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Flood Control - Elevation Certificate - 1105 W Back Forty Dr - Mace River Ranch Sub No 05 - 6/6/2019U.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:
Gardner Mace Ranch LC
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
1105 W Back Forty Dr.
City State ZIP Code
Eagle Idaho 83616
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 2, Block 7 of Mace River Ranch Subdvision No. 5, Parcel No. R5421240420
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. N43°41'17,71" Long. W116°22'03,46" Horizontal Datum: ❑ NAD 1927 ❑x 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 2A
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 3,171 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 ❑x No
A9. For a building with an attached garage:
a) Square footage of attached garage 1,014 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 County
Idaho
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s)
Number Date Effective/ (Zone AO, use Base
Revised Date Flood Depth)
160001CO153 H 10/02/2003 02/19/2003 X (Shaded) 2549.4
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69:
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑x Other/Source: LOMR F-17-10-133A&CLOMR-F-1510C
B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 ❑x 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 (7/15) 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:
1105 W Back Forty Dr.
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* ❑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, 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 AT In Puerto Rico only, enter meters.
Benchmark Utilized: IDTD PID AJ3346 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) 2550 1 ❑x feet ❑ meters
b) Top of the next higher floor 2553 4 ❑x feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) n/a. ❑x feet ❑ meters
d) Attached garage (top of slab) 2552 7 ❑x feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building _ 2550 7 ❑x feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 2551 8 x❑ feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 2552 7 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2552 8 ❑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. 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? x❑ Yes ❑ No ❑ Check here if attachment
Certifier's Name License Number
Robert L. Kazarinoff 16642
Title
�' d
PLS
Company Name
J -U -B Engineers, Inc.
Address re
250 S. Beechwood Ave., Ste 201 OF
City State ZIP Code KAP'
Boise Idaho 83709 (PAC 2V
Signature Date Telephone
©' (208) 376-7330
Copy all pages of this le tion Certif and al tachments for 1) c mmunity official, (2) insurance agent/company, and (3) building owner.
Comments (including type of eqj' men and tion, per C2(e), if applicable)
C2e. Ducts under house.
FEMA Form 086-0-33 (7/15) 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:
1105 W Back Forty Dr.
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.
i
Photo One
Photo One Caption Front Right
RAN
SNOW,
. t
•� . x. -Ad
4
Photo Two
Two Caption Right Rear
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, 201E
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:
1105 W Back Forty Dr.
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 A8.
Photo One
Photo One Caption Right Left
Photo Two Caption Front Left
IWA NK—;.
Photo Two
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6