HomeMy WebLinkAboutMiscellaneous APPLICANT 2/8/2010
.
. Frlf/4/
ELEVATION CERTIFICATE
OMS No. 1660-0008
Expires March 31, 2012
C'1~ /C?'(f
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
A1. Building ONner's Name
LLI .1..1 I Ie:
Building Street Address (including Apt.. Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
o A
State
'5PI2-IA.J(b ~1f:.Lb (':J(l.€G()~
Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
T: II - 02.- Tilt 'I
Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
;)=:QiU1s,u@D_ce\C0q1p,any Use~~~'~;a;
~OllCY.!'@llber.l;'1,;:<ii;.-Il1}C."4!;,j).'.t:... ,~
~~~ft-;.~.~~:...tt'-i:t;'~~:'1,'_:it';'~1-
JfdrIJ~il~N}~~!g::~~~~ber~)}~\>"f~ ~~.:o;
ac~N{}tlV4.t;'f~lt~:y..~!I::,'~i~
ZIP Code
911./17
A2.
City
A3.
M.
AS.
A6.
A7.
AB.
Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) r Al'T L
LatltudeILongitude: Lat. 1./4 .OJ ' ~t.. (;" ,u Long. I Z'" .ed . Z?lj" /I.J Horizontai Datum: ~AD NAD 1983
Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. Rece\\J.
Building Diagram Number,!t.- pate . 5\-\
For a building with a crawlspace or enclosure(s): A9. For a building W1eftllAtl'di~ed garage. ~
a) Square footage of cra'NIspace or enclosure(s) 702- sq ft a) Square foota~e'or attached garage J.J sq ft
b) No. of pennanent flood openings in the cra'NIspace or b) No of permanent flood openings In the attache garage
enclosure(s) within 1.0 foot above adjacent grade l1- WIthin 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b 1'344 sq in c) Total net area of flood opemngs in A9 b sq in
d) Engineered flood openings? 0 Yes ~NO d) EnglOeered flood opemr:gs? 0 Yes 0 0
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
82. County Name
L..~tJ €. c..oUA..I T
B3. State
6l2Eb ^-.J
84. Map/Panel Number
86. FIRM Index 87. FIRM Panel
Date Effective/Revised Date
UlO c.IlLN F ~Vl,j~ Z. .u~ 2. 1"1"
810. Indicate the source of the 8ase Flood Elevation (BFE) data or base flood depth entered in Item 89.
~ FIS Profile 0 FIRM Community Determined 0 Other (Describe)
811. Indicate elevation datum used for BFE in Item 89: 00 NGVD 1929 0 NAVQ 1988 o Other (Describe)
812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date 0 CBRS DOPA
85. Suffix
BB. Flood
Zone(s)
At:.
S9. Sase Flood Elevation(s) (Zone
AD, use base flood depth)
'150. L.f
DYes
RI No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
RE<QiSYr,P,:r.!)
~^..~....,,,..,, ,.
....n'1..i"~_~i.J.!"i!.f::.:;j.'&.
l.AND SUR\I~V~';:i
Title
f2-
Company Name
.~
,
Certifier's Name
Address
OR!:GOI~
JULY 19, 1194
GAAY l... CMHlEM
2€M
See reverse side for continuation.
Replaces all previous editions
,;;7__.._, ,.,,, ....,"'....,.::'. I"_i~/.,,,,",,,.
.
City
IF,RrJDs~~n~Company.~~~~,,~
V~o~~C)',N,~~;b,e~t~;' ;-.i~'- ~':,p~~;f:.~~ ~
t~ti..~:~l.il~,':-;;):f;.. ";';; ~',~ "~I~.~.(~f;.;i;.-:<~;+'-
~~,QtnB:,~(_~tl'y ~~rr.~~~.i~;~JH~,;I', ~-?
a~i-;,-.;...~~:~""" '::~'.~ 1Jo"." ~~1..""'/:---:<:',.":
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
State
liP Code
IMPORTANT: In these spaces, copy the corresponding infonnation from Section A.
Building Street Address ~ncludjng Apt.. Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner.
Comments
Signature
Date / "_ fto(bJ
I..) /0 l2rCheck here jf attachments
N 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 meters.
