HomeMy WebLinkAboutFEMA Application 1999-6-2
POAGE ENGINEERING
Fax 541-485-5624
Nov 14 '02
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL. FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
ImS)ortant Read the rnstructlons on DBa.. 1 - 7
SECTION A - PROPERTY OWNER INFORMATION
BUILDING OWNERS NAME
Bruce W,echert Custom Homes
BUILDING STREET ADDRESS (IncludIng Apt , Unit, Suite, and/or Bldg No) OR P 0 ROUTE AND BOX NO
._ 6686 MoS~f> P~"5~__--._..
CITY STATE
SDr11'J9field .-...d' '1q
~l'l.u~eRTY DESCRIPTION (LOl and Block Numbers Tax Paroel Number Legal DescnptlOn, ete)
lot 90 Levi Land~ 2np Addjtinl'\ f:'1..l..e-~~ 'H.cp~ 'J,.52_n~!\
BUilDING USE'e 9 . Residential. No dential, Addition, Accassory, ate Use a "Comments al'8a, if n.....-...ri) ,
Residentlal
-LA. TITUD!;JLONGITUDE (OPTIONAl.)
( #11". ## . ## #If' or #1# ####If)
9 34
P 08-
- 0 M B No 3067-0077
Expires July 31, 2002
- For Insurance Company Use
PoIlC'f Number
'Company NAIC Number
ZIP CODE
9747B
I ane COtl~' 01 ~.~ RecQrdii
HORIZONTAl DATUM
1-1 NAD 1927 1-1 NAD 1983
SQURCI: I_I GPS (Type)
1-1 USGS Quad Map I_I Other
. . . .
SECTION B . FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
..,. .. "
I 81 NFIP COMMUNITY NAME & COMMUNITY NUMBER, I 82 COUN1'Y NAME I 63 STATE
Springfield 415592 Lane nr~
B4 MAP AND PANEL 85 SUFFIX 86 FIRM INDEX 87 FIRM PANEL . ~o r-L.lJw" 0; g#\"l; r'~IoI"'lJ eLEVATION(S} ..
NUMBI::R 'OATE EFFECiIVE/REVISED DArE ZONE{S} (Zone AD. u~ depth of flooding)
41039C1166 F 6/2/99 6/2/99 X 511.1
B10 Indlc;ate the source of the Base Flood Elevation CBFE) <lata or base flood depth entered In 89
I-I FIS Profile I-I FIRM Lxi Community Determined 1__1 Other (DescTlbe)
811 Indlcstethe elevatron datum used for the 8FE In 89 1__1 NGVD 1929 LI NAVD 1988 1...x.1 Other (Oescnbe) ~ 1
812 Is the bUlld!n9located In a Coastal Bamer Resources System (CBRS) area or OtherwIse Protected Area (OPA)? I_I Yes Lx..! No
Des.gnabon Date
SeCTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1 Building elevat.ons are ba&ed on 1_IConstructlot' DraWings. ,'-:IBulldlng Under Construction" lx_IF,"I~hed COnstruction
RA new Elevation Certificate Will be reqUired when constructIOn of the building 18 complete
C2 BUlldmg Diagram Number? (Select the budding 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 A1-A30, AE, AI-!, A (with BFE). VE, V1.V30, V (With BFE) AR. ARIA, ARlAE, ARIA1-A30. ARJAH., ARJAO
Complete Items C3 a-I below accordmg to the bUilding diagram specified In Item C2 Stale the datum used If the datum IS different from
the datum used for the BFE In SeCtlon 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 Sectron G. a5 appropnate, to document the datum conversion
Datum, Local . Conversion/Comments Add 0.3 to local datum to reach _F.E.M.,,~ d~!
ElevaUon refElrence mark used See Comments Does the elevation reference mark used appea~ ,the Ii ~
a a) Top of bottom floor (Ineludlng basement or enclosure) f5l '2. ~ ft ~ ii : ~ ri. ''el'.i~r..
a b) Top of next higher floor ~ \'5 ~_ ft (~ ~ : LAN 8UIWle;yOfJ.
