Flood Control - Elevation Certificate - 1079 Don Vincent Lane - Renovare Sub No 01 - 8/24/2016U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY
NahOrlal rlOod Insurance Prograin Important: Read the instructions on pages 1-9,
SECTION A – PROPERTY INFORMATION
Al. Building owner's Name
OMB No, 1660-0008 —1
Expiration Date: July 31, 2015
FOR INSURANCE COMPANY USE
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No,) or P.O. Route and Box No. Company NAIC Number:
1079 South Don Vincent Lane I
City Eagle
State ID ZIP Code 83616
A3. Proporty Description (Lot, and Block Numbers, Tax Parcel Number, Legal description, etc.)
A4. Building Use (e.g,, Residential', Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitudell-ongitude: Lat. N43'411'07.37" Long. � 1 �16W�03,72" Horizontal Datum: El NAD 1927 N NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number 1Q
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosures) N/A sq ft a) Square footage of attached garage 448 sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent good openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade NIA within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8,b N/A sq in c) Total net area of 1i openings in A9.b N/A sq in
d) Engineered flood openings? El Yes 0 No — d) Engineered flood openings? 0 Yes 0 No
SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1, �NFIPCoimmunity Name & Community Number B2. County Name B3, State
�C���
P Community
Ada :EI D
[E�agle, City of 160003
B4. Map/PanelNumber B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood 89 Blase Flood Elevations) (Zone
Base
o
use I
1600100162 H October 2, 2003 Effective/Revised Date Zone(s) �AO, use base �flood depth)
February 19, 2003 AE 2570.60
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
D FIS Profile 0 FIRM El Community Determined ❑ Other/Source:
B11, Indicate elevation datum used for BFE in Item B9: E] NGVD1929 NAVD 1988 D Other/Source:
2112. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes No
Designation Date: [I CEIRS EJ OPA
SECTION C – BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: D Construction Drawings* E] Building Under Construction* N Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete,
C2. Elevations – Zones AI–A30, AE, AH, A (with BFE), VE, VI–V30, V (with FIFE), AR, ARIA, AR/AE, AR/A1–A30, AR/AH, AR/AO. Complete Items C2.a–h
below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized! Project Benchmark Vertical Datum: NAVD 88
Indicate elevation datum used for the elevations in items a) through h) below. El NGVD 1929 0 NAVD 1988 El 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) 2673.0 ED feet El meters
b) Top of the next higher floor NiA. El feet EI meters
c) Bottom of the lowest horizontal structural member I Zones only) NIA. El feet D meters
d) Attached garage (top of slab) 2572.76 El feet [] meters
e) Lowest elevation of machinery or equipment servicing the building 2572.81 ED feet [3 meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 2572.66 0 feet F1 meters
g) Highest adjacent (finished) grade next to building (HAG) 2572.71 0 feet 0 meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Ni El feet El 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 law to certify elevation
information. / certify that the information on this Certificate represents my best efforts to interpret the data available,
If understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
El Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
El Check here if attachments. licensed land surveyor? 0 Yes El No
..
Certifier's Name Aaron L. Ballard License Number 12459
Title PLS Company Name KM Engineering, LLP
Address 9233 W. State Street City Boise State ID ZIP Code 83714
Signature Date August 24, 2016 Telephone 208-639-6939
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions,
ELEVATION CERTIFICATE, page 2
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:
1079 South Don Vincent Lane
City Eagle State ID ZIP Code 83616 Company MAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments Elevation listed @ C2 line is a concrete A/C pad grade located on the north side of structure,
Signature
Date August 24, 2016
btk; I IUN't: - 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 E1 -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 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 (including basement, crawispace, or enclosure) is El feet 0 meters El above or D below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is [:] feet [:] meters E] above or EJ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood' openings provided in, Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2,b in the diagrams) of the building is _,_ E] feet [I meters EJ above of [I below the HAG.
E3. Attached garage (top of slab) is _._ [] feet [:] meters El above or D below the HAG,
E4. Top of platform of machinery and/or equipment servicing the building is —._ [:] feet [:] meters [] above or EJ 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? EJ Yes El No [] Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
Thee property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community issLied BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
r1upurty owners or owners ALIMOnzed Representative's Name
"Wul UZSZS
City State ZIP Code
Signature Date Telephone
Comments
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 items) and sign below. Check the measurement used in Items G9 -G10. In Puerto Rico only, enter meters,
G1. [J The information in Section C was taken from other documentation that has been signed and, sealed by 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. El 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. F-1 The following information (Items G4 -G1 0) 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 C1 Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: 0 feet El meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: El feet El meters Datum
G10. Community's design flood elevation:
El feet [] meters Datum
Local Official's Name Title
Uommunity Name Telephone
Signature Date
Comments
Ell Check here �ifattachments,
r ml r orm uot)-u- 11 (1/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 Building Photographs
See Instructions for Item, A6,
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:
1079 South Don Vincent Lane
City EagleState ID ZIP Code 83616 Company MAIC Number:
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 A8, If submitting more photographs than will fit on, this page, use the Continuation Page.
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
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:
1079 South Don Vincent Lane
City Eagle State ID ZIP Code 83616 Company MAIC Number-, -7
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.
Back View
2016
LNIA I-orm U615-0-33(7/12) Replaces all previous editions.