E1. Provide elevation information for the following and check the appropriate 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 (inducting basement, crawlspace, or endosure) is _' _ Ofeet Ometers Oabove or Obelaw the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is _' _ Deet Ometers Oabove or Dbelow the LAG.
E2. For Building Diagrams 6.9 with permanent flood openings provided in Section A Items 8 and/or 9 (see ~es 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is . _ 0 feet D meters 0 above or U 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 management
ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENT A TIVE) 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 E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address
City
State
liP Code
Signature
Date
Telephone
Comments
o Check here if attachments
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 and G9.
G1. 0 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. D A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.
G3. D The following information (Items G4-G9) is provided for community floodplain management purposes.
G4. Permit Number
G5. Date Permit Issued
G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement
G8. Elevation of as-built lowest floor (including basement) of the building
G9. BFE or (in Zone AO) depth of flooding at the building site
G10. Community's design flood elevation
o feet
o feel
o feet
o melers (PR)
o meters (PR)
o meters (PR)
Datum
Datum
Datum
local Official's Name
Title
Signature
Date
Community Name
Telephone
Comments
FEMA Form 81-31, Mar 09
Replaces all previous editions
,
,
.
.
Building Photographs
Continuation Page
Buikling Street Address (including Apt, Unit. Sutte, and/or Bldg. No.) or P.O. Route and Box No.
WAY
State
ZIP Code
q7l/17
City
"5 Pt.W<C- fl -
111
-,f.'~<~nce_Company_.U~~~
. :WieY Nlinber;]:~;f,;"'7/""Y::;;'_,i:!~-'~
;~~~~\i(~;~':"";;"~:;;~Ti-t':i~S~.;~'
,;~~~t'k~~}t~}{~p:~;,~.t:S~
_~~~~y~~"t~r;,~:
W~J:,.i.t~...~~.;f;~""f'<-Y'i!;'~""";"~'
t~.~j;:.J?~~~ ;.'::'}1:~tt.,lit~,:,~~~~i
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front VieNi and "Rear VieNi; and, if required, "Right Side V_" and "Left Side View."
..,~
yeDN-r
V 1~\<1
(2.€At2-
VIe:.W
1,6
tf,
v'
J>'
&~~
~q; , <3
13 0<'-
,'(;." -(:"-~
!cJ'f(
(FAX>_460389
lJun'~
P .0011002
011.07/2010
14:44 Branch En9mw9
. & .
0~ -
~dn-re.-f, ~
BRANCH ENGINEERING, INC.
310 Fifth Street
Springfield, Oregon 97477
Telephone: (541) 746-0637 .
FAX Number:. (541) 746-{)389
TELECOPIER COVER SHEET
FROM: '\<Q.II\IJ.. c.lt\U.j~
DATE:' \ h lID
, ,
Please deliver the following pages to:
NAME: '\(",\oQ.,:.\
FAX NUMBER: "'ZIo-'?l!",lD
. NUMBER OF PAGES: 2-
(Including cover sheet)
If you do experience any problems with this transmission or do not receive all the pages indicated, please
contact Branch Engineering, Inc. .
MESSAGE:
'Row-
I
At -1\,A.- ~~lAL5-T or t.o.cl-.. ~ s:.~ ~Y\J\US, :l7 1Y\lld 1-0 ~Y'--\-t>.C-t
l<on 'De...vtC\( ~jV\ O\A.y ,,+'..Qo... .to O~.Y'I 0.. S\~VI~ Ie.-\tav ~~
{tu. ~~.w'5S o-t' ~~S S...lo'5~eo.cU. ~vall^o..~~. -:Cwas "~l.A. +0
~~-t ~0. O\.AY Goi'^(''''--\-Ov- se.Y\J12-v- nos ~ o..CL.tlMpaV\.'1"~ \~\\ltv
0'<\ ~\R. :r do V'J.:>!t ~ :-f <Q.on C-ot\S,cl.o..vs ~~'S \l2.-\ttL,,- -b'm.
~~~~. A "51'O~ 1~1\ev. iN;\\ k ~\l;clo.d o.s ~ ().f. :-\- ;5
do-\c....V\O.d ~M ~().. . .
~,,~C-
~) I
1/
J>'
J-~~
~el.q
,.n:. 0'.
~r- '~
.J'
J
.0110712010
14:44 Branch En.ering
(FW417460389
P.OO2I002
@
Branch Engineering. Inc.
