HomeMy WebLinkAboutNotes Applicant 9/16/2024U.S. DEPARTMENT OF HOMELAND SECURITY OMB Control No. 1660-0008
Federal Emergency Management Agency Expiration Date: 06/30/2026
National Flood Insurance Program
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
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 Owner's Name: Jordan Vesper and Rachael Love Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: Company NAIC Number:
2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97477
A3. Property Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number:
Map/Tax Lot Number: 17-03-24-00-00104
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.): Residential
A5. Latitude/Longitude: Lat. 44.07642 Long. -122.98862 Horiz. Datum: ❑ NAD 1927 ❑ NAD 1983 ® WGS 84
A6. Attach at least two and when possible four clear color photographs (one for each side) of the building (see Form pages 7 and 8).
A7. Building Diagram Number: 6
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s): 1700 sq. ft.
b) Is there at least one permanent flood opening on two different sides of each enclosed area? ® Yes ❑ No ❑ N/A
c) Enter number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade:
Non -engineered flood openings: 0 Engineered flood openings: 10
d) Total net open area of non -engineered flood openings in A8.c: 0 sq. in.
e) Total rated area of engineered flood openings in A8.c (attach documentation - see Instructions): 3.54 sq. ft.
f) Sum of A8.d and A8.e rated area (if applicable - see Instructions): 3.54 sq. ft.
A9. For a building with an attached garage:
a) Square footage of attached garage: sq. ft.
b) Is there at least one permanent flood opening on two different sides of the attached garage? ❑ Yes ❑ No ❑ N/A
c) Enter number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade:
Non -engineered flood openings: Engineered flood openings:
d) Total net open area of non -engineered flood openings in A9.c: sq. in.
e) Total rated area of engineered flood openings in A9.c (attach documentation - see Instructions): sq. ft.
f) Sum of A9.d and A9.e rated area (if applicable - see Instructions): sq. ft.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1.a. NFIP Community Name: Springfield, City of Lane County B1.b. NFIP Community Identification Number: 415591
B2. County Name: Lane B3. State: OR B4. Map/Panel No.: 41039C1153 B5. Suffix: F
B6. FIRM Index Date: 06/02/1999 B7. FIRM Panel Effective/Revised Date: 06/02/1999
B8. Flood Zone(s): AE B9. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Depth): 454.4
B10. Indicate the source of the BFE data or Base Flood Depth entered in Item 139:
❑ FIS ® FIRM ❑ Community Determined ❑ Other:
B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
B13. Is the building located seaward of the Limit of Moderate Wave Action (LiMWA)? ❑ Yes ® No
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 2 of 8
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
FOR INSURANCE COMPANY USE
Policy Number:
2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97477
Company NAIC Number:
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ 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, AE, AH, AO, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO,
A99. Complete Items C2.a—h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: 177 Vertical Datum: NAVD88
Indicate elevation datum used for the elevations in items a) through h) below.
® NGVD 1929 ❑ NAVD 1988 ❑ Other:
Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? ® Yes ❑ No
If Yes, describe the source of the conversion factor in the Section D Comments area.
Check the measurement used:
a) Top of bottom floor (including basement, crawlspace, or enclosure floor): 450.69 ® feet ❑ meters
b) Top of the next higher floor (see Instructions): 455.53 ® feet ❑ meters
c) Bottom of the lowest horizontal structural member (see Instructions): 454.36 ® feet ❑ meters
d) Attached garage (top of slab): N/A ❑ feet ❑ meters
e) Lowest elevation of Machinery and Equipment (M&E) servicing the building
(describe type of M&E and location in Section D Comments area): 455.53 ® feet ❑ meters
f) Lowest Adjacent Grade (LAG) next to building: ® Natural Finished 451.41 ® feet ❑ meters
g) Highest Adjacent Grade (HAG) next to building: ® Natural Finished 451.98 ® feet ❑ meters
h) Finished LAG at lowest elevation of attached deck or stairs, including structural
support: 451.41 ® feet ❑ meters
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to certify elevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I 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 ® No
® Check here if attachments and describe in the Comments area.
