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Home My WebLink AboutFEMA Application 1999-6-2 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ~b9' tJ OM B No 3067-0077 Expires July 31, 2002 ~ J ~ ELEVATION CERTIFICATE Important Read the instructIOns on pages 1 - 7 SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER ~ NAME E.D Z{ ?e~t-ti L'\NN<:l'fC BUILDING STREET ADDRESS (Including Apt, Unit, SUIte, and/or 81dg No) OR P 0 ROUT~ AND BOX NO ~c...Tl no~~ Pl'\~~ C~ SM~ 'S~INC4fI6..o O~ PROPERTY DESCRIPTIONii...oi ami tiiock Numbers, I" ax i="-arcelNumberl~gaf Uescnptfon, eCc j l.o", I":> l.Cvt \--'t-lDI ~ ~ '2.~ ~o~r1i~~ BUILDING llSE' (e g , Residential, Non.resldentlai, Addition, Accessory, etc Use commenis section It necessary ) RE" S I Dl:t"\'II\\- -"--.--. -------~---- ----.- --- . LATITUDE/LONGITUDE (OP IIUNAl) HUKILUN I AL UA I UM SOURCE U GP::; (Type) ( ##0.. ##'.. ## ##. or ## ####If) ~NAD 1927 U NAD 1983 U USGS Quad Map for Illsurance Company Use PoliCy Number Conipan}; NAIC Number ZIP CODE 4'. {.. '1 & U Other - SECTION 8 .. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81 NFIP COMMUNITY NAME & COMMUNITY NUMBER 82 COUNTY NAME "SPR., N.<::; PI C\...!::l 41"$ S ~ 1. l...Ml.E: B4 MAP AND PANEL 85 i;u~ftX 8t; t:iKM iNu~ 81 fiRM I~AN~i... 8ii t:i...OOD NUMBER ..... DATE EFFECTIVElREVISED DATE ZONE(S) ~"C:''9 ~ \\~1 r J..lO-Jl:- ~/l'~" JuNC '2.., \9"Y' Ac B10 IndlC-ate the source of the Base Flood Elevation (BFE) data or base flood depth entered 10 B9 U FIS Profile U FIRM ~Commumty Determined U Other (Descnbe) B 11 Indicate the elevation datum used for the BFE 10 B9 ~GVD 1929 U NA VD 1988 U Other (Descnbe) B12 Is the bUilding located In a Coastal Barner Resources System (CBRS) area or Otherwise Protected Area (OPA)? DeSIgnation Date . B3 STATE o~ . B9 t:lA~~ FLOOD ELEVATION(S) (Zone AO use depth of flooding) 511 'Z. I_I Yes I~No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) "dmg elevations are based on LIConstructlon Drawmgs. Ll8u,ldlng UndcI Construction. LIFlnlshed Construction . A new Elevation Certificate will be required when "',ol1structlon of the building IS complete C2 BUilding Dlagra<'1 ~'l1mber. g . (Select the bulldmg diagram most similar to the bUilding for which thiS certificate IS being completed. see I'ages 6 and 7 If no diagram accurately represents the bUilding, prOVide a skf'tch or photograph) C3 Elevations - Zones A1-A30, AE, AH, A (With BFE), VE, V1-V30, V (With BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, ARlAO Complete Items C3a-1 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 th(~ BFE Show field measurements and datum con>'l."rSlon calculation Use the space prOVided or the Comments area of S.