Corporate H..dqU8iWrs
(541)7~37
3105" Street
Sprlngflold, OR 97477
Salem engIneering Office
(503) 779-2ST1
147 Common:lal St,.ot NE, sun. 10
Salem, OR 97301
Prlnctpals
M Lane Branch, PE
Damian Gilbert. PE
Ron.. D. Clou9h, PE, PLS
Rene' Fabricant, PEl SE
Ronald J. Denick. PE, GE
www.BranchEnglneerlng.CD.m
January 7, 2010
Mr. William Dinwiddie
1960 Inland Way
Springfield, Oregon 97477
RE: SUBGRADEEvALUATION
1960 INLAND WAY
SPRINGFIELD, OREGON
Branch Engineering Ine Project No. 10-015
A geotechnical engineer visited the above referenced site on January 6, 2010 to assess the building pad
subgrade shrink/swell potential and soil bearing capacity for the placement of a single-story manufacture
home that was currently on the site resting on temporary piers. The level building pad is slightly raised
above adjacent ground surface grades due to the placement of 4- to 6-inches of'W'-O aggregate. A
perimeter footing 12-inches wide has been formed with two No.4 reinforcing bars. Hand-probing and
. shallow vane shear testing indicate a consistently soft soil subgrede. Free swell testing of a representative
soil subgrade sample showed a low sluinklswell potential (<20%). The soil subgrade is suitable for a
conventional perimeter-style foundation, and an allowable soil bearing capacity of 1,000 psf. Differential
settlements are expected to be less than II2-inch over a span of20 feet We reco=end that existing
aggregate be hand-tamped in the footing areas to mitigate consolidation upon loading and that surface
water be directed away from the building pad. The outside edge of the perimeter foundation shall also be
backfilled at least 8-inches to mitigate the aggregate from sloughing out from underneath the footing.
Sincerely,
~..'
~~~\~ ."
~ ~/6'17~\\ ~.' _
~.~~
~t.D J. U~>
Expires: December 31. 2011
Branch Engineering Inc,
RonaldJ. Derrick, F.E., G.B.
Principal Geotechnical Engineer
Date Recp'ived:
PiafII1C;. e~ :.~ .
z. - "z:( - \6
CIVIL
STRUCTURES
TRANSPORTATION
GEOTECHNICAL
. SURVEYING
.
.
ELEVATION CERTIFICATE
OMS No. 1660-0008
Expires March 31, 2012
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
A1.
8uilding Owner's Name
,J LLI , \
Building Street Address (induding Apt.. Unit, Suite. and/or Bldg. No.) or P.O. Route and Box No.
L I
Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
fJ':9l-illWil@1P,:9ill!,panyUse;!i;l)j:/;'<1
m9Jl~j!!~~beI:;~~;i~:ni-'-Y' ;'l~tt!id_r:,::'~.' ~~t,
~'li:~~"..":::-t3~~,'{:V'..&~~~'_~I~~::~~
~~~q~N~m~.:~~,~:;t~:\~~-:\~:~ft;.
. " ~~g/-:,., >,"Y":';~::"i...;.~._',:, ;.<';:;;_.~~~
ZIP Code
q7477
A2.
City
A3.
State
7'>ilQjh!Cn~ I~L\') (')12.1; ('nO/...\
Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Tll.lI' t'\t:\\l 1<A-(,),~-(,)'2..-")~ ',AI( /.1)T b700
Building Use (e.g., Residential. Non-Residential, Addition, Accessory. etc.) T I
. '1' I ". lb.,
LalitudeILongitude: Lal 44 0 I '-./t?.., II.J Long. I
Attach at least 2 Photograp~ of the building if the Certificate is being used to obtain flood insurance.
Building Diagram Number
For a building ....nth a crawlspace or enclosure(s): A9. For a building with an attached garage: *
a) Square footage of crawlspace or endosure(s) 7(') L SQ fl a) Square footage of attached garage ' sq ft
b) No. of permanent flood openings in the crawlspace or :lli1 b) No. of permanent flood openings in the attache garage
enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
d) Engineered noed openings? 0 Yes 0 No d) Engineered nood openings? 0 Yes 0 No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Horizontal Datum: 0 NAD 1927
~ NAD 1983
M.
AS.
A6.
A7.
AS.
