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U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 1 FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date:July 31, 2015 No,,ono)Fieod irsuroncr Program IMPORTANT: Follow the instructions on pages 1-9. SECTION A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Allen & Pamela Ganser Policy Number: A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P0. Route and Box No. Company NAIC Number: 5621 Rankin Lane City Waunakee State WI ZIP Code 53597 A3. Property Description(Lot and Block Numbers,Tax Parcel Number.Legal Description,etc.) Lot 109,Westport Heights A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential A5. Latitude/Longitude: Lat. 43 182844 Long. -89.428316 Horizontal Datum: ❑NAD 1927 Z NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 3 A8. For a building with a crawlspace or enclosure(s): A9.For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 1254 sq ft a) Square footage of attached garage 472 sq ft b) Number of permanent flood openings in the crawlspace N/A b) Number of permanent flood openings in the attached garage or enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? El Yes ti i No d) Engineered flood openings? ❑Yes ®No SECTION B-FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3.State Dane County 550077 Dane WI B4. Map/Panel Number B5. Suffix 66.FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) 89. Base Flood Elevation(s)(Zone Revised Date A0,use base flood depth) 0241 H 09/17/2014 09/17/2014 AE 862.9 B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89: ®FIS Profile ❑FIRM ❑Community Determined ❑Other/Source: B11.Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 ®NAVD 1988 ❑Other/Source: B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes g No Designation Date: / / ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction* N Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/A0.Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters. Benchmark Utilized: Alum. Mon. Section Corner Vertical Datum: NAVD88 Indicate elevation datum used for the elevations in items a)through h)below. ❑NGVD 1929 ®NAVD 1988 ❑Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 866 . 79 ®feet ❑meters b) Top of the next higher floor 870 , 52 ®feet ❑meters c) Bottom of the lowest horizontal structural member(V Zones only) n/a . ❑feet ❑meters d) Attached garage(top of slab) 870 . 19 ®feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 869 . 30 ®feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 865 . 40 M feet ❑meters g) Highest adjacent(finished)grade next to building(HAG) 869 . 67 rg feet ❑meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including 865 , 05 ®feet ❑meters structural support SECTION D-SURVEYOR,ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.I 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. >< Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a I!Check here if attachments. licensed land surveyor'? ❑Yes ®No Google Earth Certifier's Name License Number - Chris Adams 2748 Title Company Name w t \ r-• Professional Land Surveyor Williamson Surveying and Assoc. LLC Address City State ZIP Code 104A W.Main St Waunakee W 53597 Signature�j---D - Date 3- /�)X17 Telephone 255-5705 FEMA Form 086-0-33(Revised 7/12) See reverse side for continuation. Replaces all previous editions.