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<br /> U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No.1660-0008
<br /> Federal Emergency Management Agency Expires March 31,2012
<br /> National Flood Insurance Program Important: Read the instructions on pages 1-9.
<br /> SECTION A-PROPERTY INFORMATION ForkoeCort Pali Wet.
<br /> Al. Building Owner's Name
<br /> '12blicy Ntuttbet
<br /> Alan Murdoch
<br /> A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Cpy NAIL{gym
<br /> 368 Lake Shore Drive ,,< 4" `
<br /> City Edgerton State WI ZIP 53534
<br /> A3. Property Description(Lot and Block Numbers.Tax Parcel Number,Legal Description,etc.)
<br /> Edgerton Beach Park Lot 15 and South 1/2 of Lot 16
<br /> A4, Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential
<br /> A5. Latitude/Longitude:Lat. N42d52'04" Long W89d01'11" Horizontal Datum: ❑NAD 1927 ®NAD 1983
<br /> A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
<br /> A7. Building Diagram Number 9
<br /> A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
<br /> a) Square footage of crawlspace or enclosure(s) 1,043 sq ft a) Square footage of attached garage sq ft
<br /> b) No of permanent flood openings in the crawlspace or 2, b) No.of permanent flood openings in the attached garage
<br /> enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade
<br /> c) Total net area of flood openings in A8.b 1,872 sq in c) Total net area of flood openings in A9.b sq in
<br /> d) Engineered flood openings? 0 Yes ®No d) Engineered flood openings? 0 Yes 0 No
<br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
<br /> 81.NFIP Community Name&Community Number B2.County Name 83.State
<br /> Dane County 550077 Dane County WI
<br /> B4.Map/Panel Number ' B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood 89.Base Flood Elevation(s)(Zone
<br /> G Date Effective/Revised Date Zone(s) AO,use base flood depth)
<br /> 55025C0832G June 17,2003 January 2,2009 AE 784
<br /> B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
<br /> 0 FIS Profile ®FIRM Community Determined 0 Other(Describe)
<br /> B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 ®NAVD 1988 ❑Other(Describe)
<br /> 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® No
<br /> Designation Date 0 CBRS []OPA
<br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
<br /> Cl. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction* © Finished Construction
<br /> 'A new Elevation Certificate will be required when construction of the building is complete.
<br /> C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE).AR,ARIA,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h
<br /> below according to the building diagram specified in Item A7. Use the same datum as the BFE.
<br /> Benchmark Utilized Lake Koshkonong Water Surface,8/6/2008 Vertical Datum NGVD 29
<br /> Conversion/Comments Lake Koshkonong Water Surface of 777.28(NGVD 29)=777.08(NAVD 88)
<br /> "Elevations a-g are NAVD 88 data Check the measurement used.
<br /> ©
<br /> a) Top of bottom floor(including baseme ,crawlspace, enclosure floor)Gravel=783.6 feet meters(Puerto Rico only)
<br /> b) Top of the next higher floor 788,1 © feet U meters(Puerto Rico only)
<br /> c) Bottom of the lowest horizontal structural member(V Zones only) ._©feet ❑meters(Puerto Rico only)
<br /> d) Attached garage(top of slab) N/A. El feet 0 meters(Puerto Rico only)
<br /> e) Lowest elevation of machinery or equipment servicing the building 787.8 ®feet ❑meters(Puerto Rico only)
<br /> (Describe type of equipment and location in Comments)
<br /> t) Lowest adjacent(finished)grade next to building(LAG) 783.5 n feet 0 meters(Puerto Rico only)
<br /> g) Highest adjacent(finished)grade next to building(HAG) 785.8 © feet ❑meters(Puerto Rico only)
<br /> h) Lowest adjacent grade at lowest elevation of deck or stairs,including 784:1 ®feet ❑meters(Puerto Rico only)
<br /> structural support t{11)t)
<br /> SECTION 0-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION 11 0 711�'a,
<br /> This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation �`\� s � �t
<br /> information. I certify that the information on this Certificate represents my best efforts to interpret the data available. •ate :' _ ''-•,Y ��
<br /> I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S.Code,Section 1001. ,.
<br /> ®Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a-. ": AA f_O. . ••• -
<br /> licensed land surveyor? ❑yes ®No FAL 0 Y
<br /> Certifier's Name License Number - E"4pL�, p' ••Cr
<br /> Aaron Falkosky 40083 .-,o CL1-
<br /> Title Project Engineer Company Name ��; . MADISON /1/44:-
<br /> 1 g Quam Engineering,LLC -- Wi :,:: '1
<br /> Address 4893 Larson Beach Road City McFarland State WI ZIP Code 53558 %'t...9'' �,
<br /> Signature / Date / Telephone �,s,••••.,•••.„.• ```�
<br /> J 1�/G 608-838 7750 y-lilt A , ��
<br /> FEMA Form 81-31,Mar 09 See reve e side for continuation. Replaces all previous editions
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