84. Map/Panel Number
B5. Suffix
B6. FIRM Index
Date
B7. FIRM Panel
Effective/Revised Date
2
B9. Base Flood Elevation(s) (Zone
AO, use base Oood depth)
4
B1. NFJP Community Name & Community Number
/-
F
B8. Flood
Zone(s)
Indicate the source of the Base Flood Elevation (8FE) data or base flood depth entered in Item B9.
ISi'l FIS Profile 0 FIRM Community Delennined 0 Other (Describe)
B11. Indicate elevation datum used for BFE in Item 89: ~ NGVD 1929 0 NAVD 1988 o Other (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
I'ii:l No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C2.
Building elevations are based on: 0 Construction Dra....nngs~ ~ Building Under Construction.
*Anew Elevation Certificate will be required when construction of the building is complete.
Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, Y1-Y30, Y (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, ARlAO. Complete lIems C2.a-h
below according to the building diagram specified in lIem A7. Use the same datum as the BFE. ~ \
Benchmar1<UtilizedC.I1'1 of SP~I\.IC,~II'Ii\ RM fI: 4fh7 YerticalDalum ,,-,C:,\JD:z.q '~IV&'c>n=',)FIlDi>'J c..O.S.
Conversion/Comments 0.3 ~bbl A~()~[\ T/,) 1>,t'\"\I;l/h7 "/J(:,VD J..'1 44.'10 FEe:;- '"
Check the measurement used.
44 7 ..~..Jxl feet B meters (Puerto Rico only)
45 7- .Q~ feet meters (Puerto Rico only)
t.J I A.. 0 teet 0 meters (Puerto Rico only) -1
I\J I A 0 teet 0 meters (Puerto Rico only) 1./
4'52... ...Q...1}a feet 0 meters (Puerto Rico onJft),
cf?-\'4
...Q...J&l feet 0 meters (Pu~~ ~
.~~ feet 0 meters~~ll..~'onIY)
,_0 feet 0 meters. (~~RiCO only)
o Finished Construction
C1.
a)
b)
c)
d)
e)
Top of bottom floor (including basement.~, or enclosure floor)
Top of the next higher floor
Bottom of the lowest horizontal structural member 01 Zones only)
Attached garage (top of slab)
LO\.'.'est elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
Lowest adjacent (finished) grade next to building (LAG)
Highest adjacent (finished) grade next to building (HAG)
Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
Q
g)
h)
YLj 7
447
1-.1/(>,
SECTION D - 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. I certify that the information on this Certificate represents my best efforts to interpret the data available.
/ understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
o Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? DYes 0 No
License Number
(,<1' "1.. PL~
~C,IIUFI"I? l/I,j(;., IAJ(,
Stale ZIP Code
00-r-t~^1 q1417
Telephone
Certifier's Name
l2E~ (;;(:;
Title
(' 1 1lL)Q,L\
Company Name
PQJ('J\lAL '::,()Q...VE..lJorL &>.AAl('J.(
Address .u. City
'~jb -S '.ll ~T -::'PeJA.J~nEli'l
Signature Date
PROFESSIONAL
LAND SU~VEYOR
~
OREGON
NOVEMBER 30. 2007
RENEE CLOUGH
69162LS
FEMA Fonn 81-31, Mar 09
.
.
IMPORTANT: In these spaces, copy the corresponding information from Section A. '. Fq'ftr}~U.~J1ca,Company;U~e~~~:~~
Building Street Address Qncluding Apt.. Unit, Suite. and/or Bldg. No.) or P.O. Route and Box No. ~p'o~ioJ;N~~~f;~~;_;~{J;:-:;+~~~i1f;.'Mi~ &~
~.~:jt.!'-~.~..~, l l~; ':: -.\ ~(. ..,~:l~:.i"'~~:~'/-,>~':~,,'.'_'~:
C;ly State ZIP Code -:_CO~~nyI';JAIC NUl1)ber:'?;\-~.',;:_?1'~'\~::,
~~z.;!. :-":i~~i>'~/,-,:~;" !'~Jj,\.;, ~'-; !'({;'-;:.;./.:>.".:.;
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner.
Comments
Signature
o Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
Date
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 E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation information for the following and check the appropriate 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 ~ncIuding basement. crawlspace, or enclosure) is _' _ Dfeet Dmeters Oabove or o below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is _' _ Deet Dmeters Dabove or DbelOw the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectio..a..A Items Band/or 9 (see ~es 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is . _ 0 feet U meters 0 above or U below the HAG.
