The URL can be used to link to this page

Home My WebLink AboutE-ELEVATION CERTIFICATE - 920 EAST MULBERRY STREET - POUDRE RIVER (21)CITY OF FORT COLLINS STORMWATER UTILITY POST CONSTRUCTION ELEVATION CERTIFICATE/FLOOD PROOFING CERTIFICATE PROPERTY ADDRESS: WWTP#1 @ Mulberry and Riverside TYPE OF USE (COMMERCIAL OR. RESIDENTIAL): Commercial DATE CONSTRUCTION COMPLETED:March 1989 NAME OF FLOODPLAIN BUILDING IS LOCATED IN: Poudre River (Spring Creek, Dry Creek, Poudre River, etc.) BASE FLOOD ELEVATION AT THE SITE: Fema = 4936.0 Fort Collins 4937.5 NAME, ADDRESS, PHONE OF OWNER: CitV of Fort Collins Water Utility P.O. Box 580 Fort Collins, CO 80522 221-6681 INSTRUCTIONS Complete only the Elevation Certification unless the building has been flood proofed at least to the base flood elevation. If flood -proofing has been used, complete only the Flood -Proofing Certification. The Elevation Certification may be completed by a registered professional engineer, architect, or surveyor. The Flood -Proofing Certification may only be completed by a registered professional engineer or architect. ELEVATION CERTIFICATE I certify that the building at the property location described above has the lowest floor (including basement) at an elevation of: feet NGVD (Mean Sea Level) FLOOD -PROOFING CERTIFICATION (Commercial Buildings) I certify to the best of my knowledge, and belief, that the structure at the property location described above is designed with walls substantially impermeable to the passage of water and contains structural components having the capability of resisting hydrostatic and hydrodynamic loads and effects of buoyancy that would be caused by the.flood depth, pressures, velocities, impact and uplift forces associated with the base flood and that the structure is water -tight to an elevation of: 4 / 3 i� 7 feet NGVD (Mean Sea Level/Black Bolt System) In the event of flooding, will this degree of Flood —proofing be achieved with human intervention? Ado CERTIFIER'S_NAME: D wCGS TITLE: / I►LG� q/ F2N oe ADDRES ZG 2 S nature) (Date) cc: r Building Inspection Construction Inspection Stormwater Utility G. Ku keti i Affix Seal' or Write _T M Cn.cs 4 vs Professional License fC l/K Go TiE `T�3:, F,. r o' 17609' �G r. ,,,;nisi a Aete •'`'• ELEVATION CERTIFICATE Expires May 3,O.M.S. May1-°°" ' 1993 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 STReE,4 ADDRESS (Including Apt. Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER OTHER DESCMPTIOAtot and Block Numbers, etc.) CITY STATE ZIP CODE F4. Cite I I;ns (4n �nsas 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. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION O g O I O O' C 31 I�I P An/AO Zones, use depth) 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): JIXNGVD '29 _1 Other (describe on back) S. 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:! 141lq 15Re. IDI 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 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 ofl I ! L fegNGVD (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! 1 1 1 1 U 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 LLI.� ll 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 . U 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 NGVD'29 ElOther (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.) 4. Elevation reference mark used appears on FIRM: 0 Yes ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on:A 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: I I ,U 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: 1 1 1 1 1 I .LJ feet NGVD (or other FIRM datum —see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION 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 Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide fioodpiain 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. I certify that the information in Sections Q and C on this certificate represents my best efforts fo interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Robert Smith CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) Stormwater Utility Manager City of Fort Collins Stormwater Utility TITLE COMPANY NAME 235 Mathews S eet Fort Collins Colorado 80521 ADDRESS CITY STATE ZIP September 19 1991 303 221-6589 SIGNATURE DATE PHONE Copies should be made of this Certificate tor: 1) community official, 2) Insurance agenl/company, and 3) building owner. COMMENTS: This is a transfer of elevation certificate information`to the FEMA form in accordance with 1990 CRS authorization , ON Wmi ON PILES, SLAB BASEMENT PIERS. OR COLUMNS A V A . A V ZONES ZONES - ZONES ZONES ZONES REFERENCE REFERENCE EASE LEVEL LEVEL FLOOD RERECE EFN LEVEL ELEVATION EASE FLOOD ADJACENT REFERENCE ELEVATION REFERENCE ADJACENT GRADE • ' kT% LEVEL' 'GRADE EASE FLOOD ELEVATION LEVEL 7'�' :::�•:,' +r.;'i:j: i,;.�•.: ADJACENT,-'. GRACE GRACE ' 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. Page 2