HomeMy WebLinkAboutBLD2006-00361 -Flood Certificate r 05/13/2000 18: 53 360-374_Iv DAN KOUSBAUGH SURVEY PAGE 01
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FEDERAL EMERGENCY MANAGEMENT AGENCY, O.M.B-. Na:-3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION CERTIFICATE "'"d 7 :
Important: Read the Instructions on pages 1 -7.
SECTION A-PROPERTY OWNER INFORMATION For] IInnsurancce Company Use:
BUILDING OWNER'S NAME i 4 7 �iT'i6'f'41 rfl
Sue Zalokar
BUILDING STREET ADDRESS(Including Apt,Unit,Suite,and/or Bldg.No. OR P.Q.ROUTE AND BOX NO- y
3020 Waver/ei,h Blvd. #3 ) Company NAIL Number
Cl Oregon 97„]UP CODE
rtl and L(fL
PROPERTY DESCRIPTION(Lot and ioc1t numbers,Tax Parcel Number,Legal Description,etc.)
�4�2b1`i. R1241. W.M Jeff rson C ,n v off Oil City J o i 6 IXb3_
BUIDING USE(e.g., esdenHa, onlQ -re Thal,Addri$on,Accessory,e . seComments section if necessary
Res19kntial
LATMU entiaiITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: LI CPS(Type):_
( ##°-##'-tt#.##' or ii4CVOW) LI NAD 192T Lk] NAD 1983 L_1 USGS Quad M
ap LI omen NA-t-a-TYQrtioal
SECTION 8•FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NEill COMMUNITY NAME&COMMUNITY NUMAEI2 B2.COUNTY NAME B3.STATE
530069 575 df 1625/.i `,', � - Jefferson Washi ngton
134.MAP AND PANEL es.SUFFIX 86-FIRM INDEX $T.FIRM PANEL B8.FLOOb 99.BASE FLOOD ELEVATION(S)
NUMBER DATE EFFECTIVE/REVISED VISED DATE ZONES) (Zone AO,use depth of flooding)
53(Th9 0575 , B 7/19/82 7/19/82 A Plot established
810.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
1__1 FIS Profile 1_1 FIRM LI Community Determined 1,1 Other(Describe):
B11. Indicate the elevation datum used for the BFE in B9:t-_I NGVD 1929 I A I NAVD 1988 L:I Other(Describe): _
B 12.Is the building located In a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)7 1 I Yes ICI No
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl.Building elevations are based on: (_IConetruction Drawings' I__IBullding Under Construction` 1-1Flnished Construction
`A new Elevation Certificate will be required when construction of the building Is complete.
C2.Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed-see
pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.)
C3. Elevations-Zones AI-A30, AE,AH,A(with BFE),VE,V1-V30, V(with BFE),AR,AR/A,AR/AE,ARJA1-A30,AR/AH,AR/AO
Complete Items C3a-i below according to the building diagram specified In item C2.State the datum used,if the datum is different from
the datum used for the BEE In Section 8,convert the datum to that used for the BFE.Show field measurements end datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G.as appropriate,to document the datum conversion.
Datum NAVD 88_ Converslorl/Comments Pone
Elevation reference mark used Y473-1974 _Does the elevation reference mark used appear No
❑ a)Top of bottom floor(Including basement or enclosure) ___ __ _ft. m r `
❑ b)Top of next higher floor ______ J _tt.(m) 11(DUSQq
❑ c)Bottom of lowest horizontal structural member(V zone$only) _______ ft,(m) ;o • e0*• wA ,' `G0
•
❑ d)Attached garage(top of slab) __ _ft, m D 4 `�' �'• -
.e)Lowest elevation of machinery and/or equipment TM�� ( ) `� f •,►/ ;
w ►. 1
servicing the building 2 ro ' r,
Q f)Lowest adjacent grade(LAG) R(m) s 2 •
I , ,• *' �O
____ft.(m) z S ► • VI•.r 49 O g)Highest adjacent grade(HAG) _-_ft(m) r ( 54, �0/8TS.�
❑ h)No.of ' - ✓' Q
permanent openings(flood vents)within 1 ft.above adjacent grade_ � � O�+IL LAN'0t'
❑ I)Total area of all permanent openings(flood vents)In C3h sq.In.(sq.cm) '
•
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATIO'," ,:' ' " ,"""."
This certification Is to be signed and sealed by a lend 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.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001.
CERTIFIER'S NAME L1 N$ �aER
.7f Lin P Kcal rsbaugh__ Ku 11l l'i i
AteCOMPANY NAME
4P E e+�r flan Knt�shat ph�ilrveying, Inc..Ind.. P.Sei_ -rATE i DE
race Drive Fores Washington
W 3
' S 1,1 ( ° 5120
FFMA Form Al-Z1 Al I(;Aim SFF R FRSF SIDF FOR('.ONTINI IATICN RFPI ACFS Al I PRFVIOI is FrITIONS
, • 05/13/2000 18: 53 360-374-co DAN KOUSBAUGH SURV� PAGE 02
IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
BUILDING StT ET ADDRESS(Including Apt.,link,suite,-and/or Bldg.No.)OR P.O.ROUTE AND g)X NO. Policy Number
�3Y020 Waverleigh Blvd. #3
C Portland and Oregon TE 97 IP CODE Company NAIL Numt er
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.
eve not been established for this area. See attachments for further details. Site is part of an old
huitestead grass field which has never flooded. There is an approved_septic system further south of this
parcel and closer to the river but built-on tie same field. Elevations_have been taken to_the recent floe
of December 15, 1999. ( X 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 El through E4. If the Elevation Certificate is intended for use es supporting
information for a LOMA or LOMR-F,Section C must be completed,
El.Building Diagram Number_6 (Select the building diagram most similar to the building for which this eortificato is being completed-
see pages 6 and 7. If no diagram accurately represents the building,pmvlde a sketch or photograph.)
