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Home My WebLink AboutE-ELEVATION CERTIFICATE - 706 WEST OAK STREET - OLD TOWN (3)it U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION I For Insurance Company Use: I A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Company NAI'C Number 706 W. Oak St. City Fort Collins State CO ZIP Code 90521 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Loomis ADD AMD L11 - 18 BLK 280 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential Addition A5. Latitude/Longitude: Lat. 40.5859 Long. 105.0885 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is. being used to obtain flood insurance. AT Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 133 sq ft a) Square footage of attached garage 0 sq It b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 2 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 156.30 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State City of Fort Collins 080102 Larimer CO B4. Map/Panel Number B5. Suffix_ B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 08069C0979/sheet 4 G Date Effective/Revised Date Zone(s) AO, use base flood depth) 6-17-2008 06-17-2008/07-15-2003 X/100-year 5005.5 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined ® Other (Describe) City of Ft.Collins - Old Town Master Plan 1311. Indicate elevation datum used for BFE in Item 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 ❑ CBRS ❑ OPA 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. Elevations -Zones All-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 C2.a-h below according to.the building diagram specified in Item AT Use the same datum as the BFE. Benchmark Utilized FtCollins 9-00 Vertical Datum NGVD 29 Conversion/Comments Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5005.3 ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 5007.7 ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) 0._ ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 0. ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 0. ❑ feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5005.3 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 5005.8 ® feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including 5005.E ® feet ❑ meters (Puerto Rico only) structural support 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 on this Certificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes ® No Certifier's Name Aaron Cvar License Number 36271 Titre Senior Engineer Company Name Northern Engineering Services, Inc. City Fort Collins State CO ZIP Code 80524 FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. aFor Insurance Compaanny Use: ' Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 706 W. Oak St. City Ft.CollinsState CO ZIP Code 80521 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. Comments City of Fort Collins Benchmark #9-00 with elevation of 5002.54 (NGVD 29) utilized for survey Flood vent openings measured to have one opening 6.25"xl1.5" and two openings 6.25"x.5" for a total open area of 78.15 square inches per flood vent. Two flood vents)with these rements have been provided; thus, total vent area is 156.30 square inches. Signature Date ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items Et-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. Ell. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. 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. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature A Date Telephone i Comments ❑ 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. Check the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by 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. B The following information (Items G4-G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of ompliance/Occupancy Issued /0839 1(/�y/2009 �7,O7o G7. This permit has been issued for: W New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: dL�Q�. 5- ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation 500 E._JjL_ ■ feet ❑ meters (PR) Datum Local Official's Name Title ianti V`' af r r e-- Community Name r�/ Q /r f:;�r+Cit" Telephone g� _ ylG _ Aa I—�- Signature Date -------------- cxl Comments 4v Q4— rd/�tJ" S3t-r.4* tlo444Owa ❑ Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 706 W. Oak St. City Ft. Collins State co ZIP Code 80521 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. FRONT VIEW Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 706 W. Oak St. City Ft.Collins State co ZIP Code 80521 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." REAR VIEW