HomeMy WebLinkAbout05040108-Elevation CertificateFEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
Expires Dec~
ELEVATION CERTIFICATE
Important: Read the instructions on pages I - 7.
SECTION A - PROPERTY OWNER INFORMATION
ND BOX NO
BUILDING STREET ADDRESS (thduding ApL Unit. SM're. a o B dg. N ) OR . . .
549 Bolden,vced Lane _
CITY -- ~ ZiP CODE
Carmel N 46032
PROPERTY DESCRIPTION ('~t and Block Numbers~ Tax Parcel Number, Legal DeecfiptJon. etc.
Lot #6 in The ReCat of the W~:x~s At Williams Creek. Hamilton County, Indiana
BUILDING USE (e.g., Re~dential. Non-residential. Addition. Acceeeory~ments area. if necessaPj.)
Residential
~EJLONG TUDE (OPTIONAL) -- HORIZONTAL DATUM: SOUR
(#~#'-~.~¢ ,o,r ~.~4u,#/~ [~NAD1927 E~NAD1983 [~ USGS Quad Map DO~er:
4000'00" N 086'10 0(7'W ,
- FLOOD INSUP~N~E RATE MAP (FIRM) INFORMATION
~UNITY NAME & COMMUNITY NUrv~ER 92. COUNTY NAME B3. STATE
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
[] Building u~er Construction' [] Rnished Consm.~ee
~rtificate is being com~ete~ - see pages 6 and 7, If no diegram
~r peetograp~.)
~ BFE), AR. ARIA. ARIAE, ARIA1 ~,30. AR/AH, ARIAO
d in item C2.State the datum used, If the datum bs diiferent from the datum used for me BFE in
Show field measuremen[s and datum conve~stee oa~::ula~on. Use the soace eroweee or me ~ts a~ea of
· Section G, as appropriate, to document We ee[um conversion
max ~ reference mar~ use~ appear on me FIRM? [] Yes :~] No
Top of bottom floor (induding basemen[ or enaesuml 879, 5_ft,(m)
Q b) Top of next higher floor 889,5_ft,/m~
Q c/Bottom of lowest horizontal structoral member (V zones only _ftlm~
~ d) Attached garage (top of slab) 884. 7 ft.(m)
E) e) Lowest elevation of machinery and/or equipmenl
servideg the building (Deecdbe in a Comments ereej . __ft.(m)
~ 0 Lowest edjacent Calshed) grade LAG) 8_~, [ ltl(m)
E:I g) Highest adj~ceht (finished) grade (HAG) 887. l_ft,(m)
Q h) No. of permanent openings (flood vents) within 1 ft, above adjacent grade N/_A
ID i) Total area of all permaner~ openings (flood vents) in C3,h N/A sq. in. (sq, an)
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to aw to cedi'fy elevation information.
I certi[y that the information in Sections A, B, and C on this certificate represents my bast effods to interpret the data available.
_1 understand that any false state, m_ent may beJ)unishable by Ifne or imorisonment under 18_ U,S. Code. Section 1001 __
CERTIFIER'S NAME David A, York, Reg. L,S. UCENSE NUMBER 20200053
-'~-LE Registered Lend ~rojent Menag~-~ ~COMPANY NAME Walhe Engineers. Irc.
~S -- -- -- CITY STATE ZIP CODE
10505 North College Avenue indieeapobs IN
DATE TELEPHONE
04-14~ (317) 84&6611
Replaces all previous e~itions
54c~ Bolderwx~d Lane
~ STATE -- Z~P CODE
Carmel JN 46032
SECTION D - SURVEYOR1 ENGINEER, ORARCHITECT CERTIFICATION (CONTINUED) '
Copy beth sides of this FJeva~Jon Cer'~flcata for (1) community ~dal, (2) insuram:e agent/company and (3) building owner.
The e~ev~ons shown on this Elevetton CedJfica~e are based upon constmdton doaJments prepared by Weihe Engineers. ldc
~va.~rovided by this licensed supveyor u~n the co~nda~ee and beserrem
~pccoesecJ residential smJ~be DL~II[ upon LC~ ~, --
[] Check here if aifachments
SECTION E - BUILDING ELEVATI FOR ZONE AD AND ZONE A (WiTHOUT BFE)
For Zone AO and Zone rough E4. If the Bevation Ced~este is intended for uee es suppeding informatton for a LOMA or LOMR-F,
Section C must be completed,
E1 Buildiag Diagram Number _(Select the building diagram mest similar to the bui ding for wh ch Bis ceriiiicate is being completed - see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The tee of the betfom fleer (indud ng besemest or endesure) of tbe building is E(m) in.(cm) r-J above or J-J betow (check one) the highest edjanent grade. (Use
naturaigrade, if avauaBe).
E3 For Building Diagrams 6-8 with openings (see page 7), the next higher fleer or e~va~ed lfoor (eleva¢on b) of the ~lc~ng is _ ft.(m) __in,(cm) above the hignem aajaceri[
grade. Coml~ete items O3.h and C3,i on front of form.
E4, The top of the platform of mac~JneE/end/or equipment sarvidng the building is _ E(m) _th,(cm) [] above or [] ~ow (meck one) me nlgnes[ anjacem greae. (Use
natural grade, if av~labte).
E5, For Zone AD enly tf no Ex~d depth number is avai abte, is the top of the betfom flonr etevated ld accordenee with the communitys lteedplain managemem ordinanse?
[]Yes [] No [] Unkn°wn. ThelocaloffldatmustserCythisinformatld~inSeeJbnG.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or own terns C3.h and C3.i only), md E for Zone A fwit~t a FEMAqssued or community-
issued BFE) or Zone AD must s~gn here, The s/'atements in SeCons A, B, Q and E are correof fo t~e best of my knowiedge.
~ROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAM~ --
~ESS ~ STATE -- ZIP CODE~
SIGNATURE DATE TELEPHONE
COMMENTS
[] Ched~ here if attachments
SECTION G -COMMUNITY INFORMATION (OPTIONAL)
The JesaJ offiaai who ~s authouz , and G of this Elevalton
De.cate. Complete the applicable item(s) ~ s~gn mow.
Gl. [] The inform~on in Section C was taken from other aouumentaUee that has ~ signed and ~ Dy a jlesnsee sufveyer, engineer, or amhite~ who is authorized Dy s~e
or ides4 law to cedJfy dievatien informatiee. (thdicate the soures esd date of the elevation data ld the Comments area below.)
G2. [] A communi~, olfidal completed Sec~on E for a building located in Zone A (without a FEMA4ssued or community-issued BFE) or Zone AC.
G3. [] The following infco'aaiiee (Items C¢.-G9) is provided for communib/Ex,plain management purposes.
G& DATE PERMIT ISSUED . DATE CERTIFICATE OF CO~°UANCE/OCCUPANCY ISSUED
GT, This permit has been issued for. [] New Construction [] Substanti
G8, Bevation of es-built lowest floor (including basement) of the building is: , _ft.(m) Datum:
G9. BFE or fin Zone AD) depth of flooding at the building site is: . _ ft,(m) 3mum:
-~L OFFICIAL'S NAME --
'--'~M UNITY NAM E~
SIGNATURE
COMMENTS--
TITLE
TELEPHONE
DATE
[] Ched,(here if _a~ments