CITY OF PADUCAH, KENTUCKY
Development Proposed:
Contact Mailing Address:
Telephone: Fax: E-mail:
Contact Person:
Business Address:
Telephone: Fax: E-mail:
SPECIAL FLOOD HAZARD INFORMATION:
FIRM Map Panel Number:
Special Flood Hazard Zone Associated with this Development:
Base Flood Elevation (NAVD 88 Elev):
PROPOSED DEVELOPMENT PLANS & SPECIFICATIONS:
Attach all Plans and Specifications as Required for this Development including, but not limited to, the following:
Note: All Elevations depicted shall be reference the North American Vertical Datum of 1988 (NAVD 88)
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Existing Structures with appropriate Elevations depicted.
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Development Address/Location:
Plans and Specifications prepared by a Kentucky Registered Professional Engineer or Architect (stamped and signed)
Drawn to Scale showing location, dimensions, and elevations of the vicinity along with all Supprt Material.
Proposed Structures with proposed Elevations, including Lowest Floor, Basement (if any) and all Service Equipment
(electrical, plumbing and other utility connections).
ENGINEERING-PUBLIC WORKS DEPARTMENT
SPECIAL FLOOD HAZARD AREA DEVELOPMENT PERMIT APPLICATION
This Permit Application Form and supporting documentation must be completed in its entirety and submitted to
the City Engineer-Public Works Director, Floodplain Administrator of the City of Paducah, 300 South 5th Street,
P.O. 2267, Paducah, KY 42002. The omission of required items may be cause for rejection of the submittal
without review.
APPLICANT - PROPERTY OWNER:
APPLICANT'S AGENT
(Engineer, Surveyor or Architect)
:
In accordance with the City of Paducah Code of Ordinances, Chapter 50 Article II, Flood Damage Prevention Ordinance,
this application shall be submitted to the Floodplain Administrator prior to the commencement of any development
activity within all Special Flood Hazard Area (SFHA) as identified by the Federal Emergency Management Agency
(FEMA) in the Flood Insurance Study (FIS) and shown on the Flood Insurance Rate Maps (FIRMS) for the City of
Paducah effective November 2, 2011. If at any time, development occurs which is not in accordance with the provisions
of the Flood Damage Prevention Ordinance, the person responsible shall be subject to enforcement and penalties in
accordance with the Enforcement, Violation Notice and Penalties provisions of the Ordinance.
APPLICANT SUBMITTAL INFORMATION
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Contact Person:
CITY OF PADUCAH, KENTUCKY
PROPOSED DEVELOPMENT PLANS & SPECIFICATIONS CONTINUED:
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Proposed Fill areas with Elevations and necessary support documentation.
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Existing and Proposed Drainage Facilities and necessary support documentation.
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Description of any existing Watercourse proposed to be Altered or Relocated due to Development
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Additional Permits Obtained: ____________________________________________________________________
SUBMITTAL FEE:
ENGINEERING-PUBLIC WORKS DEPARTMENT
SPECIAL FLOOD HAZARD AREA DEVELOPMENT PERMIT APPLICATION
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Elevation of Highest Adjacent Grade in accordance with Flood Ordinance definition.
Floodproofed Elevation of Non-Residential Flood Structure.
Floodproofing Certification from a Kentucky registered Professional Engineer or Architect that the Non-Residential
Flood Structure will be designed to meet all regulations. Elevation to be listed as NAVD 88 Elevation.
Kentucky Division of Water Stream Construction Permit Application or Permit Obtained along with a copy of the
"Certification of No-Net Rise." Hydraulic Analysis documention submitted with Permit Application may be required.
A Special Flood Hazard Development Permit Fee of One Hundred Dollars ($100.00) shall be submitted with this application.
SUBMITTAL CERTIFICATION:
I hereby certify that the information submitted herein with this application is, to the best of my knowledge and belief, true,
accurate, and complete and that all construction and associated activity pertaining to this application shall be
accomplished pursuant to the approved Floodplain Permit, the City of Paducah Flood Damage Prevention Ordinance and
the associated Plans and Specifications as approved.
Applicant's Signature
: _________________________________________________________ Date:______________________
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Applicant's Agent Signature
: ___________________________________________________ Date:______________________
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