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Home My WebLink AboutBLD2006-00315 Flood Certificate FROM : Jim Hart • FAX NO. 1 6�1 174-2195 411 Nov. 15 'tJ8) O :q3Arh P1 FEDERAL EMERGENCY MANAGEMENT AGENCY 0 M.B. No 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM I expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use' BUILDING OWNER'S NAME Policy Number ' Jim Hart BUILDING STREET ADDRESS(Including Apt.,Unit. Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 1379 Oil City Road CiTY STATE LIP CODE Forks Washington 98331 PROPERTY DESCRIPTION(Lot and Bloc±Numbers.Tax Parcel Number. Legal Description,etc.) El ENi SE; NWir Sec. 4, T26N, R12W, W.M., Jefferson County Tax #612042006 BUILDINGUSE(e.g.,Residential,Non-residential,Addition.Accessory.etc. Use Comments section if necessary.) Residential IATiTUDEJLONGiTUDE(OPTIONAL) HORIZONTAL,DATUM: SOURCE: I—i GPS(Type)`_—__------ice----ate-##'-tt.`.##' or JY#Ali') L_J NAD 1927 Ix I NAD 1983 ---- L_I USGS Quad Map (�(Other. _ __-----_ SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Bt.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE 530069 575 of 1625 Jefferson Washington B4_MAP AND PANEL E35.SUFFIX 66.FiRt1 INDEX B7.FIRM PANEL 88.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) 530069 0575 6 7/19/82 7/19/82 A Not established B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. LI FIS Profile iI FIRM ( _1 Community Determined I_I Other(Describe): __ B11. Indicate the elevation datum used for the BFE in B9:1—I NGVD 1929 1.X_I NAVD 1988 1__1 Oth B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Prot c,t a(OP i I Irs o Designation Date: _ I Li '- SECTION SECTION C-BUILDING ELEVATION INFORMATION(SURVEY RE Uii ED) I C1.Buildingelevations are based on: Construction Drawings' Buildin UnderConstructi '' �-1 9 I__I 9 �? I__IFinished'ConTrudior•J 'A new Elevation Certificate will be required when construction of the building is complete. y y I I C2.Building Diagram Number (Select the building diagram most similar to the building for which this cectificat is;be+ng-cempleted-see 1 pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) DEP •-' C3. Elevations-Zones Al-A30,AE,AH,A(with BFE), VE,V1-V30, V(with BEE),AR,AR/A,AR/AE. AR/AH, ARJAO 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 BFE.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 LAVD_3_ Conversion/Comments None __ _ Elevation reference mark used Y4 R 1974 M S_Does the elevation reference mark used appear on the FIRM? LYes 1(I No n3RW)t�jlmr f.• I,IAIMI`.1 a)Top of bottom floor(including basement or enclosure) _ ft.(m) G "p" s ; O b)Top of next higher floor ft. m " o Q-1(0USio O c)Bottom of lowest horizontal structural member(V zones only) _ ft_(m) y . �WAS��.�i i • ❑ d) Attached garage(top of slab) ft.(m) L Q (Z /A ' 6,, 0'\ , ,:f., O e)Lowest elevation of machinery and/or equipment ri, w i _� ,, servicingthe buildingt s ; ft.(m) E I'.. ?O ❑ f)Lowest adjacent grade(LAG) _ft.(m) ` . .•• • 983 o ' O g)Highest adjacent grade(HAG) _ ft.(m • \ 'FCr1 ' -a' 2 . 'ds,'' S_TE�, �2 a ❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade -,J'-' LC4r LAKES ' ❑ i)Total area of all permanent openings(flood vents)in C3h-__ sq.in.(sq.cm) EXP1AES tt3_2.‘0 i SECTION D-SURVEYOR.ENGINEER,OR ARCHITECT CERTIFICATIO`''V, „`` This certification is to be signed and sealed by a land surveyor, engineer,or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B. and Con this certificate represents my best efforts to interpret the data available. i understand that any false statement may be punishable by frnc or imprisonment under 18 U.S. Code,Section 1001. CFME a n�cPZ$Cou augn RLS tii11983 LICENSE NUMBER TIT_LE COMPANY NAME President Dan Kousbaugh Surveying, Inc.,P.S. ADDRESS STATE CODE450 Spiv FoCs Washington SIGNAYU2E / �f 5/1100 (360)3 ONE FFMA Farm R1.S1.Al IC S9 SFF PkFRSF SII)P r'OR CONTiNI IATION RPPI APFS AI I PRFVIC)I 1R FOITIfNR , FROM : Jim Hart • FAX NO. 1 3e.ci 374 21i 5 Nc 1E 020 0'9:a4Hi1 F' IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Us? BUILDING STREET ADDRESS)Including Apt Unit.Suite,and/or Bldg No.)OR P O ROUTE AND BOX NO Policy Number 1379 Oil City Road CITY STATE ZIP CODE Company NAIC Number Forks Washington 98331 SECTION 0-SURVEYOR ENGINEER. OR ARCHITECT CERTIFICATION(CONTINUED) Copy bath sides of this Elevation Certificate for(1)community official, (2) insurance agent/company. and(3) building owner. COMMENTS BFE s Piave not been established for this area. See attac rents for further details. This site is on a _ hegch ahnve the river ahirh has never flooded haseds�n lisrnri� inforTlafion FlPvations nave been rakPn i carpared to the recent flood of December 15, 1999. Building diagram selection is best estimate at this time. IX_) 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 8FE).complete Items El 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 2 __(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.) F2 The top of the bottom floor(including basement or enclosure)of the building is {_iJ�J ft.