Certifier's Name: Jordan Vesper License Number: 92053PE t�, S'S
Title: Civil Engineer
Company Name: N/A
Address: 35608 Camp Creek Rd R 01
City: Springfield State: OR ZIP Code: 97478 90
Telephone: (503) 881-5,,,789 Ext.: Email: jordan.m.vesper@gmail.com
Signature: Date: ) Date: 09/06/2024
Copy all pages o this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including source of conversion factor in C2; type of equipment and location per C2.e; and description of any attachments):
Machinery and Equipment will be located in the utility room at the same elevation as the "Top of the next higher floor".
Attachments for the engineered flood openings are included, construction plans call for the use of Smart Vent #1540-510.
Conversion factor used to convert NAVD88 to NGVD29 was found at the following website provided by City of Springfield
City Surveyor: vdatum.noaa.gov
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 3 of 8
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
FOR INSURANCE COMPANY USE
Policy Number:
2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97477
Company NAIC Number:
SECTION E — BUILDING MEASUREMENT INFORMATION (SURVEY NOT REQUIRED)
FOR ZONE AO, ZONE AR/AO, AND ZONE A (WITHOUT BFE)
For Zones AO, AR/AO, and A (without BFE), complete Items E1—E5. For Items E1—E4, use natural grade, if available. If the Certificate is
intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rico only,
enter meters.
Building measurements are based on: ❑ Construction Drawings* ® Building Under Construction' ❑ Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
E1. Provide measurements (C.2.a in applicable Building Diagram) for the following and check the appropriate boxes to show whether the
measurement is above or below the natural HAG and the LAG.
a) Top of bottom floor (including basement,
crawlspace, or enclosure) is: 450.69 ® feet ❑ meters ❑ above or ® below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is: 450.69 ® 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 (C2.b in applicable
Building Diagram) of the building is: 455.53 ® feet ❑ meters ® above or ❑ below the HAG.
E3. Attached garage (top of slab) is: N/A ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is: 455.53 ® 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 AUTHORIZED REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must
sign here. The statements in Sections A, B, and E are correct to the best of my knowledge
❑ Check here if attachments and describe in the Comments area.
Property Owner or Owner's Authorized Representative Name: Rachael Love and Jordan Vesper
Address: 2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97404
Telephone: (541) 521-8170 Ext.: Email: rachael.love07@gmail.com or jordan.m.vesper@gmail.com
Signature: -�,v�� Date: 09/06/2024
Comments:
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 4 of 8
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
FOR INSURANCE COMPANY USE
Policy Number:
2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97477
Company NAIC Number:
SECTION G - COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL. COMPLETION)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item(s) and sign below when:
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 state law to certify elevation information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item
E5 is completed for a building located in Zone AO.
G2.b. ❑ A local official completed Section H for insurance purposes.
G3. ❑ In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H.
G4. ❑ The following information (Items G5—G11) is provided for community floodplain management purposes.
G5. Permit Number: G6. Date Permit Issued:
G7. Date Certificate of Compliance/Occupancy Issued:
G8. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G9.a. Elevation of as -built lowest floor (including basement) of the
building: ❑ feet ❑ meters Datum:
G9.b. Elevation of bottom of as -built lowest horizontal structural
member: ❑ feet ❑ meters Datum:
G10.a. BFE (or depth in Zone AO) of flooding at the building site: ❑ feet ❑ meters Datum:
G10.b. Community's minimum elevation (or depth in Zone AO)
requirement for the lowest floor or lowest horizontal structural
member: ❑ feet ❑ meters Datum:
G11. Variance issued? ❑ Yes ❑ No If yes, attach documentation and describe in the Comments area.
The local official who provides information in Section G must sign here. 1 have completed the information in Section G and certify that it is
correct to the best of my knowledge. If applicable, 1 have also provided specific corrections in the Comments area of this section.
Local Official's Name: Title:
NFIP Community Name:
Telephone: Ext.: Email:
Address:
City: State: ZIP Code:
Signature: Date:
Comments (including type of equipment and location, per C2.e; description of any attachments; and corrections to specific information in
Sections A, B, D, E, or H):
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 5 of 8
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:
FOR INSURANCE COMPANY USE
Policy Number:
2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97477
Company NAIC Number:
SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES
(SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY)
The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones
to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the
nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H
Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section.
