Flood Control - Elevation Certificate - 1041 N Grey Pebble Way - Clear Creek Crossing Sub - 7/5/2013U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY
National blood hisurance Program Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
Al. Building Owner's Name ken Grik
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O, Route and Box No.
1041 N. Grey Pebble Way
City Eagle
State ID ZIP Code 83616
LOMB No. 1660-0008
Jul
Expiration Date: July �31, 2015
_A3- -Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 25, Block 3, Clear Creek Crossing Subdivision
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) residential
A5. Latitude/Longitude: Lat. 43-42 Long. 116-21 Horizontal Datum: 0 NAD 1927 Z NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagrarn Number 9
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 2269 sq ft a) Square footage of attached garage 1000 sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b 9 sq in c) Total net area of flood openings in A9.b 0 sq in
d) Engineered flood openings? El Yes E No d) Engineered flood openings? El Yes M No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B2 County Name
ADA Bl. NFIP Community Name & Community Number B2. County Name B3. State
Ada County, Idaho & Incorp . Areas - 1600 ADA ID
B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel FB8. Flood B9. Base Flood Elevation(s) (Zone
'L
1600100153 H 2-19-2003 Effective/Revised Date Zone(s) AO, use base flood depth)
1
2-19-2003 X 2582.1
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89.
El FIS Profile E FIRM 0 Community Determined El other/Source:
Bl 1. Indicate elevation datum used for BFE in Item B9: EJ NGVD1929 Z NAVD 1988 F-1 Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? El Yes Z No
Designation Date: El CBRS Ej OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: F] Construction Drawings* F1 Building Under Construction* 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/Al-A30, AR/AH, AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: AH7375 Vertical Datum: NAVD 88
Indicate elevation datum used for the elevations in items a) through h) below. b-NGvD 1929 0 NAVD 1988 171 Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
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
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, en architect �k
I - .. , - authorized by law LO certify elevation
Information. I certify that the information on this Certificate represents my best efforts to interpret the data available,
/ understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
El Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
0 Check here if attachments. licensed land surveyor? M Yes El No
Certifier's Name Colleen Marks License Number 7045
:Title Land Surveyor Company Name Marks Land Surveying, Inc.
Ad 5300 W Hill ill Road City Boise State ID ZIP Code 83703
W.
�a 7- -2013 Telephone 208-378-7703
Sig
Sj'ga�ts �'
J , , . I . , 5
FEMA Form 086-0-33 (7/12) See reverse side for continuation.
Replaces all previous editions.
Check the measurement used.
2582..1
Z feet
El meters
2584..8
Z feet
El meters
nn/a.
El feet
El meters
2584.1
E feet
El meters
2583.3
R feet
El meters
2583.8
E feet
F] meters
2584.4
M feet
F] meters
n/a•
❑ feet
❑ meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, en architect �k
I - .. , - authorized by law LO certify elevation
Information. I certify that the information on this Certificate represents my best efforts to interpret the data available,
/ understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
El Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
0 Check here if attachments. licensed land surveyor? M Yes El No
Certifier's Name Colleen Marks License Number 7045
:Title Land Surveyor Company Name Marks Land Surveying, Inc.
Ad 5300 W Hill ill Road City Boise State ID ZIP Code 83703
W.
�a 7- -2013 Telephone 208-378-7703
Sig
Sj'ga�ts �'
J , , . I . , 5
FEMA Form 086-0-33 (7/12) See reverse side for continuation.
Replaces all previous editions.
�N_'~'" 1=�'1_3 p_tJ= �
IMPORTANT: In these spaces, copy the c—orr
esponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box NO.
1041 N. Grey Pebble Way
City Eagle State ID ZIP Code 83616
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy bot sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Signature Date
SECTION "W E — BUILDING ELEVATION INFORMATION (SURVEY NOT - REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AOand A(without oFE\ complete Items El—E5. ��*Cpn�ca��in�ndeduzauppo�aL0MAmLOMm��qu��oomp��Geo8nnaA,B
and C. Fm/�msEl—E4.wmnam�|gmuo.�avai�mo.Ch�kthe m�mo�mentused. |npvenumcoon|»*n��me�m '
El. Provide elevation information for the following and check the appropriate boxes toshow whether the elevation iaab mhe|mwmohioxeo�mNace t
g�ue(HAG)and the lowest a�acnntgrade (L^G). ""� »
u)Top ofbottom floor (including basement, oowepao*.nrenclosure) is[]feet r-1 meters []abmmor[]below the HAG.
NTop ofbottom floor (including basement, omw|npaoo.v,enclosure) is---'---- El feet [] meters [] above or[]below the LAG
E2. For Building Dia 8-8 ithpermanent flood openings pmvidedin----`---aanu/ors(seopagone—Sof|na�m000no) the �m ' 8
(e|vvaunnC2Uin�ediagmma)ofmeuui|dinAio []�* Section''~~''~ ' en*» higher «»'
� __�� Umstem Uabove or Obelow the HAG,
E3. Attached garage (top ofslab) in ___'.___. []feet 171 meters [] above nr [] below the HAG
E4. Top nfp|x�onnofmaohino�and/or equipment ae�ioinDmebuilding io . []foot [-] meters
[] above o,[]below moHAG.
E5. Zone AOonly: bottom floor
elevated inaccordance management
nanagement
ordinance? []Yeo [] No 171 Unknown. The local official must certify this information inSection 8
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 AD must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address
City State ZIP Code
Signature
Date Telephone
Comments
H Check here if attachments.
SECTION G — COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance Gan complete Sections A, B, C (or E), and G
of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters.
G1. El The information in Section C was taken from other documentation that has been signed and sealed by a licensed 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. El A community official completed Section E for a building located in Zone A (without a FEMA -issued or cornmunity-issued BFE) or Zone AO.
G3. El The following information (Items G4—G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued
Gr This permit has been issued for: ONew Construction OSubstantial Improvement
SO. Elevation ofas-built lowest floor (including basement) orthe building: R feet meters Datum
G9. epEo,(in Zone AO) depth offlooding at the building site: []feet []meters Datum
810Community's � � El feet El meters Datum
Local Official's Name Title
Community Name
Telephone
Signature Date
Comments
Check here if attachments.
FEMA Form O8G4]-33(7Y12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
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.
1041 N. Grey Pebble Way
City Eagle
State ID ZIP Code 83616
FOR INSURANCE COMPANY USE
Policy Number:
Company NA|CNumber:
K submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; ^Fmrd View^ and "Rear View"; and, J required, ^FUgN Side Vlew^ 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.
0
FEMA Form U8d-0-33(7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 Building r
aphs
See Instructions for Item A6.