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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 ;For, uaitioepsrryiNe „ „
<br /> Al. Building Owner's Name Totiey Nttntbar X, '.
<br /> Alan Murdoch
<br /> wa��c�.M�� �"� row.., .x�
<br /> A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. °'Campanr, kiCNumbar
<br /> x
<br /> 368 Lake Shore Drive M t __ .kAt .
<br /> City Edgerton State WI ZIP Code 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 /> Al. Building Diagram Number 9
<br /> A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage:
<br /> a) Square footage of crawispace or enciosure(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 /> endosure(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 /> 01.NFIP Community Name&Community Number B2.County Name 83.State
<br /> Dane County 550077 Dane County WI
<br /> B4.Map/Panel Number 135.Suffix B6.FIRM Index B7.FIRM Panel 88.Flood 09.Base Flood Elevations)(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 09.
<br /> 0 FIS Profile ®FIRM Community Determined ❑Other(Describe)
<br /> 811. Indicate elevation datum used for BFE in Item 09: ❑ NGVD 1929 ®NAVD 1988 ❑Other(Describe)
<br /> 012. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(CPA)? El Yes ® No
<br /> Designation Date 0 CBRS 0 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 Ai A30,AE,AH,A(with BFE),VE,V1 V30,V(with BFE),AR,AR/A,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 datum 1r-10 o* "1- Check the measurement used.
<br /> a) Top of bottom floor(including basement,crawispace,or enclosure floor) 43.6 13 feet ❑meters(Puerto Rico only)
<br /> b) Top of the next higher floor 788,1 El feet El meters(Puerto Rica only)
<br /> c) Bottom of the lowest horizontal structural member(V Zones only) . 0 feet ❑meters(Puerto Rico only)
<br /> d) Attached garage(top of slab) N/A.�0 feet ❑meters(Puerto Rico only)
<br /> e) Lowest elevation of machinery or equipment servicing the building 787.8 ®feet 0 meters(Puerto Rico only)
<br /> (Describe type of equipment and location in Comments)
<br /> f) Lowest adjacent(finished)grade next to building(LAG) 783.5 ©feet ❑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 0 meters(Puerto Rico only)
<br /> structural support -
<br /> SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION Nl 1 1 t t i r 11 I I
<br /> This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ♦x%\C .. lI Y. /�}Z,rj
<br /> information. /certify that the information on this Certificate represents my best efforts to Interpret the data available. %.'s",:•' -.V
<br /> I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. ...,• !,•®Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by 3• ' ..AANO •
<br /> licensed land surveyor? ❑yes ®No FAL KY
<br /> Certifiers Name Aaron Falkosky License Number 40083 - E-408ON :Luz
<br /> Title Project Engineer Company Name Quern Engineering,LLC %�%\. MADISON '.1412...-
<br /> Address State ZIP Code ! •� �
<br /> r
<br /> 4893 Larson Beach Road City McFarland WI 53558 /���j�..,. �:!�iufi��
<br /> Signature 1 r Date £ ,//cam Telephone 608-838-7750
<br /> //>710N rA�i���
<br /> FEMA Form 81-31,Mar 09 See reverse side for continuation. Replaces all previous editions
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