HomeMy WebLinkAboutFEMA Application 2001-12-13
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FEDERAL EMERGENCY MANAGEMENT ACfENCY .
NATIONAL. FLOOD INSURANCE fJlROGFfM
. ELEVATION CERTIFICAlfE
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O.M.B. No: 3067-0077, I
~res July 31. 2002
Important: Read the instruCtIons on pa~ 1 .7.
SECTJONA-PROPERTYOWNEA INFORMAnPN _~"'~-'-'
8lJILDINGOWN~SNAME - , ' ' I" ".'. " '
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~ l!!f..... "-:- '. .,
BUILDING ~ I ~. ADDRESS llrlcludlftg Apt.. UIll'I. SUia. a.dIar ~ No.) o~ P.O. ROUTE AND BdX NO.
""'%.0 ~tto'to-J. ,-~1E:- .;, . . '
CITY . ' STATE . . . 'Z1I' CODE
. ??C:Ul'oL~1='~b CE.. , ' 'f14T1
PROPERTY U6SCRIFTION (t.ot 11M $oc:I ~..~ -; IIX ran:el Number. Leg" ~ ea:.) " ' '
Uft lO~ tbJl t.t\1.1b1a..Lb ~1> MblTJC)1.4 ~i~ 1?,' ~~ I\'S"Z.-I\'S~ c..Ai.&~ ~~
BUILDING USE (e.g.... J(eSiantiaL Ncm-.~.._ AdclIIon. J. . ar:r. ell:. Use CorrtlMflts HCIiaIt if ~ ..-: ..! ,1Ify.) PLA-T tz.:e.LDa.~
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V.T1TlJOEILONGITUDE (OPTIONAl.) HORlZONf.Al DATUM: : SOURCE; ','LJ qPS (Typer.
, #If. fill. "'.Wer ' ..#tNiMI') L.J NAC 1927 U HAC 1983 LJ USGS Cuad Map' LJOIMr:
.:....: SECTION B . FLOOD INSURANCE alATE MAP (FIRM) I,FORMATION
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81. NFIP COMMUNITY NAME & COMMJNITY NUMBER B2. COUNTY NAME' I' B3. STATE
,~t..10i=ie.cA> 4\s~~-z.. ,-~1i- O~
1M.. MAP AND PANEL ' 85. SUFFIX . 86. FIRM INDEX 87. FIRM PAllIa. .sa. FLOOD 81. SASE FlOOD B.EVAllON(S)
,NUMBER ' DATE- crrcClJVElREVlSED OAT! . ~",loo:;'Sl (ZDne~. UlIe dlIpIft oIlIoodJIIg)
4,o~G U", ~ "''2..C\~ ro.'2,-C\Cl\ . ~~e.i,) ~ . , S\\.4
B 10. Indicate 1M source of the Base FJood EJeva1fon (BFE) data or base ftood daPth entenId .. 89.
LJFJS~ Llt=lRM l)S-CommunityD...;.....,j,ined U.()Iher(O...~..jt,e):
11. JncflC8te !he elevation datum used for the BFE in B9: U NGVO 1929 U NAW 1888 iLl Other (Ot."..t,):.
d 12. Is the building IQ(;3Ied in 8 Coastal Bamer RuOUfQlS System (CaRS) atea #11 01herwi18 Protected /4Iea (~PA)? U v. ~ No
Designation cate: .
SECTION C . BUILDING ELEVATION INFORMAnON (SURtlEY REQUIRED) ,
C1. e~ilcfing e1evallons are baSed on: WCon$tnldion 0""',,,.1 ~. ~"iIding Under ~tnJCtion. . UFlI1ished CcnstNdion .
