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Home My WebLink AboutE-ELEVATION CERTIFICATE - 225 NORTH LEMAY AVENUE - POUDRE RIVER (3)FECERAL EMERGENCY MANAGEMENT AGENCY O.M.B. Nc. 3C6-7 0 NATIONAL FLOOD INSURANCE PROGRAM Expires July 3077 7, 2CO2 ELEVATION CERTIFICATE / 03 Important: Read the instructions on pages 1 - 7. l SECTION A - PROPERTY OWNER INFORMATICN For Insurance Company User 3L'ILDI'1G C`NNER'S NAME Pslicy Numt:er'<..: EVA L _ - 3(:ILDING STREET ACORESS oncluding Apt. Unit, Suite, and/or Bleg. No.) OR P.O. RCU c AND BOX NO. I Company NAIC Numoer Z2S i1/n¢rm LAmAy AvF. C: 71, STATE ZIP CCOE LATITU'LHLONGI I UUt (UN I IUNAL) MURIZONTAL DATUM: SOURCE: "GFS [type): ( xt' - ss' - Ss. Y-. of 94.9#1044") U NAD 1927 LI NAO 1983 L-,f USGS Quad Map LJ SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION NUMBER rU I DATE I EFFECTIVEIREVIS'c0 DATE I ZONE(S) ( (Zone AO, use depth of flooding) r) IA MIA C MA2G4/R. h�i MLI/u /a 1y4G A � 494C.7 SIC. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 59. L-I FIS Profile 1 XI FIRM LJ Community Determined L_J Other (Describe): E11, Indicate the elevation datum used for the BF_ in 139: Ixl NGVD 1929 LJ NAVD 1988 LJ Other (Describe): 812. Is the building located in a Coastal Barrier Resources System (CSRS) area or Otherwise Protected Area (OPA)? "Yes JXJ No Designation Date: SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LJConstruc ion Drawings' LJBuilding Under Construction' IXIFinished Construction 'A new Elevation Certificate will be required when constrvcJon of the building is complete. C2. Building Diagram Number I (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, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a-i. below according to the building diagram specified in Rem C2. State the datum used. If the datum is differentfrom 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 conversiert. Datum NGvn 1oa1 Conversion/Comments Elevation reference mark used NG.S )Z 4oz 41m aQ4oes the elevation reference mark used appear on the FIR I., Yes ,ram,) No O a) Top of bottom floor Qnduding basement or enclosuPy", 4942_ . JL_ ft.(m) m eO p,. RUT ry ❑ b) Top of next higher floor N A —•fL(m)`�iSTE••y,� O c) Bottom of lowest horizontal structural member (V zones only) AJ A _ R(m) $ o F �: ' �'•; } ❑ d Attached garage o of slab AI A It. m e U: hh4. - e 9 R P ) _() E F %�o A ❑ e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area.) �44 2 . S ft.(m) 8 ' S * `• Z / I �o = ZI 0 Lowest adjacent (finished) grade (LAG) d A d 1 . f _ ft.(m) i s 's �'•• jD f 8 LS _6=' O g) Highest adjacent (finished) grade (HAG) 4 qdZ ft.(m) N 14,9`• ,r° ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade ❑ q Total area of all permanent openings (flood vents) in C3.h Q 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, B. 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. CERTIFIER'S NAME LICENSE NUMBER Rrcu,oazr A 12urucDcno , /' .1A <A7A FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS titPO RTANT: In these spaces, copy the corresponding information from Section A. - 3UIL:7INGSTREETAOCR•.SS Inc:uein A For lnsunnca Company U�:..,.. ( 9 leg Ur.R Suite, anC/or 9:Cg. I`--) OR P.O. ROUTE AND BOX NO. Poliq Numox ,, S ,4 ig CTt STATE - p DP CCDE151-14- Company NAIL. — AIL Hamper SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community etficial, (2) insurance agent/company, and (3) building owner. CObIbIF NT: SECTION E - BUILDING ELEVATION INFORMATION R ZONE AO AND ZONE A here if ror cone Au and LoneA without BF p - g I•.„„v., orc) 17, complete lete Items Et. through E4. If the Elevation Certificate is intended. for use as supporting informationrer a LOMA or LOMR-F, Section C must be completed. E 1. Building Diagram Number _ (Select the building diagram most similar to the building for which this certificate is being Ccimpleted- 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 endosure) of the building is (check one) the highest adjacent grade. (Use natural grade, if available.) �� R(m) I I Iin.(c-n) L] above or Ucw E3. For Building Diagrams 6-6 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is ' I I I R(m) I I lin.(un) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form, E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in acccrdance with the community's flecdolain management ordinance? 11 11 Yes I I 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 authorized representative who completes Sections A, B, C (items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community -issued BF-9 or Zone AO must sign here. The statements in Seca'ons A. B, C, and E are correct to the best of my knowfedi AOORESS "IT STATE ZIP CODE SIGNATURE DATc TELEPHONE COMMENTS here V „VGI w l,o Is aumonzea oy law or ordinance to administer the community's floodplaln management ordinance can complete ections A. B, C (or E), and G of this Elevation Certificate. Complete the applicable items) and sign below, I. LJ The inforrmatieri 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 data of the elevation data in the Comments area below.) 2. LJ A community official completed Section E for a building located in Zone A (without a FEMA433tled or community -issued BFE) or Zone AO. 3. LJ The following information (Items G4-GB) is provided for community floodplain management purposes. "• - ry ISSUEO KI 7. This permit has been issued for. LJ New Construction U Substantial Improvement 3. Elevation of as -built lowest floor (including basement) of the building is: 3. SFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum: . _ -- .00ALOFFICIAL'S NAME ft.(m) Datum:TITLE /12ltfSAa uilWas-f?o6in5on F[rx� [ IbdWlliliflra%o. :OMMUNITY NAME a.-I(-0a I Check here if attachments MA Forth ....... 00