Fillable Form 20576 Floodplain Use* (City of Gahanna)

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Form 20576 Floodplain Use* (City of Gahanna)

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The Form 20576 Floodplain Use* (City of Gahanna) form is 7 pages long and contains:

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  • 63 check-boxes
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ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
RECEIVED: ________
DATE: ____________
PAID: _____________
DATE: ______________
CHECK#: ____________
Zoning File No. _________________
PC Meeting Date: _______________
PC File No. ____________________
INTERNAL USE
FLOODPLAIN USE APPLICATION
PLEASE NOTE: This application is not to be considered complete until all documents are received and approved by the Planning & Zoning Administrator.
Project/Property Address or Location:
Project Name/Business Name (if applicable):
Parcel ID No.(s):
Total Acreage:
Description of request:
APPLICANT Name (primary contact) -do not use a business name:
Applicant Address:
Applicant E-mail:
Applicant Phone No.:
BUSINESS Name (if applicable):
ATTORNEY/AGENT Name:
Attorney/Agent Address:
Attorney/Agent E-Mail:
Attorney/Agent Phone No.:
ADDITIONAL CONTACTS (please list all applicable contacts)
Name(s):
Contact Information (phone no./email):
Contractor
Developer
Architect
PROPERTY OWNER Name: (if different from Applicant)
Property Owner Contact Information (phone no./email):
APPLICANT SIGNATURE BELOW CONFIRMS THE SUBMISSION REQUIREMENTS HAVE BEEN COMPLETED (see page 2)
I certify that the information on this application is complete and accurate to the best of my knowledge, and that
the project as described, if approved, will be completed in accordance with the conditions and terms of that
approval.
Applicant Signature: _____________________________________________ Date: ____________________
THIS FORM IS AVAILABLE TO BE SUBMITTED ONLINE: www.gahanna.gov
Page 1 of 7|FLOODPLAIN USE|REV.4.24.17
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ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
FLOODPLAIN USE APPLICATION – SUBMISSION REQUIREMENTS
PLEASE NOTE: This application is not to be considered complete until all documents are received and approved by the Planning & Zoning Administrator.
STAFF
USE -
INTAKE
TO BE COMPLETED/SUBMITTED BY THE APPLICANT:
APPLICANT
STAFF USE
YES
N/A
YES
N/A
1. Review Gahanna Code Section 1191 (visit www.municode.com)
2. Review the Flood Insurance Study, Franklin County, Ohio and Incorporated Areas
3. Pre-application conference with staff
4. Legal Description
5. Location map showing the location of the site relative to adjacent sites (including scale)
6. Elevation in relation to mean sea level of the lowest floor, including basement, of all
proposed structures located in special flood hazard areas where base flood elevation
data are utilized
7. Elevation in relation to mean sea level to which any proposed structure will be
floodproofed in accordance with Section 1191.02(b) where base flood elevation data are
utilized
8. Certification by a registered professional engineer or architect that the floodproofing
methods for any non-residential structure meet the floodproofing criteria in Gahanna Code
Section 1191.20(b) where base flood elevation data are utilized
9. Description of the extent to which any watercourse will be altered or relocated as a result
of the proposed development and certification by a registered professional engineer that
the flood carrying capacity of the watercourse will not be diminished
10. A plan drawn to scale showing the nature, location, dimensions and elevation of the lot,
existing or proposed structures, fill, storage of materials, floodproofing measures and the
relationship of the above to the location of the channel
11. A typical valley cross section showing the channel of the stream, elevation of land areas
adjoining each side of the channel, cross sectional areas to be occupied by the proposed
development and high water information
12. Plan, surface, view, showing elevations or contours of the ground; pertinent structure, fill or
storage elevations; size, location and spatial arrangement of all proposed and existing
structures on the site; location and elevations of streets, water supply, sanitary facilities,
photographs showing existing land uses and vegetation upstream and downstream, soil
types, and other pertinent information
13. Profile showing the slope of the bottom of the channel or flow line of the stream for at least
500 feet in either direction from the proposed development
14. Specifications for building construction and materials, flood proofing, filling, dredging,
grading, channel improvement, storage of materials, water supply and sanitary facilities
15. Kind of development proposed (check all that apply)
□ Residential structure □ Non-residential structure
□ New structure □ New structure
□ Addition to structure □ Addition to structure
□ Renovations/repairs/maintenance □ Renovations/repairs/maintenance
