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U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 <br /> Federal Emergency Management Agency Expiration Date: November 30, 2018 <br /> National Flood Insurance Program <br /> ELEVATION CERTIFICATE <br /> Important: Follow the instructions on pages 1-9. <br /> Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and(3)building owner. <br /> SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br /> Al. Building Owner's Name Policy Number: <br /> Paul Haben <br /> A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: <br /> 7504 Lagoon Lane <br /> City State ZIP Code <br /> Webster Wisconsin 54893 <br /> A3. Property Description(Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) <br /> Big Yellow Lake Estates Lot 4& 1/16th Int in Out Lots 1 &2 S29 T40N R16W Oakland Township Burnett County Wisconsin <br /> A4. Building Use(e.g., Residential, Non-Residential,Addition, Accessory, etc.) Residential <br /> A5. Latitude/Longitude: Lat.45.916708 Long.-92.372631 Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 <br /> A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. <br /> AT Building Diagram Number 9 <br /> A8. For a building with a crawlspace or enclosure(s): <br /> a) Square footage of crawlspace or enclosure(s) 1120.00 sq ft <br /> b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 2 <br /> c) Total net area of flood openings in A8.1b 210.00 sq in <br /> d) Engineered flood openings? ❑ Yes ❑X No <br /> A9. For a building with an attached garage: <br /> a) Square footage of attached garage sq ft <br /> b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade <br /> c) Total net area of flood openings in A9.b sq in <br /> d) Engineered flood openings? ❑Yes ❑ No <br /> SECTION B—FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br /> B1. NFIP Community Name&Community Number B2. County Name B3. State <br /> Burnett County 550032 Burnett County Wisconsin <br /> B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) <br /> Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) <br /> Revised Date <br /> 550013CO261 C C 08-19-2008 08-19-2008 AE 932.8' <br /> 810. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in Item B9: <br /> ❑x FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source. <br /> B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: <br /> B12. Is the building located in a Coastal Barrier Resources System (CBRS)area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No <br /> Designation Date: ❑ CBRS ❑ OPA <br /> FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Pagel of 6 <br />