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HomeMy WebLinkAboutELEVATION CERTIFICATE 3 - 23-00222 - 125 Valley River Dr - Goodwill - Suite 201U.S. DEPARTMENT OF HOMELAND SECURITY OMB Control No. 0 Expiration Date: 06/36/30/2 0 026 Federal Emergency Management Agency National Flood Insurance Program IMPORTANT: MU LIOVP�coE RI!RWQN PAGES 9Copy all pages of this Elevation erti icate and a I attac ments for , ( ) insurance agen company, and (3) building I SECTION A - PROPERTY INFORMATION I FOR INSURANCE COMPANY USE Al. Building Owner's Name: C K C Rexburg, LLC AN2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box 1h Vallev River Dr. City: Rexburg State: ID Policy Number: Company NAIC Number: ZIP Code: 83440 A3. Property Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number: RPRXBCA0192115 (Grant Deed Instrument No. 376207) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.): Retail A5. Latitude/Longitude: Lat. 43.83479 Long. 411. 77934 Horizontal Datum: ❑ NAD 1927 ❑✓ NAD 1983 ❑ WGS 84 A6. Attach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 8). A7. Building Diagram Number: 1B A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s): A sq. ft. b) Is there at least one permanent flood opening on two different sides of each enclosed area? ❑ Yes ❑✓ No ❑ N/A c) Enter number of permanent flood openin s in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade: Non -engineered flood openings: P. Engineered flood openings: d) Total net open area of non -engineered flood openings in A8.c: sq. in. e) Total rated area of engineered flood openings in A8.c (attach documentation - see Instructions): sq. ft. f) Sum of A8.d and A8.e rated area (if applicable - see Instructions): sq. ft. A9. For a building with an attached garage: a) Square footage of attached garage: / sq. ft. b) Is there at least one permanent flood opening on two different sides of the attached garage? ❑ Yes ❑ No [N/A c) Enter number of permanent flood openings in the attached garage within 1.0 foot abo a adjacent grade: Non -engineered flood openings: 14 Engineered flood openings: d) Total net open area of non -engineered flood openings in A9.c: /V/,04 sq. in. e) Total rated area of engineered flood openings in A9.c (attach documentation - see Instructions):�t s ft. i q� f) Sum of A9.d and A9.e rated area (if applicable - see Instructions): % sq. ft. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1.a. NFIP Community Name: Rexburg City B2. County Name: Madison B3. State: ID B6. FIRM Index Date: 06/03/9991 B8. Flood Zone(s): AE B10 1311 B1.b. NFIP Community Identification Number: 16065 B4. Map/Panel No.: 16065CO020 B5. Suffix: D B7. FIRM Panel Effective/Revised Date: 0610311991 B9. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Depth): 4868.15 Indicate the source of the BFE data or Base Flood Depth entered in Item 9: �j��D /�f Zq ,t:%sti7,��r ©,•.r 4[ FIS ❑ FIRM ❑ Community Determined ❑✓ Other: p �, Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 �/ µ� ❑ NAVD 1988 ❑ Other/Source: �7,44w® B12. Is O@s"ft located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑✓ No Date: ❑ CBRS ❑ OPA B13. Is the building located seaward of the Limit of Moderate Wave Action (LiMWA)? ❑ Yes ❑✓ No FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 2 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE Policy Number: 125 Valley River Dr. City: Rexburg State: ID ZIP Code: 83440 Company NAIC Number: SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, AE, AH, AO, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO, A99. Complete Items C2.a—h below according to the Building Diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: City of Rexburg Datum Vertical Datum: NGVD29 from Map + 3.59 feet to City Datum Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑ NAVD 1988 0 Other: Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? W] Yes ❑ No If Yes, describe the source of the conversion factor in the Section D Comments area. Check tehe measurement used: meter a) Top of bottom floor (including basement, crawlspace, or enclosure floor): 4,869.98 ❑✓ ❑ t b) Top of the next higher floor (see Instructions): ❑ fee ❑ Pheter t c) Bottom of the lowest horizontal structural member (see Instructions): ❑ fee ❑ meter d) Attached garage (top of slab): ❑ fee ❑ meter t s e) Lowest elevation of Machinery and Equipment (M&E) servicing the building fee ❑ meter (describe type of M&E and location in Section D Comments area): 4,869.24 ✓ t f Lowest Adjacent Grade LAG next to building: fee meter 1 (LAG) g: El ❑✓ Finished 4,868.32 ✓❑ ❑ t Highest Adjacent Grade HAG next to building: fee ❑ meter 9) 9 J (HAG) g: ❑Natural ❑✓ Finished 4,868.70 ❑✓ t h) Finished LAG at lowest elevation of attached deck or stairs, including structural s support: �,r ; l ❑ fee ❑ meter t SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by state law to certify elevation information. 