HomeMy WebLinkAboutBLD2000-00424 Flood Certificate • CLG. vna ..... - —
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
with applicable community floodplain manageme o (LOMA or _CMR).
Use of this certificate does;ct provide a waiver of the fl¢insurance purchase requirement. This form is used only to
ON: to ensure compliance P
j1evation information necessarysupport a request for a Letter of Map Amendment orRevision
it-le the proper insurance tructionsrate, anci/or
forr completing tins form can be found on the iolfowing pages.
to_ FOR INSURANCE CC►dPANy use
SECTION A PROPERTY INFORMATIONPOUC Y NuµSER
• ' BU 1N0 OWNER'S NAME ' . .._
. . 1 i , COMPANY NAiC NuutaER
nd
STREET AOOR SS(tudk 9 Apt..UM.Suit.ands B+dg•Nun O.')OR P.O.ROUTE AND eOX NUMBER
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OTHER oESCRtPTION(to(and Block Numbers.etc.) ZtP CODE
STATE
Ctn.
SECTION B FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
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Provide the following from the proper FIRM (See Instructions): i
a.DATE OF FIRM NOEX S.FIRM ZONE 6.BASE Ftr»n ELE*WPON 1
\ 2.PANEL NU7t8ER 1 SUFFIX {1n AO 2onaf.use ow�M
1.CCI./MUNtTY NU►.teER_S3 o‘ 5 _ pyln 6 A
7. indicate s elevation datnosystem
FE 1s provided on the FIRed on the F1FIM Mor Base, and the Flood munity has establievations(BFE): shed a BFE NGVD for this building site.indicate0 Other(describe on ) o
6. For Zones A or V.where
the community's BFE:.! I t' 1•___I feet NGVO (or other FIRM datum—see Section B,Item 7). No rt,e_
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 bes
describes the subject building's reference level__a_ .
2(a). FiRM Zones Al-A30,AE, AH, and A(with BFE). The top of the reference levet :floor from the selected diagram is at an elevation
ol'. t i I I.• I.!__.) feet NGVD (or other FIRM datum—see Section 8, Item 7).
(b). F..AM Zones V t•'.'30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagra, s at an elevation of 1 1 1 1 1 1.LI feet NGVO (or other FIRM datum-se ton Them 7).
(c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is I`s 1 ! abovetr
below r (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 LL1.LJ feet above r or below 1_1 ;check
one) the highest grade adjacent to the building. it no flood depth number is available,is the building's lowest floor(reference
level) elevated in accordance with the community's floodplain management ordinance? E Yes ❑ Nor Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations. NGVO'29 I,_.i 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 8, 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 marl(used appears on FIRM: ❑ Yes ® No (See Instructions on Page 4)
5.The reference level elevation is based on: r actual construction X 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 certificate will only be valid for the building during the course of construction. A post-construction Elevation Certifica.e
writ be required once construction is complete.)
B. The elevation of the lowest grade Immediately adjacent to the building is:i i 1 1 lkk-,Qj.feet NGVD (or other FIRM datum-tee
Section B,Item 7).
SECTION D COMDIUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C. i:em I
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 I 1 1 I 1.LJ feet NGVO (or other FIRM datum—see Section 8. Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81 31,MAY 93 REP ACES Ail PREVIOUS EDITIONS SEE REVERS+:SC)€FCQ COf f 1NUATICtN
October 1993 r. \vim`;. cFi
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_ SECTION E CEATiF9CATION —~`
V
n is to be signed by a land surveyor, engineer, or architect who la authorized by ste or local law to cartlty o(ove.ion
en the elevation information for Zones Al—A30,AE.AH,A(with BFE),V1430,VE,and V;with 9FE) is required.
ficials who are authorized by loal law or ordinance to provide itoodplain rnanagornent Inlorrratton,my also sign the
n the cane of Zones AO and A(without a FEMA or community issued 8F ),a building offiial, a property owner,or an
sentative may also sign the certification. '
Aolerence fevai diagrams B,7 and 8• Distinguishing Features—If the certifier le unable to dirtily to braakawsyrnon•broakaway wall,
enclosure size,location of servicing equipment, aria use,wall openings,or unfinished area Feature(tr),then list the Features)not
inctuded In the certification under Comments below. The diagram number.Section C,item is a a�� -• : t- :. e.r.
t certify rhAi the information in Sections Et and C on this certificate represents my best a • .,,
understand that any false statement may be punishable by lino or imprisonment under - A s, ..-•:`y.1, •• c; ,
5: is-dillik AV - • ;-
CeATIPIEaSNAME RIIPI NSUR/EYING LICENSE NUM:iiiiii") a,, ��r� '
_— AR NE , R!!P(NFN 1R.T_L_S. • C/ I,b.:::!— ill / —
TITLE 8506 •• 59th AVE. E. COMPANY f1AM6 ,�n,;r: .itial../A-W At tsts
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ACOpizSS �y�1�' �►�ri 'r"��� CtTY �r .� 7. z.e
S1aNATUA ` om '
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Copies should be made of this ertifiaste for: community official,2) insurance agonticomprny, and 3)building owner.
COMMEN'TS: .._. •
,_
0$ WITH ON►ills,
tea a,____NT ►SCR$.02 COLUMNS S}
A V A A
V
ZONIS Lot+et '3 Zoom ZCr,tt9 ZONLL
nv • • fl��• 14"
.1.1"
i �j0 in'T ��.. RVtAIr,�[
jez•tirtit et."-"E....
j.
• 1 • • 1Bti riti ifl to 111 ' or,
KO�o ,axt Mr y ( 71-1A ..* T—
tltvAtvr 1 ).; )6000
if 1t"St r1 jb. flr1i0� `:^+ / ttY1t c•s......
342. u°1
a:
, Y ,
j! Itr tI,'Sr,4a: j,.
,C t';r:'
{k • fir,w.«Nrx
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Flevalions for ell A Zones should be Measured at the ton of the reference level floor.
Elevations for all V Zones should be measured at the bottom of tno iowost horizontal str.icturat mowbrn,,
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