ELEVATION CERTIFICATE Important: Follow the instructions on pages 1—9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner’s Name Policy Number:
Shannon Martin
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number Box No.
42 Road 5777
City State ZIP Code
Farmington New Mexico 87401
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) R0054587
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 36.700680 Long. -1 08.125890 Horizontal Datum: ~ NAD 1927 ~ 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 5
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 1667.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 13 c) Total net area of flood openings in A8.b 1664.00 sq in
d) Engineered flood openings? ~ Yes L~ No Ag. For a building with an attached garage:
a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? ~JYes ~ No
SECTION B-FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bi. NFIP Community Name & Community Number B2. County Name B3. State
San Juan County 350064/San Juan River 67P San Juan New Mexico
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective! Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
35045C1010 F 08-05-2010 08-05-2010 AE 5314.5
Bil. 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 ~ No
Designation Date: ~ CBRS ~ OPA
Federal Emergency Management Agency
National Flood Insurance Program Expiration Date: November 30, 2022
BlO. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
~ FIS Profile ~ FIRM ~ Community Determined ~ Other/Source: San Juan River 67P
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt. Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
42 Road 5777
City State ZIP Code
Farmington New Mexico 87401
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. 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 A1—A30, AE, AH, A (with BEE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO.
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters Benchmark Utilized: WGS 1984 Vertical Datum: WGS 1984
Indicate elevation datum used for the elevations in items a) through h) below.
~ NGVD 1929 ~ NAVD 1988 JOther/Source:_____________________________________________________
Datum used for building elevations must be the same as that used for the BFE.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) ____________________
b) Top of the next higher floor ____________________
c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG) _____________________
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
SECTION 0— 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.
Were latitude and longitude in Section A provided by a licensed land surveyor? ~ Yes No ~ Check here if attachments.
Certifier’s Name Robert A. Echols, Jr., PE Title
President Company Name
Cheney-Walters-Echols, Inc Address
909 W. Apache City
Earmington
Signature Date Telephone
4 ~ ~‘I_4 (505) 327-3303
Copy all pag:. ofthis Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
0MB No. 1660-0008
Expiration Date: November 30, 2022 FOR INSURANCE COMPANY USE Policy Number:
Company NAIC Number
Check the measurement used 5315.0 ~ feet ~ meters 5318.6 ~ feet ~ meters N/A ~ feet ~ meters N/A ~ feet ~ meters N/A
5314.9 5316.5
feet ~ meters
~ feet ~ meters
~ feet ~ meters 5314.9 ~ feet ~ meters
License Number 6580
State New Mexico
ZIP Code 87401
Form Page2of6
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
42 Road 5777
City State ZIP Code Company NAIC Number
Farmington New Mexico 87401
SECTION E—BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BEE)
For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement,
crawlspace, or enclosure) is ___________________ ~feet flmeters ~ above or ~ below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is ___________________ ~ feet ~ meters ~ above or ~ below the LAG.
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 (elevation C2.b in
the diagrams) of the building is ___________________ ~ feet ~ meters ~ above or ~ below the HAG.
E3. Attached garage (top of slab) is ___________________ ~ feet ~ meters ~ above or ~ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is ___________________ flfeet Emeters Elabove or ~ below the HAG.
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 fl No ~ Unknown. The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER (OR OWNERS REPRESENTATIVE) CERTIFICATION
The property owner or owner’s authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner or Owner’s Authorized Representative’s Name Robert A. Echols, Jr., PE
Address City State ZIP Code
909 W. Apache Farmington New Mexico 87401
Signature Date Telephone
(505) 327-3303 Comments
El Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6
0MBNo. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
42 Road 5777
City State ZIP Code Company NAIC Number
Farmington New Mexico 87401
SECTION G-COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community’s floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters.
G1. fl 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 law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2 ~ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.
G3. fl The following information (Items G4—G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate of
Compliance/Occupancy Issued
G7. This permit has been issued for: fl New Construction ~ Substantial Improvement G8. Elevation of as-built lowest floor (including basement)
of the building: __________________ ~feet fl meters Datum ___________
GO. BFE or (in Zone AO) depth of flooding at the building site: ___________________ ~ feet ~ meters Datum ____________
Gb. Community’s design flood elevation: __________________ ~ feet ~ meters Datum ____________
Local Official’s Name Title
Community Name Telephone
Signature Date
Comments (including type of equipment and location, per C2(e), if applicable)
J Check here if attachments.
Expiration Date: November 30, 2022 FOR INSURANCE COMPANY USE
ELEVATION CERTIFICATE See Instructions for Item A6.
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P 42 Road 5777
Farm ington
lumber
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; “Front View” and “Rear View”; and, if required, “Right Side View” and
“Left Side View.” When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fiton this page, use the Continuation Page.
0
Photo One
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FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page5of6
BUILDING PHOTOGRAPHS 0MB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
42 Road 5777
City State ZIP Code Company NAIC Number
Farmington New Mexico 87401
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; “Front View” and “Rear View”; and, if required, “Right Side View” and “Left Side View.” When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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Photo Three Caption Clear Photo Three
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Photo Four Caption Clear Photo Four
I. DATA FROM PANEL 35045C1010F REVISED AUGUST 5, 2010 IS ZONE AE.
2. SEE SHEET No. 2 OF 3 FOR FIRM MAP INFORMATION.
3. SEE SHEET No. 3 OF 3 FOR FIRM MAP INFORMATION. SEE FLOOD
PROFILE - SAN JUAN RIVER SHEET 67P - BASE FLOOD ELEVATION 5314.50.
SHANNON MARTIN
NOTE:
I.) TOTAL NET AREA OF FLOOD OPENING 1664 sq. in.
FLOOD ELEVATION CERTIFICATE No. 42 ROAD 5777
LOT 6 BLOCK 16 WILD HORSE SUBDIVISION FARMINGTON, NEW MEXICO 87401
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KEYED NOTES:
1667.00 sf DOUBLE WIDE MOBILE HOME FINISH FLOOR ELEVATION 5318.58.
RAISED WOODEN DECK.
CRAWL SPACE ELEVATION 5315.02.
0 EXISTING SEPTIC TANK ACCESS ELEVATION 5316.00.
EXISTING SHED.
13 EACH 8”xI6” FREE AIR VENTS WITH INVERT ELEVATION 5317.50.
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- A SURVEYORS ISSUE DATE: 08/26/2021 PRINTED: Auqust 30, 2021
FILE: D:\DWG-HWS\2021\21270\2I27OFLDCERT-082621.dWq
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FLOOD ELEVATION CERTIFICATE No. 42 ROAD 5777
LOT 6 BLOCK 16 WILD HORSE SUBDIVISIO FARMINCTON, NEW MEXICO 87401
FOR
SHANNON MARTIN
I11~L~JE~L PANEL IOIOF
FIRM
FLOOD INSURANCE RATE MAP SANJUAN COUNTY, NEW MEXICO
AND INCORPORATED AREAS PANEL 1010 OF 2750
(SEE MAP INSEX FOR FIRM PANEL LAYOUT)
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FLOOD ELEVATION CERTIFICATE No. 42 ROAD 5777
LOT 6 BLOCK 16 WILD HORSE SUBDIVISION FARMINGTON, NEW MEXICO 87401
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ISSUE DATE: 08/26/2021 PRINTED: August 27, 2021
FILE: D:\DWG-HWS\2021\21270\2I27OFLDCERT-082621.dwg
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SHEET No. 30F3
909 W. APACHE FARMINGTON. NEW MEXICO 87401 (505~327—3303