OTTAWA COUNTY FLOODPLAIN DEVELOPMENT PERMIT APPLICATION

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OTTAWA COUNTY FLOODPLAIN DEVELOPMENT PERMIT APPLICATION TO COMPLY WITH FLOODPLAIN MANAGEMENT REGULATIONS AND TO MINIMIZE POTENTIAL FLOOD DAMAGE, IF YOU ARE BUILDING WITHIN AN IDENTIFIED FLOOD HAZARD AREA, YOU MUST AGREE TO CONSTRUCT YOUR PROPOSED DEVELOPMENT IN ACCORDANCE WITH THE FOLLOWING SPECIAL PROVISIONS: 1. For RESIDENTIAL structures, the lowest floor (including basement) must be elevated to two feet or more above the base flood elevation (1percent or 100-year flood elevation). See provisions for manufactured homes in local regulations. 2. For NON-RESIDENTIAL structures, the lowest floor must be elevated to two feet or more above the base flood elevation, or flood proofed to withstand the flood depths, pressures, velocities, impact and uplift forces associated with the 1 percent/100-year flood. 3. For ALL NEW AND SUBSTANTIAL DAMAGE STRUCTURES, the foundation and the materials used must be constructed to withstand the pressures, velocities, impact and uplift forces associated with the 1 percent/100-year flood. 4. All utility supply lines, outlets, switches and equipment must be installed and elevated a minimum of two feet above Base Flood Elevation so as to minimize damage from potential flooding. Water and sewer connections must have automatic backflow devices installed. 5. For all NEW AND SUBSTANTIAL DAMAGE STRUCTURES you must submit certification NAVD 1988, on the attached form(s) from a REGISTERED ENGINEER, ARCHITECT or LAND SURVEYOR, that the elevation and/or flood proofing requirements have been met. Failure to provide the required certification is a violation of this permit. 6. Other Provisions - See attached list None 7. On a remodel/improvement, copies of receipts for materials and labor shall be submitted to the Floodplain Administrator at the completion of the project if requested by same. AUTHORIZATION I have read or had explained to me and understand the above special provisions for flood plain development. Authorization is hereby granted the permitting authority and their agents or designees, singularly or jointly, to enter upon the above-described property during daylight hours for the purpose of making inspections or for any reason consistent with the issuing authority s floodplain management regulation. I further verify that the above information is true and accurate to the best of my knowledge and belief. Signature of Applicant Date / /

APPLICATION FOR PERMIT FOR PROPOSED DEVELOPMENT OR IMPROVEMENT ON LANDS LOCATED IN FLOODPLAIN AREAS DATE / / PERMIT NO. APPLICANT NAME ADDRESS (COMMUNITY) PHONE# / / CELL PHONE# / / LIST TYPE AND PURPOSE OF DEVELOPMENT/IMPROVEMENT: LOCATION ADDRESS AND/OR LEGAL DESCRIPTION OF DEVELOPMENT/IMPROVEMENT: IS PROPERTY LOCATED IN AN IDENTIFIED FLOOD HAZARD AREA (REGULATORY FLOOD PLAIN)? YES / NO ENGINEER/SURVEYOR: ARCHITECT: CONTRACTOR: NAVD of 1988 SHALL BE USED FOR ALL FLOODPLAIN ELEVATION MEASUREMENTS BASE FLOOD ELEVATON LOWEST FINISHED FLOOR (including basement) LOWEST ADJACENT GRADE ELEVATION FLOOD ZONE TYPE: FLOOD MAP EFFECTIVE DATE / / Community Name NFIP COMMUNITY No. MAP No. PANEL No. APPROVED BY: (Ottawa County Floodplain Administrator) SIGNATURE OF APPLICANT DATE / / PLANS SPECIFICATIONS AND APPLICATION FOR PERMIT FILED BY THE APPLICANT SHALL CONSTITUTE BY REFERENCE, A PART OF THIS PERMIT. CERTIFIED ELEVATION OF LOWEST FLOOR AND LOWEST ADJACENT GRADE IS REQUIRED. HAS PERMIT FEE BEEN COLLECTED? YES NO PERMIT FEE