�)4)1_1_1in.(cm) ILI above or 1_1 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 1 1_45 1 ft.( 1__i__Jin.(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 flocdplain management ordinance?1_1 Yes 11 No f 1 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 comple"es Sections A.B,and E for Zone A(without a FEMA-issued or community-issued BFE)or Zone AO must sign here. PROPERTY OWN R'S QR OWNER'S S AUTHORIZED REPRESENTATIVE'S-NAME Dan P. KousbaughF ADDRESS Pt7Y STATE ! bE 450 Spr'ce Drive Forks Washington ti.3. 1 SIGNATURE �� SATE TELEPH9NE 1 � 5/11/2000 (380)374-5/20 COMMSNI14. infonm ion is supplied for purposes obtaining_a building oeritit and septic permit_ Actual haresit_e configuration is not kno n at this time. 1X 1 Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer tha 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. GI.11 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. 11 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_1__1 The following information(Items G4-G9)is provided for community floodplain management purposes. Gd.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OFCOMPLIANCE/OCCUPANCY ISSUED G7.This permit has been issued for. JTI New Construction J { 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 TITLE COMMUNITY NAME TELEPHONE E U t 1 V L IM SIGNATURE DATE VD COMMENTS , • r I► n• 1--I Check here if attachments FFMA Fnrrn R1-31 Al IC,99 RFPI AC,FS Al I PRFI/ICII IS FniTIC)NC FROM Jim Hart • FAX NO. : 1 360 374-2195 • Nov. 16 2020 09:45AM P3 May 11, 2000 -� ( i ►I Elevations established for Hart Parcel U��I - - Assessor's #612042006 JEFFERSON COUNTY Ele .OEPT. OF CO'�St'R`§:5YE ELOPMENT DATUM: NGS-Y 473 (1974) Elevations at potential building site: feet Southwest corner of cleared building site 174.36174. 6 feet Northwest corner of cleared building site 175.40 feet Northeast corner of cleared building site 174.48 feet Southeast corner of cleared building site 175.95 feet In area of potential drain field-southwest portion 175.45 feet Northeasterly portion TBM= Northwest corner of PUD pedestal concrete slab 175.35 feet Elevations at River: High water mark right bank of Hoh River on 12/15/99 flood 162.03 feet (This point is about 1000 feet east of potential building site) Elevations at proposed Ed Meyers building site about 800 feet northeast of Hart site. East edge of trailer pad 175.02 feet South edge of trailer pad 173.79 feet West edge of trailer pad(on old logging road grade) 174.62 feet There is an approved septic system in the old homestead field about 200 feet from the eroded vertical right bank of the Hoh River. This system(see attached permit) consists of a concrete 1000 gallon septic tank and associated drain field. This system is about 700 feet south and 2300 feet west of the proposed Hart project. Elevations noted below. As far as I know historically the Hart proposed building site area has never flooded. Elevations at permitted septic system in field: 152.66 feet On top of septic tank in the center Top of 4" PVC inlet pipe 152.05 feet Top of 4" PVC outlet pipe 151.76 feet Northeast corner of drain field on grass 151.53 feet Southeast corner of drain field on grass 152.38 feet 151.70 feet Southwest corner of drain field on grass XOUS6 Northwest corner of drain field on grassQ�wasti�9G0 I/151.75 feet o4. " r\y - Dan P. Kousbaugh I �n los R f.S 411983 ill/� o \, to t •,9�G11963 Za •r,� _ ,Psi`lSS��gJ? - NALLAKO % EXPIRES 1/31?Q02 .1.4'. • FROM Jim Hart • FAX NO. : 1 360 374-21'35 • Nov. lb 2020 09:4SHM F'4 %I �! fo de(crmutc 1( flood .nS�inn,.c wJiIJblc In tilt; .:novnl,n,tt i wnta:t VOW InSI,rance , cot or c3ll tic N�tiun.,l F;000 I„,t,-anc< 1 33 . ,; F',nenm,;t (SOU) 63S•6ti2i . { �'n _/ nPPkUxlh1a1 E SCALE ��+ ( T. 27 N. 2000 0 2000 FEET /- I T. 26 N. - ' "`,h rl d ' Al F100D INSURANCE PROGRA f ;.K I r. .. • ! 1 \� I , .I ) - 1 it 1F, II I -tom!tw ..:t r `� C� I FIRM RAI _1 .; .,: I. :KoH 11 li 11 FLOOD INSURANCE RATE MAP II !Ill' �lj lJEFFERSONCOUNTY J 0 , II WASHINGTON id , I (UNINCORPORATED AREAS) 9 1 hi , fI 0 PEgm t TTED Ssp n c SYSTEM ;1 i I 1 III i,l it PANEl�575 XOF 1625LS tiO—nRlNTc_ Q PQOPOSPB SEPTIC_ SYSTEMLSEE ANO Ecm.DIwG S!rz IIII I11 ) I1 in 1 1�COUS8 JEFFERSON COUNTY �Q' WAs-�'Q(� DEPT. OF COMMUNITY DEVELC= 1 Q', tiW %G11 O:AZ' a 1e ` 11Ifl COMMUNITY•PANEL NUMBER 16 - `o � j iii11 EFFECTIVE DATE ,I tr^,,,, JULY 19, 1982 \7 if T. '� S'..Y' Ci 1 EXPIRES 1/3/<'_A�Jc ; ;._,Q, ' , �. ------- ----- r!j. 1 21 _...._._.-_.i II it Federal Enierency Manage(nent ASenc vtCIL ,t