HomeMy WebLinkAboutElevation Certificate 06.25.2019U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
OMB No. 1660-0008
Expiration Date: November 30, 2018
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
Margaret Tolan
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
N/A Surrey Street
Company NAIC Number:
City State ZIP Code
Carbondale Colorado 81623
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 6, Elder Amended Plat
A4. Building Use (e.g.,
A5. Latitude/Longitude:
A6. Attach at least
A7. Building Diagram
A8. For a building
a) Square footage
b) Number of
c) Total net area
d) Engineered
A9. For a building
a) Square footage
b) Number of
c) Total net area
d) Engineered
Residential, Non -Residential, Addition, Accessory,
Lat. N39°24'34" Long. W107°10'31"
etc.) Residential Lot
Horizontal
Datum:
insurance.
above
grade
❑ NAD 1927
adjacent grade
N/A
I NAD 1983
0
2 photographs
Number
with a crawlspace
of crawlspace
permanent flood
of flood openings
flood openings?
with an attached
of attached
permanent flood
of flood openings
flood openings?
of the building if the
6
or enclosure(s):
or enclosure(s)
openings in the crawlspace
in A8.b
❑ Yes ❑ No
garage:
garage
openings in the attached
in A9.b
Certificate
is being used to obtain flood
379 sq ft
or enclosure(s)
N/A sq in
within 1.0 foot
1.0 foot above adjacent
in
N/A sq ft
garage within
N/A sq
❑ Yes ❑ No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
GARFIELD COUNTY, 080205
B2. County Name
GARFIELD
B3. State
Colorado
B4. Map/Panel
Number
0802051880
B5. Suffix
B
B6. FIRM Index
Date
12-15-77
B7. FIRM
Effective/
Revised
01-03-86
Panel
Date
or base flood
❑ Other/Source:
1929
(CBRS)
❑ OPA
B8. Flood
Zone(s)
A3
depth entered
❑ NAVD 1988
area or Otherwise
B9. Base
(Zone
6205.00
in Item
❑ Other/Source:
Protected
Flood E evation(s)
AO, use Base Flood Depth)
B10. Indicate the source
❑ FIS Profile
B11. Indicate elevation
B12. Is the building
Designation Date:
of the
Base Flood Elevation
[] Community Determined
for BFE in Item B9:
Coastal Barrier Resources
❑
(BFE) data
B9:
F2 FIRM
datum used
located in a
K NGVD
System
CBRS
Area (OPA)?
❑ Yes Q No
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:
Number
City State ZIP Code
Company WAIL
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
❑ Finished Construction
AR/A1—A30, AR/AH, AR/AO.
Rico only, enter meters.
C1. Building elevations are based on: • Construction Drawings* ❑ Building Under Construction*
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations — Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE,
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto
Benchmark Utilized: N-158 Vertical Datum: NAVD 29
Indicate elevation datum used for the elevations in items a) through h) below.
• NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE,
Check
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 6209.00
the measurement used.
V1 feet
• meters
❑ meters
❑ meters
b) Top of the next higher floor 6218.00
M feet
❑ feet
c) Bottom of the lowest horizontal structural member (V Zones only)
N/A
N/A
d) Attached garage (top of slab) 6209.00
• feet
feet
• meters
meters❑
❑ meters
e) Lowest elevation of machinery or equipment servicing the building
type and location in Comments)
(Describe of equipment
f) Lowest adjacent (finished) grade next to building (LAG) 6201.60
Q feet
g) Highest adjacent (finished) grade next to building (HAG) 6205.25
F2 feet • meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support N/A
K1 feet ■ meters
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by
I certify that the information on this Certificate represents my bast efforts to interpret the data available.
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
law to certify elevation information.
I understand that any false
❑ Check here if attachments.
Were latitude and longitude in Section A provided by a licensed land surveyor? M Yes ❑ No
Certifier's Name License Number
Bill W.A. Baker 23875
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Survey Department Manager.--.\.��'
Company Name
High Country Engineering
Address
1517 Blake Ave, Suite 101
City State ZIP Code
Glenwood Springs Colorado 81601
Signature JDate Telephone Ext.
f • 06-25-19 970-945-8676 139
Copy all pages of this Elevation 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)
FEMA Form 086-0-33 (7/15)
Replaces all previous editions.
Form Page 2 of 6