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Home My WebLink AboutBLD2004-00499 Flood Certificate 4r:: ULb ! II I� 11 FEDERALEMERGENCY MANAGEMENT AGENCY 1:1 �-- NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 , • ELEVATION CERTIFICATE Expires December 31, 200E I, - 2 Important: Read the instructions on pages 1-7. y.,.-- — SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDIN OWNER'S NAME '1" i I Policy Number Dennis Brandt and Susan Brandt OP"PI r f BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. 1785 Uncas Road Company NAIC Number CITY STATE ZIP CODE Port Townsend WA 98368 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Portions of the SW'/.SE'A of Section 25 and the SE'/.SE'/,of Section 26,T 29 N,R 2 W,W.M. Assessor's Tax Parcel No.902 253 012 BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) Residential LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: ( ; - '- t# or fkt#� ®NAD 1983) ❑NAD 1927 ElSG SOURCE: ®USGS Qu Quead d Map El Other GPS Static 47°58'14"±N&122°53'06"±W SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE Jefferson County 530069 Jefferson Washington B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S) NUMBER B5.SUFFIX 136.FIRM INDEX DATE EFFECTIVE/REVISED DATE 88.FLOOD ZONE(S) (Zone AO,use depth of flooding) 530069 0410 B 7/19/1982 7/19/1982 A No BFE B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. ❑FIS Profile ®FIRM ❑Community Determined ❑Other(Describe): B11.Indicate the elevation datum used for the BFE in B9:®NGVD 1929 El NAVD 1988 ❑Other(Describe): B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ®No Designation Date SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1.Building elevations are based on:®Construction Drawings` El 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 A1-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 C3.-a-i below aocordng 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 sp..- • . Section D or Section G,as appropriate,to document the datum conversion. `1t�♦%%%�'��'��°♦�-,'��' '` '_„„ Datum NGVD 1929 Conversion/Comments See Page 2 1 u-Co y Elevation reference mark used See Page 2 Does the elevation reference mark used appear on the FIRM? ❑Yes ®No k r ; 7*-' V ❑ a)Top of bottom floor(inducting basement or enclosure) 55. 0 ft.(m) r U b)Top of next higher floor ft.(m) , ,. _- 4 ❑c)Bottom of lowest horizontal structural member(V zones only) ft.(m) ;i i� ! _ 1. i ', ❑ d)Attached garage(top of slab) ft.m - ' I I T:z ❑ eLowest elevation of machineryequipment — ( ) w f rd� and/or ui ent - ,� r li 21410 �d servicing the budding(Describe in a Comments area) ._ft,(m) a 's ICI �G� 4V ❑ I)Lowest adjacent(finished)grade(LAG) 54.3 ft.(m) z -'e°A'AL LIM 014 a Lig)Highest adjacent(finished)grade(HAG) 55. 7 ft.(m) y ❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade % PtRES:10!0910. ❑ i)Total area of all permanent openings(flood vents)in C3.h sq.in. J(sq.cm) ii 7 20 Ieliee�.� ee Sit 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 Con this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. CERTIFIERS NAME Michael J.Coker,PLS LICENSE NUMBER 21410 (Washington) TITLE Survey Manager COMPANY NAME Tillman Engineering,Inc. ADDRESS CITY STATE ZIP CODE P.O.Box 1375 Port Hadlock WA 98339 SIGNATURE 77//7J /(J egkiiii DATE 11/7/2003 (360)TELEPHONE 9-9661 FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions e BUILDING STREET ADDRESS ,Apt,Unitleu lecorrespondinginformation from Section A. 1785 Uncas Road (Including b9•No.)OR P.O.ROUTE AND BOX NO. For Insurance Corrrj , "" Use: CRY Policy Number Port Townsend STATE WA ZIP CODE Company NAIC Number SECTION D D.SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance �ce� COMMENTS PY,and(3)building owner. Elevations were established by static GPS observations and differential leveling methods.The benchmark used to establish the elevation reference marks for this certification is WSDOT monument"3M16104-2"with a published elevation of 607.79 feet as referenced to the NAVD 88 datum.Conversion factor used:NAVD 88 datum minus 3.65 feet equals NGVD 1929 datum. See attached letter for additional information ardin this certification SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT For Zone AO and Zone A(without BFE),complete Items El through E4. If the Elevation Certificate is intended ®Check here if attachments Section C must be completed. BFE) for use as supporting information for a LOMA or LOMR-F, El.Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed—see represents the building,provide a sketch or photograph.) E2.The top of the bottom floor(including basement or enclosure)of the buildin pages 6 and 7. If no diagram accurately —ft.(m)—in.(cm)[]above or ❑below(� one)the highest adjacent grade. (Use natural grade,if available). 9 is E3.For Building Diagrams 6-8 with openings(see 9 page 7),the next higher floor or elevated floor(elevation b)of the buildingis — grade. Complete items C3.h and C3.i on front of form. E4.The top of the platform of machinery and/or i tt•(m) rn.(cm)above the highest adjacent natural grade,if avoidable). equipment servicing the building is —ft.(m)—in.(cm)El above or E5.For Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in acoorda 0 below(check one)the highest adjacent grade. (Use El Yes 0 No ❑Unknown. The local official must certify this informationnce with the oommunitys floodplain management ordinance? in Section G SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owners authorized representative who completes issued BFE)or Zone AO must sign here. The statements in Sections s A,B, and E ate coned s A,B,C t t t e best of mknowledge. � only), Zone A(without a FEMA4ssued or community- issued OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVES NAME Tillman En ineerin ,Inc. ADDRESS P.O.Box 1375 CITY SIGNATURE • Pod Hadlodc STATE ZIP CODE • DATE WA 98339 COMMENTS See attached letter additional information 11/7/2003 TELEPHONE certification. 360 379-9661 regarding this ce - The local official who is authorized by law or ordinance to aECTIOer the cor i COMMUNITY INFORMATION(OPTIONAL) ®Check here if attachments floodplain management ordinance can complete Sections A,B,C(or E),and G of this ElevationCertificate. Complete the applicable item(s)and sign below. G1.0 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.0 A community official completed �J architect who is authorized by state Section E for a buildinglocated in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.ElThe following information(Items G4-G9)is provided for community floodplain management G4.PERMIT NUMBER purposes. G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPUANCE/OCCUPANCY ISSUED G7.This permit has been issued for❑New Construction El Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building is: G9.BFE or(in Zone AO)depth of flooding at the building site is: _•—ft.(m) Datum: LOCAL OFFICIAL'S NAME — —ft(m) Datum: COMMUNITY NAME TITLE SIGNATURE TELEPHONE COMMENTS DATE El Check here if attachments FEMA Form 81-31,January 2003 Replaces all previous editions ITrnN • ENGINEERING 4 KIVLEY PROFESSIONAL CENTER INS. 141 OAK BAY ROAD P.O.BOX 137! PORT HADLOCK,WASHINGTON 983, E-mail:tillengr@olypen.com 360-379-9661 360-379-0150 FAX November 7, 2003 RE: FEMA ELEVATION CERTIFICATE for Dennis and Susan Brandt To Whom It may Concern: This certification was prepared prior to proposed residence to on a p posed site grading thate is be located within the Southwestelofland, and constructionenis of a new Brandt,25 and the Southeastcurrently Southwest by Dennis and Susanion quarter of the 26, 29 North, Range 2 quarter of the Southeast 1785 g West, W.M., in Jefferson County, quarter of Section 26 West Uncas Road and is currently identified asWas Assessor's Said Township 29 253 012. Said parcel also lies within a Assessor's Tax ParcelN is oted at southerly of Snow Creek where no base flood elevation902 flood plain area situated southwesterly and The elevation reference has been determined. marks used for Section C3 of the attached Elevation Certificate, were established on October 21 wre "TILLMAN CO 21, 2003, on top of two 2 plasticps stamped in the CONTROL". The elevation established ontop with red rebarfor cops to#1, locatedo NGVD h proximity of the proposed drainfield area, is 55.7of3 thee for Point located 1929 The elevation established on topas referenced#2, located South to the NGVDst approximately 390 feet from of the rebar for Pointf as 1929 datum. Dint #1, is 54.31 feet as The owner (Susan Brandt) has minor site gradingpersonally acknowledged to me that subsequent that the intended finished topquent to any proposed new residence (FEMA of bottom floor elevation for the feet (NGVD 1929) Diagram 1) will be set at an a for this certification. which is mean elevation of the approximate elevation of 55. two reference marks established Michael J. Coker, PLS �� c,�777/e"nabiCalw k ws,s1.-ki co 3 Certificate No. 21410 . r ` ' ' o kb f oNiiL LAND-- %,EXPIRES:10/09/05 i •••••••••••Veeeeee/ - 0 November 7, 2003