.p, new Elevation Certificat8 WiI be required when c:onstNc:tion of1he building Is com_
:2. Suading Diagram ~ber . -z,., (Select the building diagram mast similar to Ihe building ~Whk:h this .....t;::~ Is being.completed. 8ee
pageS S and 7. If no d'.agram accurately ... """ LJ 1he bIIIIdIng. ~ a sbIlCh or fJhGIPgraph.) : '
~. Elevations _ Zones A1-A30. AE. AH.A (wIIh BFE). \IE. V1-V30. V (with BFE). AR. MIA. ~ p..pJA1~ NvN.J. PWNJ '
Complele nems C3a-4 beloW accanrlrtg 10 the building diagntm specified in \terIt. C2. St.telthe datum Ld8d. If the datUm Is ~ frmn
the datum used far IheBFE in Sedfcln 8. conwrtthe didum to that usedfotthe 8FE. Shciiwfleld meuuremenlS and d8IuIn cc., .".,.-an
c;aJculatian.' Use Ill. spaat" , ',. ",1 at lIle CommenlS area of Section 001 SdOn~. as!appmpriate.lo dcic:Ument Ihe datdn coriversIon.
Datum ,-f.'(A1..- CorwersicmICamm<<ltS AnO 0.:1,' n> \PGIIn.. p#r>,-o,^ -To ~" ....e~."". ~'" . "
ElEl"or.,i..., reference mark used ~1lIE. (.ou.lII\~ Does the e!e-...;:.'.. niferenc:e ma~ used ap"ar Jft ~ ~~~ J~~lg
C a)"P'op ofbottorn float.. .(iincludingb85ementarendosuFe)- -su- .~-~. · '.::.........~"'..'::;'lIcrU.. '
I" . f ;:'"..J:J ~:>' ;":r' . ;r:"r-...
C' -r--rwiKt. "fti:Iar _ ~'4 . . ,~i ft.,..) .', t....'..n... ~_U'~._ -;..... ........:"1. ,
b) op Qt. " hitt'*' .. ... . "'"'!: 1-'" ,.. ". -- ..,... ."-:-. .... ..
CC),soa_..,...JloweSlhOnzo..........JCbnfmember'(V-ZQIleSonly) u'f/l. '-fft.(AI).1: . tT\ ()
a ~Attac:hedga~.(topohlab) . IJOf CDt\tt.e..'1'L "--,tL(m)al- ~~'
o e) lowest e1ewtiOf1 of mad*Iery andIbr equipment j f. ..=-=-..'......', ',w-- '
senicin9lhebui1diri9 .' " . Wl:1t"C,OAA.PtAt:re- ,'-rift.(m) Ii i .::;;:;;:;.1r.~l';:]
O f) "";----"-"'(lAG) . <;\'2. _,~"(Io/ zi ~. Jf\).......:'~I';;;:;~';;;:1'l: ,
...,-_w_w S~ z..ft.~ j "'.h,,,..h_.~... ......~.......
.0 9> Higheltadjacenlgrade.(HAG) _' . - -'~ '. -;-.;.,,,~- _."'''.
o h) No. of .' _anent....." '..... (1Iood ... ,...) WIthin 1 fL above adjacer1t 1II...l<. ~:.. ~ \-zco~
C I)TotaiateaOralpermanentopenings(loodvents)..~ z.rz,., sq.ln.lS-IlriJ..." . ---..
SecTION D _ SURVEYOR. ENGINEER; 9R ARc:HJnCTqERTlFlCATION .
This .....:O:fcatlon is to be ~ned lII1d seated by a land 51.,., ,r.'ensineer, or 8IChiled aut,., i'~,..J by law to c:ertry ~ Infannation.
, C#IIfIy that the ~toirnstiOn;, S~...:im A. B, and C On this ~. ,.p~ "'Y but ~ loiJlwpret"" data av__ '
lundemaM tltat..., false slldetJrem may be punishable by I'M QT,impdSontrlflnt t" .~ .1~ 1Jf:~~ 1001.
CEfl'TlFlER'S NAME ->()U#w~ ./1., , .O~ ca.tP~ NAME ~ '-1'.... ~\o'S ,
TI~ PC2O. c::r=.~~ ~ ~2."E.'('t)tt.- . ~e.:' e.wG.,t-&6~111U-"" ~~l.!'9 ,1A6_
, ar--' C~! ~Aft. . ~axE
ADORESS ~ 0 . ~'1- -z..."':;J~' ~~I:.- ~tZ.- c::o~.o~
"W-_Al6:nlA& ,_ ,Iii _ 1 v-1I1. ~~. (~'.lq , ~ '~'4scs
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, ,,"PORTANT: In these s...,,,,_.C:opy 1hec._,.. "ding infDrmation from Section A. .
