Flood Control - Elevation Certificate - 1745 East Lone Shore Lane - Renovare Sub No 01 - 3/28/2017U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
RECEIVED & FILED
CITY OF EAGLE
MAR 2 9 2017
Fite:
Route to:
OMB No. 1660-0008
Expiration Date: November 30, 2018
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
Al. Building Owner's Name
MDG LLC
FOR INSURANCE COMPANY USE
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number:
Box No.
1745 East Lone Shore Lane
City State ZIP Code
Eagle Idaho 83616
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 22 Block 1 Renovare Subdivision Phase 1
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. N43°41'03.68" Long. W116°19'56.71" Horizontal Datum: ❑ NAD 1927 ❑C 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 1B
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 0 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 0 sq in
d) Engineered flood openings? ❑ Yes E No
A9. For a building with an attached garage:
a) Square footage of attached garage 758 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade
c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? ❑ Yes E No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
Eagle, City of 160003
B2. County Name
Ada
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel
Number Date Effective/
Revised Date
16001C0162 H 10/02/2003 02/19/2003
B8. Flood Zone(s)
x
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
0 FIS Profile ❑x FIRM ❑ Community Determined 0 Other/Source:
0
B3. State
Idaho
B9. Base Flood Elevation(s)
(Zone A0, use Base
Flood Depth)
2571.6
B11. Indicate elevation datum used for BFE in Item B9: ❑ 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: 0 CBRS ❑ OPA
FEMA Form 086-0-33 (7/15)
Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
1745 East Lone Shore Lane
City State ZIP Code
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 A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, ARAE, AR/A1—A30, AR/AH, AR/A0.
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 -OPUS Vertical Datum: NAVD 88
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
OMB No. 1660-0008
Expiration Date: November 30, 2018
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC Number
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)
f) 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
2574, 92
0,
0
2574.65
2574.60
2574.42
2574.82
0.
Check the measurement used.
0 feet
feet
O feet
O feet
O feet
x❑ feet
O feet
0 feet
❑ meters
❑ meters
❑ meters
❑ meters
❑ meters
❑ meters
❑ meters
❑ 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.
I certify that the information on this Certificate represents my best efforts to interpret the data available..1 understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor?
Certifier's Name License Number
Aaron L. Ballard 12459
Title
PLS
Company Name
KM Engineering, LLP
Address
9233 W. State Street
City
Boise
Signature
State
Idaho
Date
03/28/2017
0 Yes ❑ No E Check here if attachments.
ZIP Code
83714
Telephone
(208) 639-6939
Copy all pages 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)
Elevation listed on line C2 e, is an A/C unit on the west side of structure. Prior to LOMR-F Case No. 15-10-0296A the subject property
was within Zone AE.
FEMA Form 086-0-33 (7/15) Replaces all previous editions.
Form Page 2 of 6
BUILDING PHOTOGRAPHS
ELEVATION CERTIFICATE See Instructions for Item A6.
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
1745 East Lone Shore Lane
City State ZIP Code
Eagle Idaho 83616
OMB No. 1660-0008
Expiration Date: November 30, 2018
FOR INSURANCE COMPANY USE
Policy Number:
Company NAIC 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.
Photo One
Photo One Caption Front view.
Photo Two Caption Rear view.
FEMA Form 086-0-33 (7/15)
Photo Two
Replaces all previous editions.
Form Page 5 of 6