E3. Attached garage (top of slab);s _' _ 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 management
ordinance? 0 Yes D 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 E are correct to the best of my knowledge.
Property Owner's or Ovvner's Authorized Representative's Name
Address
C;ly
Slate
ZIP Code
Signature
Date
Telephone
Comments
o Check here if attachments
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 and G9.
G1. 0 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. D A community official completed Section E for a building located in Zone A (without a FEMA-issued or community.issued BFE) or Zone AD.
G3. D The following information (Items G4-G9) is provided for community floodplain management purposes.
G4. Permit Number
G5. Date Permit Issued
G6. Date Certificate Of CompliancelOccupancy Issued
G7. This permit has been issued for. 0 New Construction 0 Substantial Improvement
GB. Elevation of as-built lowest floor (induding basement) of the building
G9. BFE or (in Zone AO) depth of flooding at the building site
_,~ .~ G.10.-Comrnunity's.desiglJ Oo~ elevation
I
,
I
o feet
o feel
o feet
o meters (PR)
o melers (PR)
o meters (PR)
Datum
Datum
Datum
Lqca! Official's Name.
Title
. .f~'!I~~~!ty ~~m(".. ..
Telephone
! -- .
t _. 1
'. ....-FEMA FOIm 81-31, Mar 09--1
. /J,.!i
~eaa~
Q~ ef. #
~\(1i'(l('l. 0 Check here ;f attachments
~D____
Signature
Date
Comments ".
Replaces all previous editions
I
. cq-e"'/
Branch Engineering,
f.?e 0nsfrtcd,~
Inc.
@
. .
Corporate Headquarters
(541) 746-0637
310 S~ Street
Springfield, OR 974n
Salem engineering OffIce
(503) n9-2Sn
147 Convnercial Street NE, Suite 10
Salem, OR 97301
Principals
M. Lane Branch, PE
Damian Gilbert, PE
Renee D. Clough, PE. PLS
Rene' FabricanL PE, SE
Ronald J. Derrick, PE
James A. Branch, PE, PLS
www.BranchEnglneering.com
June 16,2009
William Dinwiddie
1960 Inland Way
Springfield OR 97477
RE: Base Flood Elevation (BFE) calculation for 1960 Inland Way
Dear William,
Based on the current FIRM Panel (41039CI144F) and the tax map (18-03-02-33) for your site I
have calculated the Base Flood Elevation for your site as 450.4. This is 3.73 feet above the site
benchmark that we previously set. I have included a drawing showing the BFE calculations.
Feel free to contact me with any comments or questions.
Sincerely,
~~
Renee Clough, PE, PLS
Branch Engineering, Inc.
.
A'.~
......,"".,:"':-~~:~' ',' ~,~
O~~(> .
~\af\l'~' .
CIVIL
STRUCTURES
TRANSPORTATION
GEOTECHNICAL
SURVEYING
.
U.S. 'DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
.
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expires March 31, 2012
A2.
ILL
Building Street Address (induding Apt, Unit. Suite, and/or Bldg. No.) or P.O. Route and Box No.
IAlL
,. State rJ
A.J Ie:::.' 0,.,.
Property Description (Lot and Block Numbers, TaxParcer Number,le'gal Desaiption. etc.) _,;.._";
.,. '~ . -0 - :;z. ~ S l.Ur
Building Use (e.g"" Residential, NOrl-Reside~tial. Additio~. A~s~~;Y: 'etc.)' . O~M~tt)6u'Y'1A-L ;'
Latitudellongitude: Lat "'I" 01' ?6.b" JJ Long. ""''' ~,. ZS." "IIJ Horizontal Datum: 0 NAD 1927 D(NAD 1983
Attach at least 2 photographs of the building if the CertifiCate is being used to obtain flood Insurance.
Buirding Diagram Number4 ~
For a building with a crawlspace or endosure(s): A9. For a building YJith an attached garage:
a) Square footage of crawlspace orenclosure(s) ~55 sq fI: a) Square footage ofa1tached garage sq ft
b) No. of pennanent flood openings}n the cra'NIspace or b} No. of pennanent flOOd openings In the atta garage
enclosure{s} within 1.0 foot above adjacent grade _ 7 within 1.0 foot above adjacent grade
c) Total net area of flood openings in AB.b !lt8:: sq in c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? 0 Yes JJt1NO d} Engineered flOOd openings? 0 Yes 0 No
City
Important: Read the instructions on pages 1,9.
