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Home My WebLink AboutE-ELEVATION CERTIFICATE - 726 EASTDALE DRIVE - OLD TOWN (3)FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires July 31, 2002 nt: Read the 1 -7. SECTION A - PROPERTY OWNER INFORMATION I.: r6r Insurance Comnanv 11cn BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. ' Company*. NAIC Number 726 EASTDALE DRIVE CITY STATE ZIP CODE FORT COLLINS CO 80524 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 8, EASTDALE PARK SUBDIVISION BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ##° - ##' - ##.##" or ##.#####0) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2. COUNTY NAME 83. STATE FORT COLLINS 080102 LARIMER CO B4. MAP AND PANEL NUMBER L-A 0004 Tow^( B5. SUFFIX C B6. FIRM INDEX DATE 03-18-96 B7. FIRM PANEL EFFECTIVE/REVISED DATE 03-18-96 /-/7-9j B8. FLOOD ZONE(S) X B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) N�f /4971.4 B10. Indicate the source of the Base Flood Elevation (BEE) data or base flood depth entered in B9. ❑ FIS Profile ❑ FIRM ® Community Determined ❑ Other (Describe): 811. Indicate the elevation datum used for the BEE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction* ® Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (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 BEE), VE, V1430, V (with BEE), 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 BEE in Section B, convert the datum to that used for the BEE. 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 Datum Conversion/Comments Elevation reference mark used 2997 Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ❑ a) Top of bottom floor (including basement or enclosure) 4972. 90 ft.(m) ❑ b) Top of next higher floor N/A. _ft.(m) d ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. _ft.(m) ❑ d) Attached garage (top of slab) 4971. 23ft.(m) E ❑ e) Lowest elevation of machinery and/or equipment W v servicing the building 4971 . 44ft.(m) ❑ f) Lowest adjacent grade (LAG) 4971 . Oft.(m) Z'.m ❑ g) Highest adjacent grade (HAG) 4971, 1ft.(m) 0 N ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 4 ❑ i) Total area of all permanent openings (flood vents) in C3h 576 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. l certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. l understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME MARK F. CORBRIDGE LICENSE NUMBER CO PLS 25619 TITLE PRESIDENT COMPANY NAME ABSOLUTE SURVEYING, INC. ADDRESS CITY STATE ZIP CODE 9881 NORTH MONROE AVE #3 LOVELAND CO 80538 SIGNATURE DATE TELEPHONE %6r� �✓ q 02-09-01 (9701203-1552 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. For Insurance Company Use. it BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 726 EASTDDALE DRIVE CITY STATE ZIP CODE Company NAIC Number FT. COLLINS CO 80524 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 BENCHMARK- CITY OF FORT COLLINS BM 29-97. PUBLISHED ELEVATION 4974.83 FEET. Cie) BUILDING EQUIPMENT IS IN THE ORIGINAL STRUCTURE ❑ 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 E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. El. 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 _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(cm) above the highest adjacent grade. E4. 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? ❑ Yes ❑ 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 owner's authorized representative who completes. Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. N. �*i9�l�:RY�7:i�1�dPl�:7i��1�j1:LL-it.1��;3:1�3:69�JL•i11�1�9�/_li!Iy ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE ❑ 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. ❑ 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. ❑ 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. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED I 6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY I G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: _ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum: LOCAL OFFICIAL'S NAME COMMUNITY NAME DATE Check here if attachments FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS