLNar� `aC i�nocf ales _
ADDRESS CITY %,;j�Tr�yg,,t- ).� _ ZIP
SI . ATE PHONE
S Z 93 Z- 331
Copies Shia d be made of this Certificate for:1) community official, 2) Insurance agenVcompany, and 3) building owner.
COMMENTS:
ON WrrH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A v A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
- LEVEL
REFEPENCE
PEFEVENCE LASE
LEVEL FLOOD
ELEVATION
LEVEL
n.
). �.;t: w
BASE
BASE .: .AeIACENT PELEEFLILE
FLWO U�=OE
ELEVATION DEFERENCE AOIACENT
nwo
EIEvON
Y�
LEVEL G�pE �.
AOtACENT:
The diagrams above illustrate the paints 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.