Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
Flood Control - Elevation Certificate - 774 S Lake Pointe Way - Mace River Ranch Sub No 05 - 6/12/2017U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
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 rot inslvanr,
OMB No. 1660-0008
Expiration Date: November 30. 2018
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al. Building Owner's Name
Policy Number:
ROBERT & ELIZABETH PERKO
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
Company NAIC Number:
774 S. LAKE POINTE WAY
City State ZIP Code
EAGLE Idaho 83616
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 142, BLOCK 1, MACE RIVER RANCH SUBDIVISION NO. 5, TAX # R5421240320
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 43-41-15.57 Long. -116-21-56.66 Horizontal Datum: ❑ NAD 1927 © NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to flood insurance.
obtain
AT Building Diagram Number 9
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 3,140 sq It
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 ® No
A9. For a building with an attached garage:
a) Square footage of attached garage 1,200 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 © No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP Community Name & Community Number
B2. County Name
B3. State
CITY OF EAGLE, 160003
ADA
Idaho
B4. Map/Panel
Number
B5. Suffix
B6. FIRM Index
Date
B7. FIRM Panel
B8. Flood Zone(s)
B9. Base Flood Elevation(s)
Effective/
(Zone AO, use Base
1600100161
H
09/22/1999
Revised Data
04/28/2009
SHADED X
Flood Depth)
2549.6
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89:
❑ FIS Profile ❑ FIRM ❑ Community Determined ® Other/Source: CASE NO. 17-10-0133A, DECEMBER 06, 2016
Bl 1. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 Z NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes © No
Designation Date: ❑ CBRS ❑ OPA
LIM Form 086-0-33 (ftlb) Replaces all previous editions. Form Page 1 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:
774 S. LAKE POINTE WAY
City State ZIP Code
Company NAIC Number
EAGLE Idaho 83616
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Ct. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' Z Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations — Zones At—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, ARIA, AR/AE, 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: SEE NOTE #1, SECTION D Vertical Datum: NAVD1988
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 N 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) 2550, 9 © feet ❑ meters
b) Top of the next higher floor 2554 3 x❑ feet p meters
c) Bottom of the lowest horizontal structural member (V Zones only) ❑x feet ❑ meters
d) Attached garage (top of slab) 2553, 6 ❑x feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 2553, 8 feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 2553 1 ❑x feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 2553, 35 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2553.7 ❑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.
I 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.
Were latitude and longitude in Section A provided by a licensed land surveyor? ®Yes ❑ No ❑ Check here if attachments.
Certifier's Name License Number
PATRICK SCHEFFLER IDAHO PLS 7015
p,L L4N�
N
Title
LAND SURVEYOR
t
d 9
Company Name
IDAHO SURVEY GROUP
�J'�Zr't
Address
9i,�4 F 0 �trQ
1450 E WATERTOWER ST. #130
OF
J. Sf
State ZIP Code
city
MERIDIAN Idaho 83642
Signs tur Date Telephone
06/12I2017 (208) 846-8570
Copy all pages t2l Llevation M ficate and all attachments for (1) community official, (2) insurance agentloompany, and (3) building owner.
Comments (including type of uipment and location, per C2(e), if applicable)
1) STATION BLUE IS A LOCAL PRIVATE GPS STATION TIED TO THE LOCAL HARN NETWORK (NAVD88)
2) FEMA LOMR-F CASE NO. 17-10-0133A, DECEMBER 06, 2016 CLASSIFIES THIS LOT IN SHADED ZONE X
3) Lowest machinery serving property is AC pump on concrete pad outside building, elev=2553.8
4) Bottom of HVAC ductwork in crawlspace is at elev=2552.20
5) furnace and water heater are elevated in garage at elev=2554.2
FEMA Form 086-0-33 (7115) Replaces all previous editions. roan Faye 2 of o
CI C\/ATIMI r`CRTIFIr-ATF
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
=INSURANCECOMPANYBuilding
774 S. LAKE POINTE WAY
City State ZIP Code
EAGLE Idaho 83616
SECTION E — BUILDINGNOT REQUIRED)
IZONE OUT
BFE)SURVEY
FOR ZONE AO AND A (WIITHNFORMATION
For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOM request,
Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In erto Rico only,
complete
enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elev ion 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 ❑ feet ❑ meters above or ❑below the HAG.
b) Top of bottom floor (including basement,
❑ feet ❑ met ❑ above or ❑ below the LAG.
crawlspace, or enclosure) is
E2. For Building Diagrams" with permanent flood openings provided in Section A Items 8 a /org (seepages 1-2 of Instructions),
the next higher floor (elevation C2.b in
❑ feet meters ❑ above or ❑ below the HAG.
the diagrams) of the building is
E3. Attached garage (top of slab) is ❑ fs ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment feet ❑meters ❑above or ❑below the HAG.
servicing the building is
E5. Zone AO only: If no flood depth number is available, is the top of the botto floor elevated in accordance with the community's
local must certify this information in Section G.
floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. he official
SECTION F — PROPERTY OWNER (OR OWNE S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who comp es Sections A, B, and E for Zone A (without a FEMA -issued or
in Sections A, B, and E are correct to the best of my knowledge.
community -issued BFE) or Zone AO must sign here. The stateme
Property Owner or Owner's Authorized Representative's Nam
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check here if attachments.
For Pnna I of 8
FEMA Form 086-0-33 (7/15) Replaces all previous editions.
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:
774 S. LAKE POINTE WAY
City State ZIP Code
Company NAIC Number
EAGLE Idaho 83616
SECTION G — COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinan can complete
Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check t measurement
used in Items G8—G10. In Puerto Rico only, enter meters.
Gt. ❑ The information in Section C was taken from other documentation that has been signed and sealed a licensed surveyor,
engineer, or architect who is authorized by law to certify elevation information. (Indicate the sour nd date of the elevation
data in the Comments area below.)
G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA -i ued or community -issued BFE)
or Zone AO.
G3. ❑ The following information (Items G4—G10) is provided for community Floodplain manag ant purposes.
G4. Permit Number
G5. Date Permit Issued
G6. Date Certificate of
I A
Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substanti mprovement
G8. Elevation of as -built lowest floor (including basement)
of the building: ❑ feet ❑ meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: [-]feet ❑ meters Datum
G10. Community's design flood elevation: _ ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments (including type of equipment and cation, per C2(e), if applicable)
❑ Check here if attachments.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No.166ao008
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:
774 S. LAKE POINTE WAY
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.
aos nw �
'r
r'
PwoO
Photo One Caption FRONT VIEW
l
Photo Two
Photo Two Caption REAR VIEW
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page 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:
774 S. LAKE POINTE WAY
City State ZIP Code
Company NAIC Number
EAGLE Idaho 83616
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 AS.
1p+>
x�
At
n
Photo one
Photo One Caption RIGHT SIDE VIEW
F7
s
i
►CC oil
Photo Two - -
Photo Two Caption LEFT SIDE VIEW
FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 6 of 6