, AlIlDJ~ olt . ~I ADDfU!SS (induCIng AgL, UM. SuiIIr. ....... BIdg. tIo.) C:;R;.,~. ;::~. ~ N!D IQtpoco.
lco1"Z.o ~~~t.i ~ . ..,' i .
:m STATE; ZIP CODE
?PIZ-\ ..u.,1=(&:.vf) 0 L- 1tt4"
,9~ I n..N D - SURYEYOR;, ENGI"~, OR ARCHITECT CiW~~;1C'..liii(~~)
__ - I . . I.
:Cpy both ~des of I1is Elevation Ctftificate far (1) ~ olIidaI. (%) Jnsl....""". ,. ~ ~ ,JJgn 1...1; and (3) buiIdidg owne'.
:0MMEH1'S G.(t-(" Dr ~PQ...Ult,a.~I&I.A\ ~~ D~p.t~ ~ "-c:.t+t'?~ ~~
1M ~ -wflot: nte.. ~ Nr""Rtt!. #4.LD'Pat.L'- ~ du~~ ~TUW ~ 'T\t1!. ~~.,
c.oci.tJe,e- Of' -nt€. U.4~~IQI.L C1F Cd1~ ~ -Ri\J~11).4 Rb. Gaff DM'UlI/\ ~''1.,e.\
, . 1= .-e.~." .\)N'I""'" r;.\~ .\1 \ I I CheCk here If attaChments
_ SECTION E _ BUiLDING ELEVATION INFOAMAnON (SURVEY N.9TRECUlREO.) FOR!ZCNE /AIJ.ANDZCNEA'~ ~
;,rZoneAO and.ZcneA (wfthcutSFe). ......,bJItemsE1 throUgh E4. "",.~~iI.dbJldedftrUlea~JSJ
fO(1lJlJtion for ;j LOMA or L.OMR-F. sectbt C musl be ..,..~".i.Dl8d. ! ,
1. Building 0iagr3m Number ,(Select lI1e buiking clagram most similar la d:ie buildii1g ~ ~ this certifiCaIe iii being campleted ~
lee pages 8~7. If no dIIIgram 8CQ.,.,:.J. -,.,:..:.anIs1he.buiiding. prcmdee SkelclU"'~) , ,
2. 'The lCP of the bcIlom floor fJlldudlng basement or' encIoaute) of the building Is . , I , ~m)" , I !In.(ern) U above or U below
(check one) the higheSt ad'pICIIIC grede. , ' '.: . .
3, For Building OIegrarns,6-8 with openings (see page 7), the next h~l,l,:" ftoar or elevated ~r (e1e\'..~... b) oflhe building Is
, I 11l(m] I I fn(ap) abtNe the IIIghest adlac::ent grade. !
4. For Zone AO only: If no flood depth nunblr is mJilabIe. . the top of the bOttom floor e1~ed in 'a.._..;ana: lIriIb the camniunitt- '
floodplain management ordirumce1 U Yes W No '-.) Unknown. The local otrIdaI mil. C2ftify,this information in s.cuan G.
secnoN F _ PROPERT.Y OWNER (OR OWNER'S REPRESENT AT vEl CCi" I Ir.CATION
"ne prDpertY . ,. growner'Suuth. :,.. J,... ....entaliYuwha c:om~ SedlonsA. B. and ElorZaneA~a FEMA-issUId"or'
:cmmunftY-isaued.BFE) or zaneAO mUll sign herw. 'i . "
" "ROPERT'f OWNEiR'~ {l;:' C'1I'~.~ER'S AUTHORIZeD ~cr.~ESOOATlVES NAME,
DDRESS
:/GNATURE
:OMMENTS
CITY
CATE
STATE
TEl.EPI'tONe
ZIP CODE
, W ChIlCk hete if attachments . '
. SeCTION G -COMMUNITY INFORMATION (C~' '
e local offic:ial,who is authorimd by law cr"'.;;".",",, to adminiater 1t1e community's fIoodp' anagement an:fInanCecan c:amplelll ,
d10ns A. B.' C (or E). and G Gf this Elevation CertiIicaf8. Compleh! the spplic:able ttem(s) andaign below.' '. .
