Flood Control - Elevation Certificate - 1617 E Lone Shore Lane - Renovare Sub No 01 - 8/24/2016U -S, DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY
Nalional Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
. . ........ . ..... .
OMB No. 1660-0008
Expiration Date: July 31, 2015
FOR INSURANCE COMPANY USE
A1. Building Owner's Name MDG LLC I Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, Company NAIC Number:
1617 East Lone Shore Lane I
City Eagle
State ID ZIP Code 83616
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 29 Block 1 Rnavare Subdivision Phase l
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude:Lat. N43'41'05.70' Long. W116*20'02,11' Horizontal Datum: El NAD 1927 0 NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7.Building Diagram Number 113
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 711 sq ft
b) Number of permanent flood openings iin the crawlspace b) Number of permanent flood 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 flood openings in A9.b NIA sq in
d) Engineered flood openings? 171 Yes 0 No d) Engineered flood openings? El Yes 0 No
SECTION13 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bl. N'FIP Community Name & Community Number B2. County Name B3. State
Eagle, City of 160003 Ada
FIRM Index Date e
October
0
B4. Map/Panel Number B5. Suffix B& FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zen
16001CO162 H�u October 2, 2003 Effective/Revised Date Zone(s) AO, use base flood depth)
February 19', 2003 AE 2570.80
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item Bg,
171 FIS Profile 0 FIRM El Community Determined El Other/source:
1311. Indicate elevation datum used for BFE in Rem 139: El NGVD 1929 0 NAVO 1988 ❑ Other/Source:
812, Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? El Yes 0 No
Designation Date: E] CBRS El OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based, on: D Construction Drawings* r-1 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, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, 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: NAVID 88
Indicate elevation datum used for the elevations in items a) through h) below. 0 NGVD 1929 0 NAVID 1988 0 Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
C) Bottom of the lowest horizontal structural member (V 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 Comments)
0 Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
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.
I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
D 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? ID Yes [I 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
11gov-
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions,
Check the measurement used.
2573,72
9 feet
El meters
N/A.
0 feet
[I meters
N/A.
D feet
El meters
257142
ED feet
0 meters
2573.02
0 feet
E) meters
2573.17
0 feet
El meters
2573.39
0 feet
El meters
NIA.
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.
I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
D 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? ID Yes [I 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
11gov-
FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions,
ELEVATION CERTIFICATE,
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:
1617 East Lone Shore Lane
City Eagle State ID ZIP Code 83616 Company MAIC Number:
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINI l
Copy both sides of this Elevation Certificate for (11) community official, (2) insurance agent/company, and (3) building owner.
1;_.=VC1L1U11 llbueu cw ke ime is a composite A/C pad grade on the west side of the structure.
Signature
Date August 24, 2016
Z>l I IUN L - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BEE), complete Items EI -E5. If the Certificate is intended to support a LOMA or LOMB -F request, complete Sections A, 13,
and C. For Items EI -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevafion, 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, crawlspace, or enclosure) is El feet El meters El above or El below the HAG.
b) Top of bottom floor (including basement, craWspace, or enclosure) is 171 feet El meters D above or El 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 El feet [] meters EJ above or El below the HAG.
E3. Attached garage (top of slab) is _._ E] feet El meters El above or 0 below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is n feet [:1 meters El above or C] 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? El Yes E] No El 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 Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
[:3 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 -G10, In Puerto Rico only, enter meters.
G1. D 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. El A community official completed Section E for a building, located in Zone A (without a FEMA -issued or community -issued BEE) or Zone AO,
G3. Ell The following information (Items G4 -G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit —Issued--] G(F Data Certificate Of Compliance/Occupancy Issued
G7, This permit has been issued for: El New Construction El Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: El feet El meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet El meters Datum
G10. Community's design flood elevation:
El feet El meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
Check here if attachments.
FEMA Form 086-0-33 (7/12) 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.J. Route and Box No. Policy Number:
1617 East Lone Shore Lane
City Eagle State ID ZIP Code 83616 Company NAIL 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 (7112) 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. Po icy Number;
1617 East Lone Shore Lane
City Eagle State ID ZIP Code 83616 Company MAIC Number:
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.
rrzivim rorm ubb-u-j3 (au) Replaces all previous editions.