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Flood Control - Elevation Certificate - 774 S Lake Pointe Way - Mace River Ranch Sub No 05 - 6/12/2017
U.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