. SECTION A - PROPERTY INFORMATION
~'E,9i'~ins.[ni:ii.ee:'~0~P@Y~Q's'f;,t~~;f,;
'Po"CY.Nllmber'!t~~dIIiis'!ft;l '.'
ii,~:~1~.w-J~~~~~~li
ii~;fl~~_~~i
ZIP Code "f7 7 .
A 1. 8uilding Owners Name
A3.
A4.
AS.
A6.
A7.
A8.
81. NFIP Community Name & Community Number
~ '1155'11
BS.Suffix
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
84. Map/Panel Number
82. County Name
l....WG'
B8. Flood
Zone(s)
AI2
89. Base Rood Bevation(s) (Zone
AD, use base flood depth)
5'O.i./
B7. FIRM Panel
EffectiveJRevised Date
1/'039 AJ6 Z. WI
810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item 89.
~FIS Profile 0 FIRM Communily Delermined 0 Othe[ (DeScribe)
B11. Indicate elevation datum used for BFE in Item B9: IX1 NGVD 1929 0 NAVD 1988 DOlher(Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area Dr Otherwise Protected Area (OPA)?
Designation Dale 0 CBRS DOPA
o Ves ~ No
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Certlfle(s Name p - L /' hl
P.lJEt:> LDV""
TItle l>P JA.Jc...lPAL 51 )2J/I;VO~omparry Name BeAAJCM.
Address '3/D S ":!I ~T. Cily nP/2JU(brl6U)
Signature Date
C1. Building elevations are based on: KI Construction DraYJings. 0 Building Under Construction"
*A new Elevation Certificate will be required when construction of the building is compfete.
C2, Elevations - Zones A1-A30, AE, AH, A (wilh BFE), VE. V1-V30. V (with BFE), AR. ARIA, ARJAE, ARJA1.A30, ARJAH, ARlAO. Complete Items C2.a-h
below according 10 the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized CrN oP sPlZJA.J(M:U5L/) BM.u- LIB 7 Vertical Datum IJ tiV/l. 2'1
ConversiOlliComments O. ~ 1=8:E.r AII[)€.I) ro P.'M to 4fS 7::: AlA\lt> 29 1/117.90 Pee:,-
Check the measurement used.
.5' 00 feet B meters (Puerto Rico only) ,
lis J . q IE feet meters (Puerto Rico only) 1\
/oJ 4 0 feet 0 me'ers (Puerto Rico only) t-b.
AlIA 0 fee. 0 meters (Puerto Rico only) 7.t.1
*"''1- nfeet o meters (Puerto Rico only) X.
~~ .~~
1/47 ..ii.lfeet 0 meters (Puerto Rico 0Ji:8'~~
till? ...:a. feet 0 meters (Puerto Ri~~ .,
l//.i7 ....2... feet Dmeters(Pue ~.
~
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certtfy elevation
infonnation. I certify that the information on this Cerli(JCate represents my best efforts to Interpret the data ava/7able.
I understand that any false statement may be punishable by fme or imprisonment under 18 U.S. Code, Section 1001.
IXf Check here if comments are provided on back of form. Were latitude and longnude In Section AJ!!.Ollided by a
Iicenseclland surveyor? DYes ~ No
Ucense Number
::Jdln7 :;~
_";;;.I"l _Kl& . I JJ.C...
state ZIP Code
q7L177
Telephone I 7'"
-!;t.j. .."'. f:) 7
See reverse side for continuation.
o Finished Construction
Q
g)
h)
a} Top of bottom floor (induding basemen~or enclosure floor)
b) Top of the next higher floor
c} Bottom of the lowest horizontal structural member fV Zones only)
d) Attached garage (top of slab)
e) lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Corrvnents)
lowest adjacent (finished) grade next to building (LAG)
Highest adjacent (finished) grade next to building (HAG)
Lowest adjacent grade at lowest elevation of deck or stairs, Including
structural su rt
1//1 7
FEMA Form 81-31. Mar D9
REGISTERED
PROFESSIONAL
LAN!>. ~lI~VEYOR
~;?-
OREGON
NOVEI.IBER 30, 2007
RENEE CLOUGH
69162LS
epr~ElotIi1r.oioo'\
.
