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Home My WebLink AboutMiscellaneous APPLICANT 6/15/2009 " "" " 0, " i U.S. DEPARTMENT OF HOMELAND SECURITY' ( Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE '10MB No. 1660-0008 Excires Februarv 28. 2009 Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION LFor Insurance Company.Use: 1 Policy Number A 1. Building OWner's Name Helfrich Family Revocable Trust A2. Building Street Address (Including Apt., Unit, Suite. and/or Bldg. No.) or P.O. Route and Box No. 2833 20fu Street City Slate ZIP ~~rinHfield. OR 97477 A3. Property Description (Lot and Block Numbers, TaxParcelNumber, Legal Description, etc.) 17-03-24.Q0 - 00500 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential AS. Latitude/longitude: Lat. 44_076293 Long. -122.9944 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood Insurance. A7. Building Diagram Number "";1' ". " A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attach~ garage, provide: a) Square footage of crawl space or enclosure(s) 3600 sq 11 a) Square foolage of attach~d garage sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within',1.0 foot above adjacent grade ~ walls within 1;0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b .....3.QQQ.... sq in c) Total net area offload o~~njngs in A9.b 0 sq in SECTION B - FLOOO INSURA~CE-RATE MAP (FIRM) INFORMATION: ,,' Horizontal Datum: NAD 1927 x NAD 1983 81. NFIP Community Name & Community Number Lane County 415591 82, County Name Lane B3. State OR J 41039C 1153 F 86. FIRM Index Date 06102199 B7, FIRM Panel EffectivelRevlsed Date 06102199 I B8. Flood Zone(s) A II: B9 Base Flood Elevation(s) (Zone : AD, use base flood depth) " 452.1 B4. Map/Panel,Number B5. Suffix 810, Indicate the source oftha Base Flood Elevation (BFE) data'or base flood depth entered in Item 89; o FIS Profile x FIRM Community Determined Other (Describe) 811. Indicate elevation datum used for BFE in Item 89:. X NGVD 1929 NAVD 1988 o Olher (Describe) ~ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date _ 0 CBRS DOPA DYes xNo SECTION C - BUILDING ELEVATION INFORMATION,(SURVEY REQUIRED) C1. Building elevations are based on: D Construction Drawings"" X Building Under Construction"" pO Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. I! C2. Elevations -Zones A1-A30, AE, AH, A (wilh BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH/ARlAO, Complete items C2.a-g below according to the building diagram specified in Item A 7. Benchmark Utilized TBM sDlke in Dowemole = 453. t Vertical Datum NGVD 1Q29 ConversionlComments Check the measuremenl used. a) Top of bottom floor (including basement, crawl space, or enclosure f100rt b) Top of the next higher floor c) B~ttom of the lowest horizontal structural member (V Zones only) d) . Allached garage (lop of slab) e) Lowest elevation of machinery. or equipment servicing the building (Describe type of equipment in Comments) ~ Lowesl adjacent (finished) 9rade (LAG) g) Highest adjacent (finished) grade (HAG) 453.16 x feet x-feet o feel x feet x feet . , o meters (Puerto Rico only) o meters (Puerto' Rico only) o meters (Puerto'Rico only) o meters (Puerto Rico only) i' D meters (Puerto. Rico only) it' nla 485.73 449.3 449.3 x feet x feet D meters (Puerto.;Rico only) D meters (Puerto'~Rico only) , SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifiCation is to be signed and sealed by a land surveyor, engineer, or architect aulhorized by law to certify elevation information. I certify that the information on this Certificate represents my best.efforts to interpret the data available. ' 1 understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Certifier's Name James T. McL~ughlin Title Registered Professional. Land Surveyor Company Name Address 2428 Ranch Drive City Springfield Slate OR ZIP Code 97477 Ucense Number 2583 ~ REEiISTt<RED.~ .. ( - ROFESSrONAl l D SVRVEYOR \ .......... o Check. here if,comments are provided on back of form. Signature Date Telephone 541.729.4886 '0 t:170N J ~y 191991 ~A~. ~.~.T?M4.. AV~f<. '.IN ~5;l\;3. f~pj"'es'milllb08 FEMA Form 81-31, February 2006 See.reverse side for continu~ti~n. . .. ) / Replaces.~1I previous editions '" "; .' " ", ;Date;RecelVed.,~/ ~1 . .- Planner: At. . :... .... dl : ~ o " ( 4)!jt. IMPORTANT: .In these spaces, copy the corresponding infomiation from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 2833 20th ,Street City State ZIP Code Sprin9field, OR 97477 . For Insurance Company Use: Policy Number Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificat~ for (1) community official, (2) insurance agenVcompany, and (3) building ow~er. Comments ~la, TBM spike in-tJvn.:;..tJv;e. pluS 1.25 hi minus el 453.10 454.35 Ffloor 1 1/8" above floor tr 1,19 5,02 '1.25 453.16 , 449,33 , 453,10 Dat~ 'G) ~~~ I'l.cD9 Signature p Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AD 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 E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter met~rs. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent 9rade (HAG) and the lowest adjacent grade (LAG). ' . I a) Top of bottom floor (including basement, crawlspace, or enclosure) Is 0 feet o meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is 0 feet 0 meters 0 above or 0 below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of In'~tructions), the next higher floor (elevation C2.b in the dla9rams) of the buildin9 is . 0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is 0 feet 0 meters 0 above or 0 below the HAG, E4. Top of platform of machinery and/or equipment servicing the bUilding is 0 feet 0 meters 0 above or 0 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 manageme"nt ordinance? "0 Yes 0 No 0 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 community.issued BFE) or Zone AO must sign here. The statements In Sections A, B, and IE are COfTBct to the best of my knowledge, ,. Property OWner's or Owner's Authorized Representalive's Name, Address City Slale ZIP Code Signature Date Telepho~e , Comments I 1 Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's f1oc;>qplain 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. and G9. G1. -0 Th'e information in Section C was taken from other documentation that has been signed and sealed by a /lcensed surveyor, engineer, or architect who is authorized by law to certify ele'\'iiUon information. (IndIcate the ~ource and date of the elevation data in the Co'mments area below.) -" G2. 0 A community official completed Seotion E for a building located in Zone A (without a FEMA-Issued or community,issued BFE) or Zone AO. G3. 0 The following information (Items G4,~G9.) is provided for community floodplain management purposes. I G4. Permit Number I G5. Date Permillssued I G6. Date Certificale Of ComP1,iance/Occupancy Issued G7. This permit has been issued for: 0 New Construction 0 Substantiallmprove:ment G8. Elevation of as-built lowest floor (includin9 basement) of the buildin9: _0 feet 0 meters (PR) Datum ~ G9, BFE or (tn Zone AOl deoth of flooding at the buildlna site: p feet 0 meters (PR) Datum Local Official's Name Title Community Name Telephone Signature , " Dale Comments FEMA Form 61-31. February 2006 Date Received: '/1:J=1/ Planner:n AL . Replaces all previous editions