1 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 and describe in the Comments area. Certifier's Name: Shane C. Remer License Number: PLS 12222 Title: President LAND S�O�PL SG Company Name: Cornerstone Geomatics, LLC N ��`'� vCE Address: 5497 Rammell Rd. /��6�fZ 0 City: Idaho Falls State: ID ZIP Code: 83401 Signature: Date: 1011612023 C. Telephone: (208) 932-4423 xt.: Email: s_hane@cornerstone eomatics.com Place ea ere Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including source of conversion factor in C2; type of equipment and location per C2.e; and description of any attachments): The finished floor is 1.83 feet above the BFE of 4868.15 feet. Machinery and Equipment has been added to the building in the form of a compactor. The compactor pad is 1.09 feet above the BFE = 4868.15 feet. rev fey o ��"�i.� f E �T/o-�• GEC ��i - i��-r /A FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 3 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 125 Valley River Dr. Policy Number: City: Rexburg State: ID ZIP Code: 83440 ( Company NAIC Number: SECTION E — BUILDING MEASUREMENT INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO, ZONE AR/AO, AND ZONE A (WITHOUT BFE) For Zones AO, AR/AO, and A (without BFE), complete Items El—E5. For Items E1—E4, use natural grade, if available. If the Certificate is intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rico only, enter meters. Building measurements are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑✓ Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. El. Provide measurements (C.2.a in applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement,crawlspace, or enclosure) is: 1.28 ❑✓ feet ❑ meter ❑✓ above or ❑ below the HAG. s b) Top of bottom floor (including basement,crawlspace, or enclosure) is: 1.66 ❑✓ feet ❑ meter Z above or ❑ below the LAG. s E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (C2.b in applicable Building Diagram) of the building is: ❑ feet ❑ meter ❑ b ❑ b I E3. Attached garage (top of slab) is: E4. Top of platform of machinery and/or equipment servicing the building is: 0.54 ❑✓ feet meter ❑ ❑✓ above or El below the HAG. s E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown The local official must certify this information in Section G. a ove or e ow the HAG. ❑ feet meter ❑ ❑above or ❑below the HAG. s SECTION F — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge ❑✓ Check here if attachments and describe in the Comments area. Property Owner or Owner's Authorized Representative Name: Shane C. Remer Address: 5497 Rammell Rd. City: Idaho Falls Signature: "L M2M2 Telephone: (208) 932-4423 State: ID ZIP Code: 83401 Date: 10/16/2023 Email: shane@cornerstonegeomatics.com Comments: This certificate is being completed to address the addition of a compactor which has been added to the property. The trash compactor concrete pad is 11 " higher than the adjacent parking lot finished elevation. FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Buildin Street Address (includin A t Unit Suite and/or Bld N r P O R t d B N FOR INSURANCE COMPANY USE g g p ., g. o.) o ou a an ox W. 125 Valley River Dr. City: Rexburg State: ID ZIP Code: 83440 Policy Number: Company NAIC Number: SECTION G — COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item(s) and sign below when: G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item E5 is completed for a building located in Zone AO. G2.b. ❑ A local official completed Section H for insurance purposes. G3. ❑ I-i the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and G4. ❑ The following information (Items G5—G11) is provided for community floodplain management purposes. G5. Permit Number: G6. Date Permit Issued: G7. Date Certificate of Compliance/Occupancy Issued: G8. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: ❑ feet El meters Datum: G9.b. Elevation of bottom of as -built lowest horizontal structural member: ❑ feet ❑ meters Datum: G10.a. BFE (or depth in Zone AO) of flooding at the building site: ❑ feet El meters Datum: G10.b. Community's minimum elevation (or depth in Zone AO)requirement for the lowest floor or lowest horizontal structural member: El feet El Datum: G11. Variance issued? ❑ Yes ❑ No If yes, attach documentation and describe in the Comments area. The local official who provides information in Section G must sign here. I have completed the information in Section G and certify that it is correct to the best of my knowledge. If applicable, I have also provided specific corrections in the Comments area of this section. Local Official's Name: Title: NFIP Community Name: Telephone: Address: Signature Ext.: Email: Date: State: ZIP Code: Comments (including type of equipment and location, per C2.e; description of any attachments; and corrections to specific information in Sections A, B, D, E, or H): FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 125 Valley River