=ctlon 0 (~Sectlon G, as appropnate, to document tl-Je datum conversIon Datum Conversion/Comments Elevation reference mark used Does the E:levatlon reference mark used appear on the FIRM? U Yes ~.,. No o a) Top of bottom floor Qncfudlng basement or enclosure) "S \ 'l.. .:1.... ft (Ill) ~ o b) Top of next higher floor 5l<o ~ ft (m) ~ .. ~LV~':'I'1 ~f I..;'l/~ e~lllonzOntal mrrvl~; a~ 111C::~ I ;lJm\V zones only) _ it (m) ~ ~ -< 00 o d) Attached garage (top of slab) .J \~ ~ ft (m) E-g o e) Lowest elevation of machinery and/or equipment ~ ; servicing the bUilding N I J\ _ ft (m) ~ ~ o f) Lowest adjacent grade (LAG) 'S l4- -L ft (m) ~ 1 o g) Highest adjacent grade (HAG) 'S \ '\- ~ ft (m) ~ C/) o h) No of permanent opemngs (flood vents) Within 1 ft above adjacent grade \ 1.. ~ o I) Total area of all permanent openll1gs (flood vents) In C3h \ ~4-~ sq In (sq em) t~1 REGISTERED PROFESSIONAL ,~~:~.~ . ; <J OREGON i FEB 19, 1999 i . JAMES W. COLTON : " ... #58756 , \. SECTION D .. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 2.x?\~e ~ I '2./'!J1 /0"> ThiS certification IS to be Signed and sealed by a land surveyor, engll1eer, or architect authonzed by law to cer'lfy elevation Information I certify that the mformatlOn In SectIOns A. B, and C on thiS certificate represents my best efforts to Interpret ,he data available I,rnrll'rstand that any false statement may be pUnishable by fine or Impnsonment under 18 U S Code, Section 1001 -cf ER S NAME , . { C LICENSE NUMBER ...JAV\C"::>........ C\..TCN O~ . L:' .... '5~T~'=> TITLE L~D S\l(Z...--J e"'(o~ COMPANY N~RD - N E S~ - "F", ~ :s &SN.DfP- ADDRES~.c::. {3;A>< l.'2.I~'S CITY EuG~c: S~~ ZIPCOD~,~<- SIGNATURE~ l-.. ~ DATE 1/z?,fo1.. TELEPHONE 5+1 ?>"'+ \~St. FEMA Form 81- ,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS r FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM "38b"'l II ( OM B No 3067-0077 Expires July 31, 2002 \ , ELEVATION CERTIFICATE Important Read the instructIOns on pages 1 - ~ SECTION A - PROPERTY,OWNER INFORMATION \' -For Insurance Company Use - Policy Number BUILDING OWNER ~ NAME t.i) Z{ ?e~~ L"NNc.'fC E>UILDING STREET ADDRESS (Includmg Apt, Unit SUI!e and/or Bldg No) OR P 0 ROUTE AND BOX NO ~ c.. '1'1 1"\0 ~ ~ PA, ~ ~ CITY STATE 5fR.INC<f=leLO 01:2... PROPERTY DESCRIPTIONiLO! ana l:llock Numbers "lax fJarcel Number\~~al Uescnplion, e!c) LOI l~ l.C:" \ l-"c-.li)I~ ~ l...I>t"'-- ~c:.~rT\~~ BUILDING USE (e 9 , Resldentlai, Non-residential, Addition, Accessory eic Use C;ommenis section ,f necessary ) R~-;:"D~"'"TI~ ..--.----- -----, _. LA TITUDElLONGITUDE (OPTIONAL) ,'>G HUKILUN I AL DA I UM SOURCE U GPS (l ype) ( ##0 _ ##' _ ## ##' or ## #####j L:.J'NAD 1927 U NAD 1983 U USGS Quad Map COmpany NAIC Number ZIP CUOE 4', ~1& U Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 'I B1 NFIP COMMUNITY NAME & C;UMMLlNITY NUMljl=K ti~ C;UUNIY NAME: -s.pR.IN~f'I~ 41"$ s-; 1.. L.N-.E, B4 MAP AND PANEL 85 SuFFix db FiRM INDEX l:ll t-IRM I-'ANtL titi RUUl)- NUMBER .