H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG):
a) For Building Diagrams 1A, 1B, 3, and 5-8. Top of bottom 454.24 ® feet ❑ meters ® above the LAG
floor (include above -grade floors only for buildings with
crawlspaces or enclosure floors) is:
b) For Building Diagrams 2A, 2B, 4, and 6-9. Top of next 455.53 ® feet ❑ meters ® above the LAG
higher floor (i.e., the floor above basement, crawlspace, or
enclosure floor) is:
H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the
H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram?
® Yes ❑ No
SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections
A, B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should
indicate in Item G2.b and sign Section G.
® Check here if attachments are provided (including required photos) and describe each attachment in the Comments area.
Property Owner or Owner's Authorized Representative Name: Rachael Love or Jordan Vesper
Address: 2640 Hayden Bridge Rd
City: Springfield State: OR ZIP Code: 97477
Telephone: (503) 881-5789 Ext.: Email: rachael.love07@gmaii.com or jordan.m.vesper@gmail.com
Signature:( Date: 09/06/2024
Comments:
Required photos will be submitted after construction.
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 6 of 8
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
BUILDING PHOTOGRAPHS
See Instructions for Item A6.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE
2640 Hayden Bridge Rd
Policy Number:
City: Springfield State: OR ZIP Code: 97477
Company NAIC Number:
Instructions: Insert below at least two and when possible four photographs showing each side of the building (for example, may only be
able to take front and back pictures of townhouses/rowhouses). Identify all photographs with the date taken and "Front View," 'Rear View,"
"Right Side View," or "Left Side View." Photographs must show the foundation. When flood openings are present, include at least one
close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9.
Photo One
Photo One Caption:
Clear Photo One
Photo Two
Photo Two Caption: Clear Photo Two
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 7 of 8
ELEVATION CERTIFICATE
IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON INSTRUCTION PAGES 1-11
BUILDING PHOTOGRAPHS
Continuation Page
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE
2640 Hayden Bridge Rd
Policy Number:
City: Springfield State: OR ZIP Code: 97477
Company NAIC Number:
Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," 'Right Side
View," or "Left Side View." When flood openings are present, include at least one close-up photograph of representative flood openings or
vents, as indicated in Sections A8 and A9.
Photo Three
Photo Three Caption:
Clear Photo Three
Photo Four
Photo Four Caption: Clear Photo Four
FEMA Form FF -206 -FY -22-152 (formerly 086-0-33) (8/23) Form Page 8 of 8
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M
ELEVATION REFERENCE MARKS
REFERENCE ELEVATION
MARK (FEET NGVD) DESCRIPTION OF LOCATION
RM355 509.06 A CH2M HILL railroad spike set 0.7
foot above ground in the south side
of power pole No. 191980 line 1702
designated GAK-9, located 6.1
miles east along McKenzie View Road
from its intersection with Coburg
Road.
123000'00"
44005'37"
v
m
w
CL
V)
Z
O
44003'45"
123000'00"
M
JOINS PANEL 1155
I
I
N
122°58'07"
0 '
440537"
JOINS PANEL 1161
477
44003'45"
122°58'07"
;•t �- '< SPECIAL FLOOD HAZARD AREAS INUNDATED
BY 100 -YEAR FLOOD
ZONE A No base flood elevations determined.
ZONE AE Base flood elevations determined.
ZONE AH Flood depths of 1 to 3 feet (usually areas
of ponding); base flood elevations
determined.
ZONE AO Flood depths of 1 to 3 feet (usually sheet
flow on sloping terrain); average depths
determined. For areas of alluvial fan flooding,
velocities also determined.
ZONE A99 To be protected from 100 year flood by
Federal flood protection system under
construction ; no base flood elevations
determined.
ZONE V Coastal flood with velocity hazard (wave
action); no base flood elevations determined.
ZONE VE Coastal flood with velocity hazard (wave
action); base flood elevations determined.
