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Home My WebLink AboutElevation Certificate " pM ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM AENTlON: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to _de elevation information necessary to ensure compliance with applicable community floodplain management ordinances. to delermine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LaMA or LaMA). Instructions for completing this form can be found on the following pages. a.M.S. No3067-00n EJtpm~s May 31, 1993 SECTION A PROPERTY INFORMATION I FOA INSUAJ.NCE COMPANY USE I POLICY NUMBER I COMPANY NAJa NUMBER BUILDING OWNER'S NAME Mike Ferrier S'i!'lEET ADORESS (Incluoing ApI., UM. SUlla andlor Blog. NumCa,) OR P.O. ROUTE AND BOX NUMBE::1 ~14419 Waters edge Trail N.E. ~ - -- OTHER DESCRIPTION (LoI and Bled< Numcers. aIC.) Lot 32, BOUDIN1S MANOR, Scott County, Minnesota CITY Prior Lake ZIP CODE 55372 STATE MN SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FlAM (See Instructions): 1. CCMML:NITY NUMBE,'" 2, ?ANEL ,'lUMBER :1. SUFFIX 4, DATE OF FlAM INOEX 5, FlAM ZONE 6, BASE FlOOO ELEVATION (in AO ZOlln. us. deQUI) 270432 0002 C Nov. 19,1997.<.~ AE 909 7. Indicate the elevation datum system used on the FlAM for Base Flood Elevations (8FE): 'Y;NGVD '29 .-,; Other (describe on back) 8. For Zones A or V, where no 8F~ is provided on the FlAM, and the community has established a BFE for this building site, indicate the community's 8FE: : . ~ feet NGVD (or other FlAM datum-see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions. indicate the diagram number from the diagrams found on Pages 5 and 6 that best Acribes the subject building's reference level ----1- . ~.FIAM Zones A 1 -A30. AE. AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of 909 . ~4teet NGVD (or other FlAM datum-see Section B, Item 7). . (b). FlAM Zones V1 -V30, VE. and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram. is at an elevation of ; , : ! i.~ feet NGVD (or other FlAM datum-see Section B, Item 7). (C). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is ...~ feet above = or below _ (check one) the highest grade adjacent to the building. (d). FlAM Zone AO, The floor used as the reference level from the selected diagram is ;'.~ feet above I I or below fI (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest tloor (reference level) elevated in accordance with the community's floodplain management ordinance? . Ye, , No: I Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: Y NGVD '29 ~ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section a, Item 1], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) / 4, Elevation reference mark used appears on FlAM: LJ Yes ~ No (See Instructions on Page 4) 5. The reference level elevation is based on: :~actual construction Ii construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level tloor in place, in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: I : 9 O~.ill feet NGVD (or other FlAM datum-see Section B, Item 7). SECTION 0 COMMUNITY INFORMATION If the community oHicial responsible for verifying building elevations specifies that the reference level indicated in Section C. Item 1 .ollhe "lowest floor" as defined in the. c~mmunity's floodplain management ordinance, the elevation of the building's "lowest .r" as defined by the ordinance is:: , . I ; I..U feet NGVD (or other FlAM datl,lm-see Section B. Item 7). 2. Dale of the start of construction or substantial improvement FeMA Form 81-311 MAY 90 REPU<CES ALL PREVIOUS ~DITIONS SEE REVERSE SIDE FOR CONTINUATION "' SECTION E CERTJACATJON -ThiS certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al-A30, AE. AH, A (with BFE),Vl-V30,VE, and V (with BFE) is required, ,Community officiaJs who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building officiaJ, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features-If the certifier is unable to certify to breakaway/non-breakaway waJl, enclosure size, location of servicing equipment. area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.. J certify that the information in Sections B and C 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. James E. Boerhave Minn. Reg. No. 7095 UCENSE NUMBER (or Affix Seal) Boerhave Land Surveying, Inc. COMPANY NAME Prior Lake CITY CERTIFIER'S NAME President TITLE Nov. 25, 1998 DATE MN 55372 STATE (612) 445-9154 PHONE ZlP 14243 Mitoka AOORe~. ,~ SIGN.DdAe Circle N.E. Copies should be made of this ~rtltlcate for: 1) community oHlcial, 2) insurance agent/company, and 3) building owner. COMMENTS: e ON SLAB wrTH BASOlEHT ON PILES. PIERS. OR COLUMNS ,~~~~~ ~ . . _ .' :-.~>_..I r ~~ ' r 1"'~"-l """.~~ ~ t1 r ~t;L:i::X~ fUVA T10H I ~EI'V'VCIi I EHT LEVEl. . QAAQE l~efE"ENCE ~ LEVEl. . ltr \ I .~~.~ ==-- ........- r V ZONES 'Viir ~ IIIE1=EI to;- ~l ~ ~. ~' '\ El~ ~~ \\ ~I \\/\:':;t~ l'~l"''''(''.: ~~t{~WtiR~l&~j;iI~~R ~:{~'=.~ A V ZONES ZONES A -I'tr ZONES . . r~~ :~I c~EI'V'ENC~1 a....cE . .. .:ti' LEVEL . , ;;t;1 , r!;~i"' ..r.."....:...'!r ~"1't~.'N~.,...;~ A ZONES e The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations tor all A Zones should be measured at the top of the reference level floor. Elevations for all V. Zones should be measured at the bottom of the lowest horizontaJ structural member. Page 2