HomeMy WebLinkAboutBLD2000-00413 Flood Certificate 360-683- •
360-683-5310
s , sp Clark Land Office
V E DFEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM 0.4E37
'M 8 No. 3087.00 7 "
APR 3 COG ELEVATION CERTIFICATE Expires July 31, ZaQ�
Jot; . COUNTY Im•ertant: Read the instructions on pates 1 - 7.
DEPT. SECTION A -PROPERTY OWNER INFORMATION For insurance Company Use:.ING OWNER'S NAME
Fred Wurden Poky Number
i
8U1=DING STREET ADDRESS(Including Apt Unit,Suite,and/or Bldg. No i OR P 0 RCUTE AND BOX NO
131 Dosewa 1 1 i ps Company NAIC Number
CI (
Brinnon STATE ZIP •r,
WPROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number, Legal escnption. �p 98320
D
EiUILDIN US (e.g, estdential, Non•res antral, d ion, Accessory etc. se Com erns
secaon Rpsidnntial ne�ssa .}
LATITLCE/LCNGITUDE(OPTICNAL) HORIZONTAL DATUM: SOURCE:( �°-�'•�.>�' or A4tt.tti�t+#At°} Li NAD 1927 �J NAD 1983 I___!,..".;PS (Type):
IL USGS Quad Map Other:
SECTION 3-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
31 NFP COMMUNITY NAME 3 COMMUNITY NUMBER i 82. COUNTY NAME
TATE
53C069 II Jefferson i 83.s Washington
MAP ANC PANEL I B B6
�. SUFFIX . FIRM INDEX I Washington
NUMBR 87. FIRM PANEL 88.FLOOD ( 89.BASE FLOOD ELEVATION(S)DATE EFFECTIVE/REVISED DATE ZONES) I (Zone AO,use depth of flood rig)
1235 1 B ' 7/19/82 7/19/82 A4 1 •
310. Indicate the source of the Base Flood Elevation (EFE)data or base flood depth entered in 89. 21 .00
I_J FIS Profile t FIRM ; I Cornmurity Determined n
III I I _t, er(Describe):
311. Indicate the elevation datum used for the BFE in 89: al NGVC 1929 iI .NA1'D 1988 jI Other(Describe):
312. Is :he building located in a Coastal Barrier Resources System (CBRS)area or C:herwise Protected Area (OPA)? Li Yes IX I No
Designation Date:
SECTION C -BUILDING ELEVATION INFORMATION (SURVEY RECUIREDI
C 1. Building elevations are based on: JConstruction Drawings' _
'A new Elevation Certificate will be required when construction of the buildingris complete.
g Under nstruction' IXIFinished Construction
02. Building Diagram Number g (Select the building diagram most similar to the building for which this certificate is being completed - see
paces 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.)
03
_: vations-Zones Al-A30, AE,AH,A (with BFE). VE, V1-V3C, V(with BFE;;, AR, AR/A,AR/AE,AR/Al-ASO,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 Jsed for the 8FE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provides or the Comments area of Section D or Section C.as appropriate,to document the datum conversion.
Datum - Conversion/Comments
Elevation reference ce mark used Rh( 2 F, Does the elevation reference mark used appear
J a) Top of bottom floor(including basement or endosu-e) on the FIRM? X I Yes (_! No
J b) Top of next higher floor
22 7 ft.(m) rF�-_ ==__ :._._.;_ ,
J c) Bottom of lowest horizontal structural member!V cones only) —ft(m} "
o) Attached garage(top cf slab) —ft.(m
e) Lowest elevation of machinery and/or equipment t C�` S[
servicing the building 22 . 7 ft.(m) S a 51 i : ` -T -y t
-I ') Lowest adjacent grade(LAG)
g)Highest adjacent grade(HAG) r 2 ;
/
20 . 3 rt.(m) � � iu2s
!0 h) No.of permanent openings(flood vents) within 1 ft.above adjacent grade 18 S 'i%J�._ i
2 i) Total area of all permanent openings(flood vecAs)in C3h 1 , 512
J
sq. in. (sq. cm) � L uliD
SECTION Co-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATI•` _ ' _
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
certify that the information in Sections A, 8, and C on this certificate represents my best efforts to interpret the data available.
understand That anv false statement ma be that false nie bee Qoisl'able bffr e or rrrrnsonmenby fine or rrrlpnsonment under 16 U.S. Code, Section 1001.
tRR�NA
Kenneth A. Clark, PLS 1 ENSF NUMBER
rITLt 1 Z223
Owner/Principal Surveyor Clark L Office
AbORESS
P. Q BOX 21 9 9 CHY sTAT£
NA UR _ Secruim WA 4,382 PDE
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