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Home My WebLink AboutE-ELEVATION CERTIFICATE - 920 EAST MULBERRY STREET - POUDRE RIVER (20)(Including W -1W - ##.##" or ##.#####0) FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the instructions on Pages 1 - 7. O:M.B. No. 3067-0077 Expires July 31, 2002 peC(A!� SECTION A - PROPERTY OWNER INFORMATION I Forinsurance.CompanyUse: I Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. STATE Addition, Accessory, etc. Use HORIZONTAL DATUM: SOURCE: Ll GPS (Type): L NAD 1927 LI NAD 1983 Ll USGS Quad Map L Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFI COMMU TY E & COMMUNITY NUMBER B2. COUNTY NAME B3 TI�TjTE ( r 6) O A WI 21r— Ol ®V`aCL O B4. MAP AND PANEL B5. SUFFIX B& FIRM INDEX B7. FIRM PANEL 68. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE I EFFECTIVE/REVISED DATE ZONE(S) (Zone AD, a depth of flooding) 0o C 3 35. 2. B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. I FIS Profile & FIRM Ll Community Determined lJ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ICI NGVD 1929 lJ NAVD 1988 IJ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LI Yes L'X-j No Designation SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LlConstruction Drawings' IJBuilding Under Construction' L&Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 3 (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, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-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 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 conversion. DatumQl(rl/Q1 �/ _q conversion/Comments Elevation reference mark used 30-q 7- Does the elevation reference mark used ap ❑ a) Top of bottom floor (including basement or enclosure) ft.(m) d ❑ b) Top of next higher floor 939 ft.(m) a ❑ c) Bottom of lowest horizontal structural member (V zones only) _ ft.(m) o ❑ d) Attached garage (top of slab) ft.(m) E ❑ e) Lowest elevation of machinery and/or equipment w servicing the building �%�3y . ft.(m) ❑ f) Lowest adjacent grade (LAG) 41936. 8 ft.(m) z3 ❑ g) Highest adjacent grade (HAG) 9939. 7- ft.(m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade _Q_ ❑ i)•Total area of all permanent openings (flood vents) in C3h io sq. in. (sq. cm) t'6 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,' Section 1001. a8aIy TITLE COMPANY NAMt ' /�eQ7i�(iP�+L EN(r/NECiZ 114oivre-viieRr G://i~TSoN ADDRESS CITY STATE ZIP CODE 1g01 13 ST. G41re 600 Da✓v--"2 • . c0 9-02.02 J1VNAIUKIr—1 t / //, >// ,�•., u„'c 2 11A /00 �c�crnvrvc -303-382, 5 FEMA Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Section A. I For InsuranceCompany Use. I ZIP SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS 1_1 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 E3. If 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 floor (including basement or enclosure) of the building is LLI ft.(m) LLlin.(cm) Ll above or Ll below (check one) the highest adjacent grade. E3. 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? LI Yes LI No LI 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 representafive who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS 1-1 Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's 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. Ll 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 or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. LI 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. Ixl The following information (Items G4-G9) is provided for community floodplain management purposes. G7. This permit has been issued for: I(l New Construction Ll Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: 4113 6 °L ft.(m) Datum: j )6 VD Ral G9. BFE or (in Zone AO) depth of flooding at the building site is: <iR 3 S ft.(m) Datum: n)GU D 14 oZ9 ra'l!/I1Ci/rs'/IrL�!'� a..r'��t�IF.'�S. ►ir!_!+t��Qs•�•e • COMMENTS - FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS