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Home My WebLink AboutFEMA Application 1999-6-2 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important Read the instructions on pages 1 - 7 SECTION A - PROPERTY OWNER INFORMA nON BUILDING OWNER'S NAME Bruce Wlechert Custom Homes BUILDING STREET ADDRESS (Including Apt, Unit, SUite, and/or Bldg No) OR P 0 ROUTE AND BOX NO 931 67th Pl ace CITY STATE Sprlngfleld Ore~on PROPERTY D,f'CRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal DescnptJon, etc) Buk.g',tG ~E (e 9 , ~~I~~ntt~l~o~~~?de~tJ~P AdAd~lg~, ~~~sOry, eic ~~ ~ ~o~~entsS JrJa~~ ~e~I~~) 11 S S ReSldentlal LATITUDElLONGITUDE (OPTIONAL) HORIZONTAL DATUM ( ##0 _ ##' _ ## ##" or ## #t###f') LI NAD 1927 LI NAD 1983 o M B No 3067-0077 Expires July 31, 2002 --For(lnscrranee GOril?an:Wse:: ~}(" ~~J ~b'- ;:p-.....,g'l;-'--o{"":l;:.r~ e""t'~~ ..h-'--~\Ir- ...;!!A.~~ ZIP CODE 97478 I 3..n.~ r.()I)nty ~t Re.cords SOURCE LI GPS (Type) LI USGS Quad Map LI Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION l B1 NFIP COMMUNITY_NAME & COMMUNITY NUMBER B2 COUNTY NAME B3 STATE SDrln~fleld 41559? I ~np- 0~~~r~ B4 MAP AND PANEL B5 SUFFIX B6 FIRM INDEX B7 FIRM PANEL B8-FLOOD B9 BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth aT fiooolng) 41039C1167 F . 6/2/99 6/2/99 512.2 B 1 0 lnd~cate the source of the Base F!ood E!evatlon (8t::E) data or base flood depth e'1tered In 89 I_I FIS Profile I_I FIRM . x1communJty Determined I_I Other (Descnbe) B11 IndIcate the elevation datum used fort1e BFE In B9 I_I NGVD 1929 I_I NAVD 1988 I~ther (Descnbe) B12 Is the bUilding located In a Coastal Barner Resources System (CBRS) area or Otherwise Protected Area (OPA)? DeSignation Date lor:~l LI Yes i~ No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ~ C1 BUilding elevations are based on I-I Construction Drawlngs* I-I BUilding Under Constructlon* 'r.::1!5In1shed Construction *A new Elevation Certificate Will be required when construction of the bUilding IS complete C2 BUilding Diagram Number 2. (Select the bUilding diagram most slmljarto 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, ARIA, ARlAE, ARJA..1-A30, ARJAH, ARJAO Complete Items C3 a-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 BFE 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 0 or Section G, as appropnate, to document the datum conversIon Datum I OCii 1 Conversion/Comments -kbb <9?' --ro LD~ DA='nJW\ TO ~ '\=',E:.M A bA:--\lJI^- Elevation reference ~ark used See Comments Does the elevation reference mark used appea~rft'heFlRM? :r""~:~ o a) Top of bottom floor (including basement or enclosure) ""5 \"'Z- l ft ~ ~ f ~'. -, ~6':,\i, 1, o b) Top of next higher floor 5lS ift(;;f}..~ ~ ~_>'C; ,- ,-,~'->:::;~:-; o c) Bottom of lowest hOrizontal structural member (V zones only) ~ /~ _ ft (m) ~ * <=0..",,,,,"",,,, o d) Attached garage (top of slab) S i 4 ~ ft (lilt) ~ ~ o e) Lowest elevation of machinery and/or eqUipment ~-= serviCing the bUIlding (Descnbe In a Comments area) "5 \ 4 ~ ft (;l;iij ~ ~ o f) Lowest adjacent (finished) grade (LAG) S \ 4- i ft (-) ~ ~ CI) o g) Highest adjacent (finished) grade (HAG) 0:::; 14- .2 ft ~ ~ o h) No of permanent openings (flood vents) wIthin 1 ft above adjacent grade ,'? ~ o I) Total area of all permanent openings (flood vents) In C3 h t'-\-O'1- sq In (~ ~~A~. i~ ;., . -: . : --j" :!! "'-,....~ '- ~ e..' ~ ( .. &.1 I I i'\\); , ,', ' r 'n'"~~ .' ~~..H~~"'.( ~ :. V'Sb ';l~v , -, Ij.. "'- ~"","~...,.-=<-t(,. ~....' ""'""....... ...-...':;;; . E:... '.::~ ~ 6- ~: ~L, SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ThiS certification IS to be signed and sealed by a land surveyor, engineer, or architect authonzed by lawto certify elevatIon information I certify that the mformatlOn m SectIOns A, B, and C on thiS certIficate represents my best efforts to mterpret the data avaIlable 4nderstand that any false statement may be pUnishable by fine or Imprisonment unde.c.!?~~ Code, SectIon 1 001 RTIFIER'S NAME Ll\...cN:::.E NUMBER Jonathan A, Oakes Ore con L. S. #2105 TITLE C.OMPANY .NAM~ - Professlonal Land Surveyor poaqe tnqlneerlnq & SUrVeYlnq. Inc, ADDR~~O, Box 2527 ~ {)fk 'frrgene S6~TE ZIP c~9~02-0152 SIGNATURE ~ ~ (I \ DATE TELEPHONE ~ ' ~ l<O O,? 541/485-4505 FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT In these spaces, copy the correspondmg mformatlon from Section A BUILDING STREET ADDRESS (Including Apt Unit, SUite, anclJor Bldg No) OR P 0 ROUTE AND BOX NO 931 67th Place CIlY Spnngfleld ;~~QAW~n~< G5ffiPanyJ,J~ .:::";;"1:'* ~~e~~2Y:l5l~~\?~f:.!f~ ?':~1ti~<.:-sf~~;~"-~1i~ STATE ZIP CODE Ore~on 97478 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 COMMENTS - Cltv of SDrlnqfleld benchmark d~scrlbed as a chlseled squnrp curb at the mldpolnt of the curb return at the southwest corner of 67th & Thurston Road. Elevatlon 512_81 1n thp tnr of thp the lntersectlon of I_I 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 E1 through E4 If the Elevation Certificate IS Intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed E1 BUilding Diagram Number (Select the bUilding diagram most similar to the bUilding for which thIS certlficate \S bemg completed- see pages 6 and 7 If no diagram accurately represents the bUilding, proVide a sketch or photograph) E2 The top of the bottom floor (mcludmg basement or enclosure) of the bUilding IS 1--1-1 ft (m) 1_1_lm (cm) I-I above or I-I below (check one) the highest adjacent grade (Use natural grade, If available) E3 For BUilding Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the bUlldmg IS 1-1-1 ft ("1) I_i_I'" (cm) above the highest aOJacent grade Complete Items C3 hand C3 Ion front ofform E4 For Zone AO only If no flood depth number IS available, IS the top of the bottom floor elevated In accorda'1ce with the community's _Jl09_~~I~"-I"I!~nagement ordinance? I I Yes I I No I I Unknown The local offiCial must certify thiS mformatlon m Section G SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authonzed representative who completes Sections A, B, C (Items C3 hand C3 I only), and E for Zone A (Without a FEMA-Issued or community-Issued BFE) or Zone AO must Sign here The statements In SectIOns A, a, C, and E are correct to the best of my knowledqe PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME SIGNATURE CIlY DATE STATE TELEPHONE ZIP CODE ADDRESS COMMENTS I_I Check here If attachments , SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local offiCial who IS authonzed by law or ordinance to administer the communrty'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 mformatlon 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 mformatlon (IndIcate the source and date of the elevation data m the Comments area below) G2 I_I 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 I_I The followmg mformatlon (Items G4-G9) IS proVided for community floodplain management purposes G4 PERMIT NUMBER I G5 DATE PERMIT ISSUED I G6 DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7 ThiS permit has been Issued for I-I New Construction 1-1 SubstantIal Improvement G8 Elevation of as-bUilt lowest floor (mcludmg basement) of the bUilding IS G9 BFE or (In Zone AO) depth of flooding at the bUilding site IS LOCAL OFFICIAL'S NAME _ ft (m) Datum _ ft(m) Datum TITLE COMMUNITY- NAME TELEPHONE SIGNATURE DATE COMMENTS . I_I Check here If attachments REPLACES ALL PREVIOUS EDITIONS FEMA Form 81-31, JUL 00