FLOODWAY AREAS IN ZONE AE
OTHER FLOOD AREAS
ZONE X Areas of 500 -year flood; areas of 100 -year
flood with average depths of less than
1 foot or with drainage areas less than
1 square mile; and areas protected by
levees from 100 -year flood.
OTHER AREAS
ZONE X Areas determined to be outside 500 -year
floodplain.
ZONE D Areas in which flood hazards are
undetermined.
C\ UNDEVELOPED COASTAL BARRIERS
identified Identified Otherwise
1983 1990 Protected Areas
Coastal barrier areas are normally located within or adjacent to Special
Flood Hazard Areas.
Floodplain Boundary
Floodway Boundary
Zone D Boundary
10 { Boundary Dividing Special Flood
Hazard Zones, and Boundary
1����� Dividing Areas of Different
Coastal Base Flood Elevations
Within Special Flood Hazard
Zones.
Base Flood Elevation Line;
513 Elevation in Feet. See Map Index
for Elevation Datum.
Cross Section Line
Base Flood Elevation in Feet
(EL 987) Where Uniform Within Zone.
See Map Index for Elevation Datum.
RM7 X Elevation Reference Mark
0 M2 River Mile
Horizontal Coordinates Based on North
97007'30", 32022'30" American Datum of 1927 (NAD 27)
Projection.
NOTES
This map is for use in administering the National Flood Insurance Program;
it does not necessarily identify all areas subject to flooding, particularly from
local drainage sources of small size, or all planimetric features outside
Special Flood Hazard Areas. The community map repository should be
consulted for more detailed data on 8FE's, and for any information on
floodway delineations, prior to use of this map for property purchase or
construction purposes.
Areas of Special Flood Hazard (100 -year flood) include Zones A, AE, A7 -
A30, AH, AO, A99, V, VE and V1 -V30.
Certain areas not in Special Flood Hazard Areas may be protected by
flood control structures.
Boundaries of the floodways were computed at cross sections and
interpolated between cross sections. The floodways were based on
hydraulic considerations with regard to requirements of the Federal
Emergency Management Agency.
Floodway widths in some areas may be too narrow to show to scale. Refer
to Floodway Data Table where floodway width is shown at 120 inch.
Coastal base flood elevations apply only landward of 0.0 NGVD, and include
the effects of wave action; these elevations may also differ significantly
from those developed by the National Weather Service for hurricane
evacuation planning.
Corporate limits shown are current as of the date of this map. The user
should contact appropriate community officials to determine if corporate
limits have changed subsequent to the issuance of this map.
This map may incorporate approximate boundaries of Coastal Barrier
Resource System Units and /or Otherwise Protected Areas established
under the Coastal Barrier Improvement Act of 1990 (PL 101-591).
For community map revision history prior to countvwide mapping, see
Section 6.0 of the Flood Insurance Study Report.
For adjoining map panels and base map source see separately printed
Map Index.
MAP REPOSITORY
Refer to Repository Listing on Map Index
EFFECTIVE DATE OF
COUNTYWIDE FLOOD INSURANCE RATE MAP:
JUNE 2,1999
EFFECTIVE DATE(S) OF REVISION(S) TO THIS PANEL:
Refer to the FLOOD INSURANCE RATE MAP EFFECTIVE DATE shown
on this map to determine when actuarial rates apply to structures in
zones where elevations ordepths have been established.
To determine if flood insurance is available, contact an insurance agent or
call the National Flood Insurance Program at (800) 638-6620.
01&.0011 -mi -
APPROXIMATE SCALE IN FEET
500 0 500
NATIONAL FLOOD INSURANCE PROGRAM
FIRM
FLOOD INSURANCE RATE MAP
i
LANE COUNTY,
OREGON AND
INCORPORATED AREAS
PANEL 1153 OF 2975
(SEE MAP INDEX FOR PANELS NOT PRINTED)
CONTAINS:
COMMUNITY NUMBER PANEL SUFFIX
SPRINGFIELD, CITY OF 415592 1153 F
LANE COUNTY,
UNINCORPORATED AREAS 415591 1163 F
I
AP NUMBER
4103901153 F
MqAc� EFFECTIVE DATE:
w
p JUNE 2,1999
0
Federal Emergency Management Agency