Flood Control - Elevation Certificate - 395 W Back Forty Dr - Mace River Ranch #2 - 12/15/2016U,S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Policy Number:
James and Jeanne Buschine
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
395 W. Back Forty Drive
City State ZIP Code
Eagle Idaho 83616
A3_ Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 9, Block 2, Mace River Run Subdivision No. 21
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat.43'41'1723"N Long. 116°21'33.75"W Horizontal Datum: O NAD 1927 E 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 9
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 2,599 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 21
c) Total net area of flood openings in A8.b 1,680 sq in
d) Engineered flood openings? ❑ Yes ❑x No
A9. For a building with an attached garage:
a) Square footage of attached garage 1,167 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes ❑x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name B3. State
City of Eagle 160003
Ada Idaho
B4. Map/Panel
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood Zone(s)
1139. Base Flood Elevation(s)
Number
Date
Effective/
(Zone AO, use Base
Revised Date
Flood Depth)
16001 C0153
H
02/19/2003
04/28/2009
AE
2553
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69:
❑ FIS Profile ❑ FIRM ❑ Community Determined 0 Other/Source: LOMR Case No. 08-10-0528P
1311. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 [E NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 7 of 6
ELEVATION CERTIFICATE
OMB No, 1660-0008
Expiration Date: November 30, 2018
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:
395 W. Back Forty Drive
City State ZIP Code
Company NC Number
Eagle Idaho 83616
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction x❑ 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, ARIA, ARAE, AR/Al-A30, ARIAH, ARIAO.
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: Boise River Study BM No. 135 Vertical Datum: NAVD88
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 ❑x NAVD 1988 ❑ 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) 2555 69 ❑x feet ❑ meters
b) Top of the next higher floor 2558 71 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) n/a 0 feet ❑ meters
d) Attached garage (top of slab) 2558 5 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 2558 71 ❑x feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 2557 34 0 feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 2S57.69 X feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including n/a ❑x feet ❑ meters
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.
l certify that the information on this Certificate represents my best efforts to interpret the data available. l understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 9001.
Were latitude and longitude in Section A provided by a licensed land surveyor? El Yes ❑ No ❑Check here if attachments.
Certifier's Name License Number
Jeremiah B Fielding 12220Q
p.
�p1STEgF 9`
Title
Owner
20
0
Company Name
Eagle Land Surveying, LLC.
/`Z►�
Address
106 W. Main Street Unit D
+,�d�'H�`3
'9 rE Of No
Af{ B•
City State ZIP Code
Middleton Idaho 83644
Signature Date Telephone
!�
12/15/2016 (208) 861-7513
Copy all p es of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
Furnace is located in the garage.
FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 2 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018
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:
395 W. Back Forty Drive
City State ZIP Code
Company NAIC Number
Eagle Idaho 83616
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.
a.
Photo One
Photo One Caption Front View
f
i
t r
r -
n
r
Photo Two
Photo Two Caption Rear View
FEMA Form 086-0-33 (7115) Replaces all previous editions. corm rage o ui v