Flood Control - Elevation Certificate - 785 S Brentbrook Ln - Mace River Ranch Sub No 04 - 8/6/2018U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 201 e
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of th=s Elevation Certificate and all attachments for (1) community official, (2) insurance agenticompany and (3) building owner
SECTION A — PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
Al Building Owners Name
Policy Number.
Derek Nalewajko
Company NAIC Number.
A2 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
785 S. Brentbrook Ln
City State ZIP Code
Eagle Idaho 63616
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 64 Block 1 Mace River Ranch Subdivision No. 4 Parcel R5421230220
A4. Building Use (e.g. Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. N43.68811 ° Long. W116.37366' _ Horizontal Datum: ❑ NAD 1927 Jx NAL '983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance,
AT Building Diagram Number 9
A8. For a building with a crawlspace or enclosure(s)
a) Square footage of crawlspace or enclosure(s) 2,910 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 food openings? ❑ Yes ❑x No
A9. For a building with an attached garage:
a) Square footage of attached garage 1,675 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) B9. Base Flood Elevat n(s)
Number Date Effective/(Zone AO, use Ba:
Revised Date flood Depth)
16001CO153 H 10/02/2003 02/19/2003 AE 8 X(Shaded) 2544.9
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑ FIS Profile ❑ FIRM ❑ Community Determined Q Other/Source. LOMR-F 16-10-0423A
811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source
B12 Is the build ng located in a Coastal Barrer Resources System (CBRS) area or Otherwise Protected Area (OPA)? J Yes X No
Designation Date L CBRS F -J OPA
FEMA Form 086-0-33 (7/15) Replaces all previous eddions. Farm Pagel of 6
n&AG \Iw 4aaA MAD
ELEVATION CERTIFICATE 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:
785 S. Brentbrook Ln
City State ZIP Code
Company NAIC Number
Eagle Idaho 83616
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1 Building elevations are based on ❑ Construction Drawings* ❑ Building Under Construction* 0 Finished Construction'
A new Elevation Certificate will be requ red when construction of the building is complete
C2 Elevations - Zones Al -A30, AE, AH, A (with BFE). VE, V }-V30, V (with BFE), AR. ARIA. ARAE, AR/Al-A30. AR/AH, AR/AO.
Complete Items C2.a-h below according to the budding diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: IDTD PID AJ3346 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.
Check the measurement used
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 2546.0 0 feet ❑ meters
b) Top of the next higher floor 2549.4 _ 0 feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) n/a. 0 feet ❑ meters
d) Attached garage (top of slab) 2548. 7 0 feet ❑ meters
e) Lowest elevation of machinery or equi nt servicing the building 2547 0 0 feet E] meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 2547.7 0 feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 2549.2 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2549 2 0 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 represenis my best efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment cinder 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a ncensed land surveyor? 0 Yes ❑ No ❑ Check here if attachments.
Certifier's Name License Number
Michael Byms 11334
Title
A`t�`
PLS
Company Name
J -U -B Engineers, Inc.
Address d' r�
250 S. Beechwood Dr. Suite 201 E Of
City State ZIP Code
Boise Idaho 83616
Date
Signa tu DTelephone
O/ (208) 376-7330
Copy all pagd& VAElevation 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)
C2(e)=Ducts under house. Garage Mechanical Pad = 2549.3. A/C Pad = 2548.5. Second Story Mechanical (Furnace)= 2561.0.
C2(0 NW corner of house
C2(g) Front Patio
C2(h) Columns on front and back patio.
Landscaping / topsoil not complete.
FEMA Form 086-0-33 (7/15) Replaces all previous editions Form Page 2 of r
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.
785 S. Brentbrook Ln
City State ZIP Code
Company NAIC Number
Eagle Idaho 83616
SECTION E — 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 o
enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or b. w
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,
crawlspace, or enclosure) is _ . ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions),
the next higher floor (elevation C2.b In
the diagrams) of the building is _ . ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is ❑ feet ❑ meters ❑ above or ❑ 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 communit
floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Se n 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 or Owner's Authorized Representative's Name
Address City State ZIP Cod
Signature Date Telephone
Comments
❑ Check here if attachments.
FEMA Forth 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6
ELE ATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
IMPO ANT: In these spaces, copy the corresponding Information from Section A.
FOR INSURANCE COMPANY USE
Build Street Address (including Apt, Unit, Suite, and/or Bldg. No ) or P.O. Route and Box No.
Policy Number:
785 S Brentbrook Ln
City State ZIP Code
Company NAIC Number
Eagle Idaho 83616
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The I cal official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sect s A, B, C (or E), and G of this Elevation Certificate. Complete the applicable ftem(s) and sign below. Check the measurement
used Items G8-1310. In Puerto Rico only, enter meters.
G1 The information in Section C was taken from other documentation that has been signed and sealed by a ilcensed 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 A community official completed Section E for a building :orated in Zone A Iw thout a FEMA -issued or community -issued BFE]
or Zone AO.
G3 The following nformation (Items 134-1310) is provided for community floodplain management purposes.
G4 rmit Number
G5. Date Permit Issued
G6 Date Certificate of
Compliance/Occupancy Issued
G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as-buih lowest floor (including basement) ❑feet E] meters
of the building: - 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 „fficial's Name Title
Community Name Telephone
S igrim -re Date
Comm nts (including type of equipment and location, 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. 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:
785 S. Brentbrook Ln
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 the
instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View'; and, if required 'Right Side Vi and
"Left Side View." When applicable, photographs must show the foundation with representative examples of the flood open s or
vents, as indicated in Section AS If submitting more photographs than will ft an this page, use the Continuation Page.
_
n
Prom OM
Photo One Caption Front View - 8/3/2018
5 •-
Photo T—
Photo Two Caption Rear View - 8/3/2018
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELE ATION CERTIFICATE Continuation Page Expiration Date: November 30, 2018
IMPO TANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Build
g Street Address (including Apt., Unit, Suite, and/or Bldg- No.) or P -O. Route and Box No.
Policy Number.
785—
Brentbrook Ln
City
State ZIP Code Company NAIC Number
Eagle
Idaho 83616
If s
thng more photographs than will fit on the preceding page, affix the additional photographs below Identify all photographs
wit
to taken; "Front View" and "Rear View". and, if required, 'Right Side View" and 'Left Safe View " When applicable,
phu
phs must show the foundation with representative examples of the flood openings or vents- as indicated in Section A8.
� r
4.
._ Prom One
Phot
. r)e Caption Left Rear View - 8/3/2018
s
Prom T—
Pho
rro Caption Right Rear View - 8/3/2018
FEM , rorm 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6