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Home My WebLink AboutApplication APPLICANT 10/6/2022iCity of Springfield Development & Public Works 225 Fifth Street Springfield, OR 97477 Floodplain Overlay District Development 6FIELNOD Required Project Information A licant Name: A (Applicant. complete this section) Phone: Com an :S' ,_ / • 17 Email:a� n.., Address: -7a S+- 7 Applicant's Rep.2 I Phone: 3f1. Iv8O, t-1 ZO Company: P A Email: Address Pro er Owner: 44r. Phone: Company: Email: Address: ASSESSOR'S MAP NO: (CIO -SO? -S2 TAX LOT NO S.: I Or✓O Property Address: S o r. OK 17-)q-7-2 Size of Property: ,.Z 2 Acres Q' Square Feet ❑ Zoning: Existing Use: �4a✓vt� Description of If you are filling in this form by hand, please attach your proposal description to this application. Proposal: Signatures: Please sin and print your ,Required Property Information Associated Cases: GW c name and date in the aro riate box on the next ae. (City Intake Staff." complete this section) r CaseNo.: ZZ'i)ao 2L- i Date: 16116Ja7. Reviewed by: rw.' (MAO Application Fee: a==rr Technical Fee: $ kO%A(S_ Postage Fee: $0 TOTAL FEES: $ 2( PROJECT NUMBER: Revised 3/9/22 Sandy Belson 1 of 4 M Signatures The undersigned acknowledges that the information in this application is correct and aaurate. It: Date: / y` �' Z -2— Signature If the applicant is not the owner, the owner hereby grants permission for the applicant to act in his/her behalf. Owner: Date: Signature Print NArK.e.q Tl✓"f—: r`_OR -`•R(— YD /,j' bled ST/c_,c NOME o•c/ a�ao•��/GJy Revised 3/9/22 Sandy Belson 2 of 4 Floodplain Overlay District Development Submittal Requirements Checklist NOTE: If you feel an item does not apply, please state the reason why and attach the explanation to this form. ❑ Application Fee - refer to the Development Code Fee Schedule for the appropriate fee calculation formula. A copy of the fee schedule is available at the Development & Public Works Department and on the city's website. The applicable application, technology, and ostage fees are collected at the time of complete application submittal. L�' loodplain Development Application Form roperty Ownership or Control - a copy of the deed to the property, present lease agreement, or other evidence showing the applicant is exclusive ownership or control of the property, or has consent of all owners to act on their behalf. ❑ Narrative explaining the proposal and any additional information that may have a bearing on the action to be taken, including findings demonstrating compliance with the Floodplain Overlay District Development Standards described in SDC 3.3.430. Three (3) Copies of a Plot Plan drawn to scale to include: ❑ The nature, location, dimensions, and elevations of the development area ❑ Name, location, and dimensions of all existing and proposed structures ❑ Name, location, and dimensions and amount of fill and/or excavations ❑ Name, location, and dimensions of all storage of materials ❑ Name, location, and dimensions of all drainage facilities ❑ Base flood elevation area ❑ Elevation in relation to mean sea level m- ❑ Of the natural grade(s) of the proposed development area (for structures, show elevations at the corners of the proposed structures) prior to excavation or the placement of fill ❑ Of the lowest floor (including basement) of all structures and all attendant utilities of all new and substantially improved structures (in accordance with SDC 3.3.425(C)(2) ❑ To which any structure has been flood -proofed ❑ Other Permits - Copies of required local, state, and federal permits ❑ Floodproofing Certification - Provide certification by a registered professional engineer or architect licensed in the State of Oregon that flood -proofing methods for any non- residential structure meet the flood -proofing criteria for non-residential structures in SDC 3.3.430(B)(3)(c). ❑ Floodway - Certification by a registered professional engineer demonstrating through hydrologic and hydraulic analyses performed in accordance with standard engineering practice that proposed encroachment(s) will not result in any increase in flood levels within the community during the occurrence of the base flood discharge (unless a CLOMR is approved by FEMA). ❑ Watercourse - Description of the extent to which any watercourse will be altered or relocated. ❑ Base Flood Elevation data for subdivision proposals or other development when required per SDC 3.3.425(C)(1) and SDC 3.3.430(A)(7) ❑ Substantial Improvement Calculation for any improvement, addition, reconstruction, renovation, or rehabilitation of an existing structure Revised 3/9/22 Sandy Belson 4 of Floodplain Overlay District Development Application Process 1. Applicant Submits a Floodplain Overlay District Development Application to the Development & Public Works Department The application must conform to the Floodplain Overlay District Development Submittal Requirements Checklist on page 4 of this application packet. Planning Division staff screen the submittal at the front counter to determine whether all required items listed in the Floodplain Overlay District Development Submittal Requirements Checklist have been submitted. Applications missing required items will not be accepted for submittal 2. City Staff Conduct Detailed Completeness Check • Planning staff conduct a detailed completeness check within 30 days of submittal. • The assigned Planner notifies the applicant in writing regarding the completeness of the application. • An application is not deemed complete until all information as required by SDC 3.3.435(8), including all information necessary to evaluate the proposed development, its impacts, and its compliance with the provisions of the Springfield Development Code and other applicable codes and statutes have been provided. • Incomplete applications, as well as insufficient or unclear data, will delay the application review process and may result in denial. 3. City Staff Review the Application and Issue a Decision Floodplain development approval is a Type I decision and thus is made without public notice and without a public hearing since there are clear and objective approval criteria and/or development standards that do not require the use of discretion. Decisions address all the applicable approval criteria and/or development standards. • Applications may be approved, approved with conditions, or denied based on the findings of fact showing compliance/non-compliance with the floodplain development standards in SDC 3.3.430. • The City mails the applicant and any party of standing a copy of the decision, which is effective on the day it is mailed. • The decision issued is the final decision of the City and may not be appealed. 