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Home My WebLink AboutFEMA Application 1999-6-2 FEDERAL EMERGENCY MANAGEMENT AGENCY NA TJONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE ) Important' Read the instructions on pages 1 - 7, SECTION A . PROPERTY OWNER INFORMATION BUILDING OWNER S NAME Bruce Wlechert Custom Homes BUILDING STREET ADDRESS (Including Apt, Umt, SUIte, and/or Bldg No) OR P 0 ROUTE AND BOX NO 6777 Moses Pass CITY STATE SQrlOQflpJd . _. ')0 PROPERTY DESCRIPTION (Lot and l:lIocx Numbers, Tax Parcel Number, Legal Descnptlon, ere) LOT 3q I.RV1.lnnrhllil ?ntLAillhtlon Flle-15. c;lHloc: l1S?-ll'1'1 BUILDING USE (e 9 , ReSidential, Non-residential, Addition, Accessory, etc Use Comments section rf necessary) . ReSldentlal . LATITUDElLONGITUDE (OPTIONAL) ( #if - ## . ## ##' or #:II ####If) o M B No 3067-0077 Expires July 31,2002 j"Ej,r IiLsy1fu1Ce~p3fiY)js?" ~:;~-~ ~pL_-~N ----~;~~~~1'~ __~ ~~~~~~r ZIP CODe 97478 I rlnp rnllnty Pl rlt Perrwric: HORIZONTAL DATUM U NAD 1927 U NAD 1983 SOURCE. U GPS (Type) U USGS Quad Map U Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B3 ST.ATE Orponn B4 MAP AND PANEL B5 SUFFIX 86 FIRM INDEX B7 FIRM PANEL B8 FLOOD NUMBER DATE EFFECTIVElREVISED DATE ZONE(S) 41039C1166 F 6/2/99 6/2/99 X B10 Indicate the source of the Base Flood ElevatIon (8FE) data or base flood depth entered In 89 U FIS Profile U FIRM ~j Community DetermIned U Other (Describe) 811 Indicate the elevation datum used for the BFE In 89 l2d'NGVD 1929 U NAVD 1988 U Other (Describe) 812 Js the: bUilding located In a Coastal Barner Resources System (CBRS) area or Otherwise Protected Area (OPA)? ieslgnatJon Date B1 NFIP COMMUNITY NAME & COMMUNITY NUMBER Sprlngfleld 415592 B2 COUNTY MilliE Lane B9 BASE FLOOD ELEVATION(S) (Zone AD, use depth of flooding) S\'Z. ~ UYes tKJ No SECTION C.. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 BUIlding elevatIons are based on UConstructlon Drawlngs* UBUlldlng Under Constructlon* I)9Flnlshed Construction * A new Elevation Certificate Will be required when constructIon of the bUildIng IS com plete C2. BUilding Diagram Number ~ (Select the buIlding diagram most Similar to the bUilding for which thiS certificate IS belng,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 8FE), AR, ARIA, ARlAE, AR/A1-A30, AR/AH, ARJAO 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 m SectIon 8, 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 Sectlon D or SectIon G, as appropriate, to document the datum conversion. Datum Lo[kl.. ConverslonlComJ11ents}d)b O.? \t) lJ::Lkl..- ~jlA 10 F Jr. f'l~. ElevatIon reference mark used ?a Cj)~M.WT? Does the elevatIon refEfrence mark used appear ..~ ~1~.p:!11~~ b#" o a) Top of bottom floor (Including basement or endosure) '3 \4- 'S ft (~\ -- "~F". J'"t.:. ...,'~.'^' a._..""~ ) - J ~ ''-AINu J~H.N".NlS"~'r...Hl o b) Top of next higher floor ~ n ~ ft (m) ~ ' 't' o c) Bottom of lowest hOrizontal structural member 01 zones only) 1-4 / ;... - ft (m) :! ~ ~- , ' - --A ru o d) Attached garage (top of slab) C5 \ S .51.. ft (m) ~ -g \ A A (J - o e) Lowest elevation of machmery andlbr eqUipment ~;; ~-t[,~, .!..1 servlClng the bUlldmg t.) \Cp _0 ft -, ~!! ,-~ -- ,,- ""liGON .:.: -- -J \- E ~ JUlV <:.), t~i o f) Lowest adjacent grade (LAG) CS \ \ '- ~- ft~) ~ ~ rJONATHAN A: OAKES o g) Highest adjacent grade (HAG) "5 \~ -'a... ft.(m)" \;' - ':HOO . I o h) No of permanent opemngs (flood vents) WIthin 1 ft above adjacent grade t to ~"-, . ~/l -'-- o I) Total area of aU permanent openrngs (flood vents) In C3h 20'Z4 sq m {~.} L~ ~ '7 I ? J.XJl-.. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ThIS certification IS to be sIgned and sealed by a land surveyor, engineer, or architect authonzed by law to certify elevabon Information II , that the mformatlon In SectIOns A, B, and C on thIS certIfiCate represents my best efforts to Interpret the data avai18ble. f ur ,uerstand that an} false statemef"7t may be punIshable by fine or ImDnsonment under 18 US Code, SectJon 1001 CERTIFIER'S NAME A 0 k LICENSE NUMBER Jonatnan . a es Orp nnn I c: :It? 1 nJ:; TITLE CQMPANY NAME - ProfeSSlonal Surveyor Poaqe Enqlneenna &. SJ!rVf>V1nCL 1I1C ADDRESS P.O Box 2527~ CIlC;gene S"b'RTE - - Z1P9~04DO~ SIGNATUREj~A-. ~ (€tt9.~ oz.. TELEPHONE 541/485-4505 _ __ _ ___ .... ___ ~._I 1_ r-r""\,~rl""\Prl.'C IMPORTANT In these spaces, copy the corresponding mformatlon from Section A BUILDING STREET ADDRESS (Including Apt, Umt, SUite, and/or Bldg No) OR PO ROUTE AND BOX NO 6777 Moses Pass CITY Spnngfleld . For Insurance Company Use .;.~ f'o)~?'Num.b.er ~ , :.). '" v.. ~!;!~__ ..:t ,~" STATE ZIP CODE ,Q;l!T1P<!nY-",~IC;:.NY'!1~.l<~~""e OR 9747R >-:::\~:';i~~ A?-:~:t::'{;,-~" ~~~ SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) msurance agent/company, and (3) bUlldmg owner COMMENTS CltV of Spr1nafleld benchmark descr1bed as a ch1seled square 1n the too of curb at the mldoo1nt of the curb return At tnf> sou1:hwpc::.t, r.QLnpr n.f....t.hp lnt.prspctlon of filth II. Thurston Road. Cltv datum 512.81 J:.E.M.A di'ltUlll_5.J1 1 Elevations shown have been converted to F.E.M.A. datum '-_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 E 1 BUlldmg Diagram Number (Select the bUlldmg 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) E2 The top of the bottom floor (mcludlng basement or enclosure) of the bUlldmg IS 1_1_1 ft (m) 1_1_110 (cm) I_I above or I_I below (check one) the nlgnest aOjacem graoe (Use natural grade, If available) E3 For BUilding Diagrams 6-8 With openmgs (see page 7), the next higher floor or elevated floor (elevation b) of the bUlldmg IS 1_1_1 ft (m) 1_1_110 (cm) above the highest adjacent grade Complete Items C3 hand C3 Ion front of form E4 For Zone AO only If no flood depth number IS available, IS the top of the bottom floor elevated In accordance With the community's f100dplam manaQement ordinance? '-_I Yes I_I No '-_I Unknown The local offiCial must certify thiS Information In Section G SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authOrized 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, 8, C, and E are correct to the best of mv knowled,qe PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS L-I Check here If attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local offiCial who IS authonzed by law or ordinance to administer the community'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 10 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 Information (IndIcate the source and date of the elevation data In the Comments area below) G2 I_I A community offiCial completed Section E for a building located 10 Zone A (Without a FEMA-Issued or community-Issued BFE) or Zone AO G3 I_I The follOWing information (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 I_I Substantial Improvement G8 Elevation of as-built lowest floor (mcludlng basement) of the bUilding IS G9 BFE or (In Zone AO) depth of flooding at the build 109 site IS LOCAL OFFICIAL'S NAME __ ft (m)Datum _ ft (m)Datum TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS '-_I Check here If attachments I=I=r..AA I=nrm A1_~1 1111 nn RI=PI Arl='::: AI I PRI=\/I011C::: I=nITIONC:::