- DATE EFFECTIVElREVISED DATE ZONE(S} flC~.,C\\<.:.1 r J..N~t,I"""'I""I J\J~ 2.,l9"l' Ae B 1 0 Indicate the source of the Base Flood ElevatIon (BFE) data or base flood depth entered In B9 LI FIS Profile U FIRM ~Communrty Determined U Other (Descnbe) B 11 Indlc3te the elevation datum used for the BFE In B9 !B-NGVD 1929 U NA VD 1988 U Other (Descnbe) B12 Is the bUilding located In a Coastal Bamer Resources System (CBRS) area or OtherwIse Protected Area (OPA)? DeSignation Date ! B3 STATE o~ . ti9 tiAfit: FLOUD EhEVATION(S} (Zone AO. use depth offloodl'lg) Sl\ 1. LIYes I~No SECTION C - BUILDING ,ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building elevations are based on UConstructlon D,awmgs* L_lBulldlng Under Constructlon* LIFlnlshed CO'lstructlon 'A new Elevation Certificate will be reqUired when constructlO'l of the bUilding IS complete C2 BUilding Diagram Number. g (Select the bUilding diagram most ~Imilar to the bUilding tor which this certificate IS belr;\:! (:ompleted _ see pages 6 and 7 If no diagram accurately represents the building, pro,vlde a sketch or photograph) C3 Elevations - Zones A1-A30, AE, AH, A (With BFE), VE, V1-V30. V (With BFE), AR, ARIA, ARlAE, ARlA1-A30. AR/AH, AR/AO Complete Items C3a-1 below according to the building dIagram speCified In Item C2 State the datum used If the datum I~ 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 SnctlOn [) or Section G, as appropnate, to document the datum conversion Datum Conversion/Comments ~- Elevation reference mark used Does th!: elevation reference mark used appear on the FIRM? U Yes ~No o a) Top of bottom floor Oncludlng basement or enclosure)' "5 \ 'l... .:1.- ft (m) iii o b) TOp of next higher floor S l<o .9_ ft (m) ~ f . REGISTERED ", o ....) 00(;0,10 uf luvy",,,, olonzond;1 !:;,;;,;~tu'dl,"c",l:Jer(\i LV118~ 0,';'1) _:t (m) ~ ~ I PROFESSIONAL o d) Attached garage (top of slab) ~ \4- ~ ft (m) ~ ~ I. LAND SUR~OR o e) Lowest elevation of machinery and/or equipment :i ~ ".'{j'. ...,. -.. .0... ...... .. .' _.. servicing the bUIlding N 11\ _ ft (m) E ~, . ,_.~. ~.. .... .u, o f) Lowest adjacent grade (LAG) "S l4- -L ft (m) ~ &> : OREGON . o g) HIghest adjacent grade (HAG) 'S \ 4-' -L ft (m) ~ If): .FES 19, 1999 o h) No of permanent openings (flood vents) Within 1 ft above adjacent grade \ 1.. ~. JAMES #~'7~OlTON o I) Total area of all permanent openings (fiood vents) In C3h \ ~4-& sq In (sq em) " .... , SECTION 0 - SURVEYOR, ENGINEER: OR ARCHITECT CERTIFICATION 2.x.?lltE'S 17./~'! 0) ThiS certificatIon IS to be Signed and sealed by a land surveyor, engmeer, or architect authonzed by law to certIfy elevation mformatlOn I certify that the mformatlOn m SectlOm A. B, and C on thiS cerf1ficate represents my best efforts fO mterpret the data available I understand that any false statement may be pUnishable by fine or Impnsonment under 18 US Code, SectIOn 1001 CERTIFIER'S NAME , . I C LICENSE NUMBER -->At-'lE"::> 'N c\..Tc"-' I o~ . L~. ....' 5~1 '5'=:. TITLE L -.::: ..n,.J r.::.vo~ COMPANY NAME - n..':: a-It. ~o ~U.........." , , ~RD - NE 'S~ - r"" ~ :5~N. c: ADDRESs.. ""'''''''?'''S CITYI_ _ _ STAlE ZIPCODE... .A~..., p. (:. C;A)( I.. "- I J t:..uG c-N c: OK , '--\ ., T'-l '- SIGNATURE~ ~, (' CL- DATE I /2~!C1... TELEPHONE5~\ ~++ \aSz.. FEMA Form 81~ AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPu\CES ALL PREVIOUS EDITIONS