THE FOLLOWING SHALL APPLY: A permit is issued with the condition that the lowest floor (including basement floor) of any new or substantially improved (over fifty percent of market value) building or structure will be elevated at least TWO FEET, above the Base Flood Elevation. See Ottawa County Floodplain Management Regulations dated, AUGUST 5, 2010, For all Developments and Provisions For Flood Hazard Reduction. WITH THE ISSUANCE OF A PERMIT, THE DEVELOPER/OWNER UNDERSTANDS THAT CERTIFICATION NAVD 1988 BY A REGISTERED ENGINEER, ARCHITECT, OR LAND SURVEYOR OF THE AS BUILT LOWEST FLOOR ELEVATION (INCLUDING BASEMENT) OR FLOODPROOFED ELEVATION OF ANY NEW OR SUBSTANTIALLY IMPROVED BUILDING IS REQUIRED. A COPY OF THE CERTIFICATION SHALL BE DELIVERED TO THE COUNTY FLOODPLAIN ADMINISTRATOR. ON A REMODEL/IMPROVEMENT, COPIES OF RECEIPTS FOR MATERIALS AND LABOR SHALL BE SUBMITTED TO THE COUNTY FLOODPLAIN ADMINISTRATOR AT THE COMPLETION OF PROJECT IF REQUESTED. All provisions of: Ottawa County Flood Damage Prevention Regulation shall be complied with. Resolution/Order: 87-7 Signature of Owner/s, or, Developer Dated This day of,20

WAIVER PLEASE READ AND SIGN: The flood insurance rate maps (firm), Ottawa County Floodplain Regulations, and other flood data used by the County Flood Plain Administrator in evaluating flood hazards to proposed developments are considered reasonable and accurate for regulatory purposes and are based on the best available scientific and engineering data. On rare occasions greater floods can and will occur and flood heights may be increased by manmade or natural causes. Issuance of a Development Permit or Variance does not imply that developments inside or outside the identified areas of special flood hazard will be protected from flooding or flood damage. Issuance of a Development Permit or Variance shall not create liability on the part of Ottawa County, the County Flood Plain Administrator, the Ottawa County Floodplain Board or any officer or employee of Ottawa County (hereinafter collectively called County ) in the event flooding or flood damage does occur. Therefore, the undersigned do(es), for his/her/their own part and on behalf of his/her/their successors and assigns, and/or heirs, executors and administrators, or employees hereby remise, release and forever discharge County of and from any and all manner of actions and causes of action, rights, suits, judgments, claims and demands whatsoever in law or equity, including claims for contribution, arising from and by reason of any and all KNOWN AND UNKNOWN, FORESEEN AND UNFORESEEN bodily and personal injuries or death, damage to property, and the consequences thereof, which hereafter may be sustained by the undersigned or by any and all other persons, associations and corporations, whether herein named or referred to or not, from all liability arising from the issuance of a Development Permit or Variance. Dated this day of, 20., Owner/s Developer or,

ADDITIONAL INFORMATION REQUIRED: The applicant must submit the checked documents below before the application can be processed: A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. Development plans, drawn to scale, and specifications, including where applicable: details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used, details of flood proofing utilities, details for flood openings in addition. Top of new fill elevation and Compaction certification (Procter Test) Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 1 percent or one hundred year flood elevation. A copy of all data and calculations supporting this finding must also be submitted. For flood proofed structures, applicant must attach certification from a registered engineer or architect. Pre Elevation Certificate, and Post Elevation Certificate, when project is completed, North American Vertical Datum 1988 shall be used. Plans showing the extent of watercourse relocation and/or landform alterations. Other: I have determined that the proposed activity is / is not in conformance with the County Flood Plain Regulations, dated August 5, 2010. The permit is / is not issued subject the designated fee being paid and to the conditions attached to and made part of this permit. SIGNED: (Ottawa County Floodplain Administrator) DATE / /