. LJ The information in SediotI C was.. ~".' fi'am .:.,:" ,doCUment3don !hat ". been Signecf am embossed by a licenSed wtVfitor. ,
engineer; or . " ":,,'\K! who IB aut[ ,", 1.... J by Stale or Ioc:ai law to ~-...:.rJ ele'lation inform;jtion. (Indicate the ~ and datil of !he
~ation data in the Commenll area WcIw.) ': " ~ ' .' .
~ U ~ community offlciaI completed S<<tian'E for a building located in Zane A (Wi1hout a FE!WMssued or communitY-lssued BFE,) g(
Zone AO.'. " j
I. U The fallowing infarrna1lon (Items ~ is providIId for c;gmmunityiloodplain m8nagerrient p..' ',' ...:...
... . . :
... PERMIT NUMBER G5. DATE PERMIT ISSUED ., ~1E ~nFl(;Aii; ~ i:U*;:;.r~~ANCY
::-lM permit hIlS been issued lOr: U New C ". 'I',' Jdioi1 L.J Substantiat ImprovernetW ;
. 8evation of ~11l1al~",..,11laor (U1CkIding basement) at.. building is: :
. BFE or (m Zoile AO) depttI Gf lIooding at the tluIlcIna site is:
XAL. OFFICIAL OS NAME
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. _ ft.(In) DaIum:
. _ft.(m) Datum:
TITLE
CMMUNITY NAME
GNATURe
JMMENTS
TEU!PHCNE
DATE
..
I ~ hElre if atllict.ments
AS-PI Ar,J:~ All ~n& ~ J:ntTln.....q
... ~Nm A1..11 AI ~ $IQ
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DA \110 MLLER RESIDENCE
6720 AARON LANE
SPRINGFIELD. OREGON
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'~~ S 88~53.0t' E 75.00' .r ,~...
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AARON LANE .
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, LEGAL DESCRIPTION
LOT 103 OF LEVI lMDING SECOND AOOITlON
AS PLATTED AND RECORDED IN FILE 75. SlDES
US2-l1S5 OF THE LNlE COUNTY PLAT RECORDS
, IN lANE COUNTY. OREGON.
THIS DDES NOT, CONSTITUTE A BOOOARY SURVEY AAD
IS SUBJECT ro ANY INACCURAOES THAT A SUBSEQUENT
BOUNDARY SLRVEY MAY DISClOSE.
I. JONA T~N 'A. OAKES. A REGISTERED PROFESSIONAL LAND SURVEYOR.
DO HEREBY CERTIFY THAT A MORTGAGE LOAN INSPECTION OF THE
ABOVE DESCRIBED PROPERTY WAS HADE BY HE n-us 31ST DAY OF.
OCTOBER 2001 AND THAT THE BUl.DlNGS UPON, SAID LOT DO NOT,
ENCROM:li UPON J1.lE STREHs NOR UPON THE ADJOINING PROPERT'I'
00 THAT TIiE ,BtJlLDlNGS \.fON THE ADJOINING PRoPERTY 00 NOT
ENCROACH uPON SAID LOT, EXCEPT AS SHOWN.
P.OAGE ENGINEERING AND SURVEYING. INC.
P.O. BOX 2527 EUGENE. OREGOH 97402'
tS411 48S-4505 OWN. BY.: CLS
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MI 1727: I
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SCALE: 1-..30'
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REGISTEREO.......
PROFESSIONAL
LAND SURVEYOR
){~A.~
OREGON
JlA.. Y 13. 1084
JON A THAN A. OAKES
" 2105 ./
EXPIRES: DECEMBER 31. 2002
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