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HomeMy WebLinkAboutAPPLICATION - Bensen, Bruce - DIV1 Lot 6 & 7 - FloodplainFLOODPLAIN Permit No. ��~© DEVELOPMENT PERMIT APPLICATION Name of Applicant 0Er' Lt r- La.64FA_L) C-, >J Date Address / ` E Al 2-11)0 t)0 i2V'7_ - ��J1K (/yU Phone Location of Proposed Development Legal Description Description of Proposed Works New Building Mobile Home Placement -- Addition/Alteration Subdivision of land Residential — On Single Lot — Fill .—..__ Non Residential In Mobile Home Park — Watercourse Alteration — _Other „. Estimated Cost _` / . 5� Attach the following information where applicable: Plans of the development to be undertaken including any filling and any watercourse or drainage way alteration. Specifically, the following information is required: (1) Mean sea level (MSL) elevation of the lowest flor (including base- ment) of all proposed structures; (2) MSL elevation to which any proposed structure will be floodproofed; (3) certification by a registered professional engineer or architect that the floodprooring method meets the community floodproofing criteria; (4) a description of the extent to which any watercourse will be altered or relocated, and (5) base (100 -year) flood elevation data for a development or subdivision greater than 50 lots or 5 acres. The following is to be completed by the Local Administrator:... The proposed development is located in the 4%c Floodway .Floodfringe The Base Flood Elevation oP depth number at the development site: Source Documents: t= L i-"l17i0,% 0,P Rri%rCA-T7 Map Effective Date: Plan Review MSL elevation or depth number to which the structure is to be elevated/floodproofed feet. Are necessary information, certificates, and other permits attached? —Yes -L- No Action ©The proposed development is in conformance with applicable floodplain standards. PERMIT IS APPROVED ❑The proposed development is not in conformance with applicable floodplain standards (explanation attached). PERMIT IS DENIED Date Elevation Certification Signature (Local Administrator) The certified as -built MSL elevation of the lowest floor of the structure is feet. The certified as -built MSL floodproofed elevation of the structure is -- feet. Certificates of a registered professional engineer or land surveyor documenting these elevation are attached. Certificate of Occupancy or Compliance Issued: Signature Date Signature (Local Administrator)