Loading...
HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 345 EAST MOUNTAIN AVENUE - OLD TOWN (4)ELEVATION CERTIFICATE O.M.B. No 3067 C, -- Expires May 31, ; 99; FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the ficod insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community fioodplain 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 LOM R' . Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I Unit. Suite anolor Slog. Number) OR P.O. ROUTE AND BOX NUMBER Numcers. etc.) POLICY NUMBER COMPANY NAIC NUMBER STATE ZIP CODE ., c o e05z4l.' s�heweea+30 SECTION 8 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX e. DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION (in AO Zones, use depm) 0130102 0004- G 3, -- / 8 - 9G X ¢97Z. 0 09 Town 504 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): X. NGVD '29 I I1 Other (describe an back) 8. 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:1 I I 1 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 I . 2(a). FIRM Zones Al-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I I 17 2J All feet NGVD (or other FIRM datum —see Section S, 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 1 1,L 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 1. I.L 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 1u .I � 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 fioodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: 110 NGVD '29 ❑Other (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 S, Item 77, 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: ® Yes ❑ No (See Instructions on Page 4) 5. The reference level elevation is based on: R 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 cardreate 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 isd 19 n 1 . [7J 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 Sedan C, Item t 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 • I 1 ! .1 i feet NGVD (or other FIRM datum —see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEW Form 81 -1 11`+MY 90 REPLACES ALL PRE`/IOUS EDITIONS SE= REVERSE SIDE FOR CONTINUAT IC,. 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 8FE),V1—V30,VE, and V (with SFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued 8FE), 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 wail. enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list th (s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be en I, 1 certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret t(� %)4 '1 understand that any false statement may be punishable by fine.or imprisonment under,18 U.S. Code, n 1001. a 4s:02 CERTIFIER'S NAME LICENSE NUMBER (or Affix Sea]) . 1 o .;.n570 r Colo-,..... [... !t 4,50 TITLE _ _ COMPANY NAME AlVCQ� ADDRESS CITY STATE ZIP /0.3 S. rr, S>F.F64 Callinf, CO 8032 SIGNATURE DA PHONE 3 30 9 O — 3 Copies should be mad of this Certificate for: 1) community official, 2) insurance agenVcompany, and 3) building owner. COMMENTS: ON SLAB A v ZONES ZONES WA09 wm+ BASEMENT A tr zoNEs BASE ON PILES. PIERS. as COLUMNS A v 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.