E2.The top of the bottom floor(Including basement or enclosure)of the building Is f 1 I ft.(q _I__f in_(cm) I X I above or I�i 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)5 I ft.})I—I—fin.(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?L_,I Yes LI No LI Unknown. The local official must certify this rrrag8pn ih Section i1 •
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFIC'A 10N. '
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- 1
yy�p Icy�� a�t ? 17 2r.►L5
P Y RTYow $198l1 OWNER'S AUTHORIZED REPRESENTATIVE'S NAV1 -
ADDRE5S Qrive ForksC Washi ton 983317 p i i�i /
SIGNATIJE2 5��1/La10 (3 T 572(1{T4 i�5 t,UU1�1 ( ijGL?
DATE TELEPHONE
LAMENT S
lnform3tion is supplied for taint building_Derinit and sep is rmit 9 gra,1 _
selection is best estimate at this time. _ L-,,XI 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_I_I 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. II 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 G4-09)Is provided for community floodplain management purposes.
G4 PERMIT NUMBER" GrbATE PERfArTTSSUEr G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY-1
ISSUED
G7.This permit has been issued for: I _I New Construction If Substantial Improvement
GB.Elevation of es-built lowest floor(including basement)of the building is: tt.(m)Datum:
G9.BFE or(in Zone AO)depth of flooding st the building site is: _ R.(m)Datum:
AL TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS - --
I__j Check here if attachments
FFMA Form Al-31.Al in AA RFPI ACFS Al I PRFVI011S FreTIC)Ns
05/13/2000 18: 53 360 374 JODAN KOUSBAUGH SURVEY PAGE 03
•
May 11, 2000
Elevations established for Zalokar Parcel
Assessor's#612042003
DATUM: NGS-Y 473 (1974) Elev. 186.95 feet
Elevations at potential building site:
On grass at base of well head 153.78 feet
In field 100 feet west of well head 152.65 feet
In area of potential drain field-100 feet north & east of well 154.42 feet
50 feet north & 100 feet east of well 153.99 feet
25 feet north & 100 feet east of well 154.39 feet
30 feet south & 100 feet east of well 154.19 feet
TBM' 12" spike driven into the top of an 18" alder stump 155.91 feet
Elevations at River: -
On field grass at edge of bank erosion 151.60 feet
(This point is about 900 feet south of potential building site)
High water mark right bank of Hob River on 12/15/99 flood 147.90 feet
From the grass at the edge of the bank erosion it is 115 feet to the right bank of the Hob
River across a gravel bar(5/6/2000). It is a 6 foot drop from the point shot as the high
water mark from the December flood to the gravel bar. The land directly south of the grass
edge of the bank erosion and across the river is at least 4 to 5 feet lower in elevation and
would be flooded before any water would reach the field. The field has been established
for many years and to my knowledge and that of the nearby property owners has never
been flooded. There is an approved septic system in this field about 200 feet from the
eroded vertical right bank of the Rob 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 of the proposed Zalokar project. Elevations note_ below,,
I LI�C_ E % E lf � D
Elevations at permitted septic system in field:
On top of septic tank in the center JUN 2 7 20�6 152.66 feet
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 'EVEERSON COUNTY DC11151'53 feet
Southeast corner of drain field on grass 152.38 feet
Southwest corner of drain field on grass ,,... ,,,,,,,,,,, , 151.70 feet
Northwest corner of drain field on grass , %(.008,0p 151.75 feet
NS'Dan P. Kousbaugh 0 1.
1tLS !#11983 , t $
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S FolBTEA.' Q.
s%NAB LM
EXPIRES 1/3/P/rz
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.0". To determine od insurance is ava eilNationalable in this community,
ro .
contact your ' ce agent,or call th Flood Insurance
/i 7' ,i 33 Program,at (800) 638-6620.
/ 1121 !V
APPROXIMATE SCALE If T. 27 N. 2000 0
2000 FEET
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11 , a till
11144
II A '1 4 r , friAL FLOOD INSURANCE PROGRAM
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FIRM
FLOOD INSURANCE RATE MAP
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JEFFERSON COUNTY,
WASHINGTON
(UNINCORPORATED AREAS)
9
t PEnmiTTED storm sVS rem
PANEL 575 OF 1625
p Pmoposao sePric. 3 Vsrem (SEE MAP INDEX FOR PANELS NOT PRINTED)
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JUN 2 7 Ztiurii
l jfiERSOft CRINTY E1CO
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COMMUNITY-PANEL NUMBER
Y A1.41 A , 4
i-,..„.....,,J.:... 530069 0515 B
EFFECTIVE DATE:
JULY 19, 1982
2 1
Federal Emergency Management Agency
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