Q c) Bottom of lowest honzDntal structural member (V 20M! only) ~ iA_ -- ft (m) i ~ I, ,., A' ~
a d) Attached garage (top ofslab) S r~ ~ ft (.-) ~ ~ ("" /J _ I
a e) Lowest elevation of machinery and/or equipment ~ :- ~
serviCIng the bUilding (Descnbe In 8 Comments area) "5 ~~ _<2.... ft (a) i ~ . ,. - . ORt.t4i~~'
Cl f) Lowest adjacent (finIshed) grade (LAG) S \? \ ft ~ z j .0.\' 1a,1~ ;
o g) Highest adjacent (finIshed) grade (HAG) CS \ 4 :'2. ft (e) ~ rn '- JONATH#1N.A. O.~ES .~
o h) No of permanent openrngs (flood vents) Within 1 ft above adjacent grade n ~"", ..~~,. ",. , , .,.. "
a I) Total area of all permanent openings (flOOd vents) In C3.h 'Z..'Uo sq In (sq cm) ...-. ~. ~ \ 7...QD7_
- . ~
SECTION D . SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
ThIS certification IS to be signed and sealed by a land surveyor, engineer, or archJIect authOrized by law to certify elevation information
/ cartdy that the mformation In Sections A, B, and C on thiS cortdicate represents my best efforts to mterpret the data avsllable
I understand that any fa/$fJ statement may be pUnishable by fine or Impnsonment under 18 U S Code, Section 1001
CERTIFIERS NAMS Jonathan A, Oakes LICENSE NUMBER
TITLE .
Professlonaa'Land Surveyor
ADDRESS P,O. Box 2527
SIGNATURE --.J~~~
FEMA Form 81-31. JUl 00
COIVIPANV.NAME
Poage
Cfrv
I:.ugene
DATE
\l. 13co~
SEE REVERSE SIDE FOR CONTINUATION
Oregon L.S. #2105
& SurveYlng\. Inc.
ZIP c60E
97402-0152
TELEPHONE
~41l4R5-4sn5
R.EP~CES AL.L. PREVIOUS EDITIONS
Engl neeri n$J
ST&t
POAGE ENGINEERING
Fax 541-485-5624
Nov 14 '02
9 35
P 09
IMPORTANT In these spaces, copy the corresponding Information from Section A
BUilDING STREET ADDRESS (Inc:lvdl"9 Apt. Unit Suite tJ.nd/or BIdS No) OR P 0 ROUTE AND BOX NO
- 6686 Moses Pass
CITY STATE ZlP CODE I ComPany NAlC Number
Spnngfiel d OR 97478 ~
,
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICA nON (CONTINUED)
For Insurance Company U<;e
Policy Number
ADDRESS
CITY
STATE
ZIP CODE
~srGNAiURE
COMMENTS
DATE
TcLEFHONE
I_I Check here If attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
- ."
The local offiCial who IS autt'lonzed by law or ordmance to administer the community's floodplain management ordinance can complete
Sections A. e, C (or E)l'and G_of thiS Elevabon Certificate Complete the applicable Item(s) and Sign below
G1 L-=.J The fnformatfon In Section C was taken from other documentation that has baen sIgned and embossed by a lIcensed surveyor,
engineer, or architect who 15 authonzed by state or focal law to certtfy elevation Informatton (IndIcate the source and date of the
elevation data In the Comments area below)
G2 I_I A communrty offiCIal completed Section E for a bUilding located in Zone A (without i;J FEMA-Issued or communrty-issued BFE) or
Zone AO
<33 I_I The followJng information (Items G4-G9) ,5 prOVided for community floodplam management purposes
G4 FE:RMli NOMeER I G5 DATE PERM" ..:>.:>o...iED I G6 DATE CERTIFICATE OF COMPlIANCefOCCUPANCY
ISSUED
G7 ThIs pemut has been Issued for- I_I New Construction LI Substantial Improvement
<38 Elevation of as-built lowest floor (includIng basement) of the building IS
G9 BFE or (In Zone AO) depth of floodrng at the bUilding site IS
LOCAl OFFICIAL'S NAME
__ ft (m) Datum
_ ft (m) Datum .
TITLE
COMMUNITV NAM~
SIGNATURE
TELEPHONE
--DATE
COMMEN,S
1__1 Check here If attachments
FEMA-FOml81~31, JUL 00
REF?LACES ALL PREVIOUS EDITIONS