Dr. Policy Number: City: Rexburg State: ID ZIP Code: 83440 Company NAIC Number: SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section. H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG): a) For Building Diagrams 1A, 1 B, 3, and 5-9. Top of bottom 1.66 ❑✓ feet ❑ meters ❑✓ above the LAG floor (include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A, 2B, 4, and 6-9. Top of next ❑ feet ❑ meters ❑ above the LAG higher floor (i.e., the floor above basement, crawlspace, or enclosure floor) is: H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram? ❑✓ Yes ❑ No SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections A, B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G. ❑ Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Shane C. Remer Address: 5497 Rammell Rd. City: Idaho Falls State: 1D ZIP Code: 83401 Signature: Date: 10/1612023 Telephone: (208) 932-4423 xt.: Email: shane@comerstonegeomatics.com Comments: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS Continuation Paqe Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: FOR INSURANCE COMPANY USE 125 Valley River Dr. Policy Number: City: Rexbu State: ID ZIP Code: 83440 Company NAIC Number: Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," "Right Side View," or "Left Side View." When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. Photo Three Photo Three Caption: Photo Four Photo Four Caption: FClear Photo Three Clear Photo Four FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page A of 19 LIZ. DEPARTMENT OF HOMELAND SECURITY Federal Emergency MarAgement Agency National Flom! Insurance Program UU[ClIng Gwrier's Na" A2, Sodding Street Addresein ludirg Apt., A4, AS, A6, AT A8, Ili ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY ) or P.O. RW& and Box No. OMB No16W-0008 Expires March 31, 2012 State iJl4e)#1 ZIP Code PrOPeftY Desoription (Lot Ad 8IOci_(Numb_ers­_­j5a_`n_ 49) Tax Parcel ra Nurnber, .Iegal Das&mion, etc.) 801ding U80 (e.g., Resjdenfial.lf� �"IWIIW dtiftion, Accessory, etc.) Latflude/LOng,Wde: Lot Long, Attach at least 2 photographs of the bulk If the Cenificate [a being used to obtain flood Ing1jra, Buflding CUWam NuMbel -LIP-11 'e. For a buiidhw Mth a ongwis a.-& err ..,Q HOflZoAtaj Datwn: 0 NAo 1927 Z[W—196$ ?. UNW17tsi: A9. For a bitilding With an attached garage: 8) Square footage Of crawlspacq or enclosure(s) $41 ft Square footage of attached gaWe b) No. of parrnanent flood operings In the craws pa or sq ft anclosure(s) within 1.0 fbot abv�e adjacent grade b) No, Of PsMiallent flood OP"ings in the allachad garage c) Total net area of flood openings in AS.b Wittiki 1 .O foot above adjacent grade d) Engineered flood npe�nlngs? [] Yes C1 No aq In c) Total not area of flood OW11193 irl A91 sq in d1l Ent'sin—A fl— 1 vfm" ngs f U TIM LJ NO SJJRANCE RATE MA(FIRM) INFORMATION F 4M- Ind" 117 ' 81� F—IRM Date��E� 101C Date vnion(a) AO, USO base flood dooth' f 810, Indicate th " source 01010 SOSO Flood Elevation (SFE) data or base flood depth entered in stern 89. FIS Proffle nFIRM COMMUnitY Oets"ned (Describe) 3 41. Ind,cate elevation dawfn used for SFE in item ag: 8'2, Is the bufting NOVO 192a NAVD ISM Other ( escribe), RS)afbao(Olhem ep. ( A). Designation Date_—__ is rotected Area Qp ? 0 CBRS [] OPA LJ Y93 SECTION9. Ill UIL01 GEJLEVA-nBWI�i� ; i � NFOWATIC REQUIRED) G1, Buftng elevations are based on-- an %,Irma13 'A new Elevation Cwtkate will be required when constucrwr of he bWiding is C2. Elevations - Zones AI-A30 AE, AH, A (vWth complete, Ffnished ConsOuctibn beJOW aworlding to the ��l di 8FE1 VF­ V1430, V (wft BFE), AR, APJA,, ARIAIE. AF;VA1_A30,AMAH. A � fa 0 arls Warns in Item AT Use #a Sam datum as the SFE, APJ 0 (;omP I It , C2, -h Benchmark Utilized C,+.4, "r— IZA"U.— converslwvcomments 111) b) C) d) a) h) Yerticaf Top Of b0d0m $001I (Intluding basement, crawjsparam' cr on Chad( "asuren1wit used, dosure ftoor) —7 set TOP of ft next higher floor 14 A r, metem (Riarto Rko Only) Bottorn!)f the 'owe -$I h"ZOntal Sttucttltai M9.Mber (V ZcrW$ only) feet Msttlm (Puerto Rico only) Attached gar4e (lop of alab) test n*ter$ (PU*rtD Rico orgy) Lowest elevation of trachin" Or 9q'JIPnVr'-t 381VICIng ft buRftg meters (Puerto Rk-,o only) (Descrfbe type of equipment and location In Conwlan1s) feel.Met Om (Mmrto Rico only) Lowest adjacent (ffAiShed) grade next to building (LAG) J 'C' Highest adfacent (firtl3hed) grade next to building (HAG) meters (Nrefto Rico only) Low"t adjacent grade at lowest elevation of deck or staim, including et Meters (PL*do Rico only) Net rnatsm (Puarto Rxo only) reprownt.- my be thst &ny /91s& stsfwnerlt may b. PWM.&,e by fine or 61 ShVfts 10 1r*rPr-@t ft data Ovaftablw ChHck here it aurnments afu otavided w bark of form. imprisann*nt tinder I a U� S, CW9, q� I L Were fattude, and IoNitude in Section A 'prov,Wed by a lit'A""rf Replaces all previous editions i ■ wpm F: '7 ,r A^ ..27 r ate..,. so