4. Next Steps • Approval of a. floodplain development permit is required before construction or development begins within any area of special Flood hazard established in SDC 3.3.420(8). Upon placement of the lowest floor of a structure (including basement) but prior to further vertical construction, applicant must obtain documentation, prepared and sealed by a professional licensed surveyor or engineer, certifying the elevation (in relation to mean sea level) of the lowest floor (including basement). Where base flood elevation data are utilized, the applicant must obtain As -built certification of the elevation (in relation to mean sea level) of the lowest floor (including basement) prepared and sealed by a professional licensed surveyor or engineer, prior to the final inspection. Revised 3/9/22 Sandy Belson 3 of U.S. DEPARTMENT OF HOMELAND SECURITY OMB N 1660-0008 Federal Emergency Management Agency National Flood Insurance Program Expiratioo. n Date: November 30, 2022 ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owners Name Policy Number: Aaron & Stephanie Bolkan A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 1560 Harbor Drive City State ZIP Code Springfield Oregon 97477 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Tax Map 18-03-02-32 Taxlot 1000 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 44.031455 Long. -123.023461 Horizontal Datum: ❑ NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 0 A8. For a building with a crawispace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 0.00 sq It b) Number of permanent flood openings in the crawlspace or enclosures) within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0.00 sq in d) Engineerediflood openings? ❑ Yes 0 No A9. For a building with an attached garage: a) Square footage of attached garage 0.00 sq It b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of floodopenings in A9.b 0.00 sq in d) Engineered flood openings? ❑ Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State Lane County 415591 Lane Oregon B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective! Zone(s) (Zone AO, use Base Flood Depth) Revised Date 41039C F 06-02-1999 06-02-1999 AE 447.0 B10. Indicate the source of the Base Flood Elevation SFE) data or base flood depth entered in Item 139: 0 FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: Bl 1. Indicate elevation datum used for BFE in Item B9: x❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area DPA)? ❑ Yes 0 No Designation Date: ❑ CBRS ❑ OPA FEMA Farm 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 . IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1560 Harbor Drive City State ZIP Code Company NAIC Number Springfield Oregon 97477 SECTION C —BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑x Construction Drawings* ❑ Building Under Construction' ❑ Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, Al AH, A (with BFE), VE, V1—V30, V (with BFE), AR, ARIA, ARAE, Al Al ARlAD. Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. Benchmark Utilized: CITY OF SPRINGFIELD By # 485 Vertical Datum: NGV029 Indicate elevation datum used for the elevations in items a) through h) below. x❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) N/A ❑ feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet ❑ meters J) Attached garage (top of slab) N/A ❑ feet ❑ meters a) Lowest elevation of machinery or equipment servicing the building N/A ❑ feet ❑ meters (Describe type of equipment and location in Comments) D Lowest adjacent (finished) grade next to building (LAG) 445.6 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 446.1 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/Afeet meters ❑ ❑ structural support SECTION 0 — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that theinformation on this Certificate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes x❑ No ❑ Check here if attachments. Certifiers Name License Number Brent W. Coming LS 89960 REGISTERED PROFESSIONAL Title Professional Land Surveyor MND SURVEYOR DIGITALLY SIGNED Company Name EGR & Associates, Inc. OREGON Address 2535 B Prairie Road MARCH 8, 2022 BRENT W. CORNING 88880 City State ZIP Code Eugene Oregon 97402 RENEWS: 12/31/27 Signature Date Telephone Uypryt LV. L� 04/11/2022 (541)688-8322 Ext. Copy all pages of this Elevation Certificate a d all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) This is a pre -certification for a proposed single family dwelling. FEMA Farm 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1560 Harbor Drive City State ZIP Code Company NAIC Number Springfield Oregon 97477 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items El -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropnale boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.1b in the diagrams) of the building is ❑ feel ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ 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, and E for Zone A (without a FEMA -issued or oommumty-issued BFE) or Zone AO must sign here. The statements in Sections A, S, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone's Comments ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1560 Harbor Drive City State ZIP Code Company NAIC Number Springfield Oregon 97477 SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized 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. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued SFE) or Zone AO. G3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes. 34. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) ❑ feet ❑ meters of the building: Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum Gig. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1560 Harbor Drive City State ZIP Code Company NAIC Number Springfield Oregon 97477 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section AB. If submitting more photographs than will ft on this page, use the Continuation Page. Photo One Phom Ona Photo One Caption Front View -,2020 Clear Photo One Photo Two I.., Photo Two Caption Rear View -,2020 Clear Photo Two FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1560 Harbor Drive City State ZIP Code Company NAIC Number Springfield Oregon 97477 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front VIeW' and "Rear View`, and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo Three Fhum Three Photo Three Caption Clear Photo Three Photo Four Phot Four Photo Four Caption Clear Photo Four FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 ��^nAV,41'o h Vik 6-,'M ot's+s (II du 6,�5 kz! TT 4f4+-rl 9k 'q!1 �I 931 3® G 3,61 10 r;; caf6-3