.
City
.,F:pr Insura~C9.ri1i\iii1Y;1.f..:tij!Wro
:POllcyNu[!'.~~~~~~",.
i~~~'ki~,!~W~~~~~1\~~
IELb Stale DR.. 7'1 217 Code ~;m'f:~!~~.M1[~i
SECTION D -SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION.(CONTI"!!JED)
Copy both sides of this Elevation Certificate for (1) community official. (2) insurance agenUcompany. and (3) building owner.
Comments
1'>/2..
r-~Ul PtllFAJ'T" ~e.l2..tJ/rJAj("
(' OM ~Tfl..l)Q" 1./)1..)
f/,OlLhM1fO W4s
TH-1="JZg c..QE
Ii'
LO\.tJp.'1'..o-
Date a
.. .0 7 0 Check here ~ attachments
ON 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. 8,
and C. For,ltems E1-E4, use natural grade. if available. Check the measurement used. In Puerto Rico only, enter meters.
Provide elevation infonnation for the follO'Ning and cJ1eck the appropriate 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 Oncludlng basement. crawlspace, or endosure) is _.~. Dfeet Dmeters Dabove or Dbelow the HAG.
b) Top of bottom noor (incJuding basement, crawlspace, or enclosure) is _. _ Deet Dmelers Dabove or Obelow the LAG.
For Building Diagrams 6-9 with permanent flood openings provided in Sectlq.n.,A Items 8 and/or 9 (see ~es 8.9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is _' _ 0 feel U meters 0 above or U below the HAG.
Attached garage (top of slab) is _" _ 0 feet 0 mefetS 0 above or 0 below the HAG" . .
Top of platform of machinery and/or equipment servicilig the building is~. _ 0 feet 0 melers 0 atxive or'". 0 below the HAG."
Zone AD only: If no flood depth number is available, is the top of the bottom floor elevated in aCCO/'dance with the community's floodplain management
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 O\Yl'lElr's authorized representative who completes Sections A. B, and E for Zone A ('Without a FEMA-issued or community-issued BFE)
or Zone AD must sign here. The statements in Sections A, B. and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
El.
E2.
E3.
E4.
E5.
Address
City
State
ZIP Code
Signature
Date
Telephone
Comments
o Check here if attad1ments
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 GB and G9.
Gl. 0 The infonnation in Section C was taken from other documentation that has been signed and sealed by a ficensed surveyor: engineer, or archited who
Is authorized by law to certify elevation information. (Indicate the SOtrce and date of the elevation data in the Comments area below.)
G2. 0 A community official completed Section E for a building 1~led Irr Zone A ('Nlthout a FEMA-issued or communtty-issued BFE) or Zone AD.
G3. D The folloVll'ing Information (Items G4-G9) is provided for community floodplain management purposes.
G4. Penni! Number
G5. Date Permit Issued
G6. Date Certificate Of CompliancelOccupancy Issued
G7. This permit has been issued for. 0 New ConstruC!i?" 0 ~ubslantiallmprovement
GB. Elevation of as-built lowest floor (lndudlng basement) of the building
G9. BFE or (In Zone AO) depth of flooding at the building site
G10. Community's design flood elevation
(' --;:-~-;;;~~I:;;;:e--""-'!
L_ Cq~~;;'~~~~;~:,', J
Signature
Oteot
Oleot
Oleel
o meters (PR)
o melers (PR)
o melers (PR)
Datum
Datum
Datum
TItle
,L-lb
"V ;.;;--
W~d"~
Rae'<'
\)~\a f 5\'\
~\a(\(\\:l ,.
Telephone
Date
....--e..m""*'ts.---.--.-....1
I !/,,-};". -:::'~;r:~ _
~ ~;~..;i' .,~.;.; :~.r.,;..:{~1'.g~ ,
\ ~~.i~t.~; ~r'" I
......~ .-~.~_..,._...- ~.........-~.....
o Check here If attachments
Replaces all previous editions
_.
i I:I;Mf\:forrn 81;31;'Mw,ll9 !
I____...-~,--,~_....__...