□ Manufactured home installation
□ Accessory structure: dimensions:_____________________________________
□ Filling or grading □ Dredging or excavation or mining
□ Materials/equipment storage: please attached a description
□ Watercourse alteration (any change that occurs within the banks of a watercourse)
□ Water supply / sewage disposal □ Bridge or culvert placement / replacement
□ Subdivision >50 lots or 5 acres □ Other development >5 acres
□ Other: please attach description
CONTINUE TO PAGE 3
Page 2 of 7|FLOODPLAIN USE|REV.4.24.17
ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
THIS FORM IS AVAILABLE TO BE SUBMITTED ONLINE: www.gahanna.gov
APPLICATION ACCEPTANCE
This application has been reviewed and is considered complete and is hereby accepted by the Zoning Division of
the City of Gahanna and shall be:
Forwarded to the City of Gahanna Planning Commission for consideration.
Forwarded to the Local Floodplain Administrator for consideration.
Planning & Zoning Administrator Signature: _______________________________________ Date: ___________
16. If the proposed construction is an addition, renovation, repair or maintenance to an existing
structure:
Cost of proposed construction: $________________________
Estimated market value of existing structure: $________________________
17. A statement including the following information:
- The type of development (please list all that apply: new, residential, non-residential,
installation, materials storage, existing structure, alteration, accessory, addition,
filling/grading, mining/dredging, watercourse alteration, manufactured structure, other-
explain).
- If the proposed construction is an alteration, addition, or improvement to an existing
structure, indicate the cost of the proposed construction.
- If existing structure, please list the estimated market value.
NOTE: An existing structure must comply with the flood protection standards if it is substantially improved
(an improvement equal to or greater than 50% of the market value of the structure). FEMA maintains
that the “substantial improvement” definition applies to existing structures only, & that once a structure
meets the definition of “new construction” any further improvements to that structure must meet “new
construction” requirements. For floodplain management purposes, “new construction” means structures
for which “start of construction” began on or after the effective date of the initial Flood Insurance Rate
Map issued by FEMA for the community
- Does the proposed development involve a subdivision or other development containing at
least 50 lots or 5 acres (whichever is less)? Yes or No
NOTE: If yes, base flood elevation data is required from applicant (if not provided by FEMA)
18. 18. Application fee (in accordance with the Building & Zoning Fee Schedule)
19. Application & all supporting documents submitted in digital format
20. Application & all supporting documents submitted in hardcopy format
21. Authorization Consent Form Complete & Notarized (see page 4)
22. After structure is built: return ELEVATION CERTIFICATE FORM to the Zoning Division of the
City of Gahanna
INTERNAL USE
Page 3 of 7|FLOODPLAIN USE|REV.4.24.17
ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
AUTHORIZATION CONSENT FORM
(must sign in the presence of a notary)
If you are filling out more than one application for the same project & address, you may submit a copy of this form with additional applications.
AUTHORIZATION FOR OWNER’S APPLICANT OR REPRESENTATIVE(S) If the applicant is not the property owner, this section
must be completed & notarized.
I, _______________________________________, the owner or authorized owner’s representative of the subject property listed on
this application, hereby authorize _________________________________________ to act as my applicant or representative(s) in all
matters pertaining to the processing and approval of this application, including modifying the project. I agree to be bound by all terms
and agreements made by the designated representative.
Property Owner Signature: _______________________________________________ Date: ____________________
AUTHORIZATION TO VISIT THE PROPERTY
I, ___________________________________, the owner or authorized owner’s representative of the subject property listed on this
application, hereby authorize City representatives to visit, photograph and post notice (if applicable) on the property as described in
this application.
Property Owner Signature: _______________________________________________ Date: ____________________
Subscribed and sworn to before me on this ______ day of ________________, 20______.
State of _________________ County of __________________
Stamp or Seal
Notary Public Signature: _______________________________________________
AGREEMENT TO COMPLY AS APPROVED
I, ___________________________________, the applicant of the subject property listed on this application, hereby agree that the
project will be completed as approved and any proposed changes to the approved plans shall be submitted for review and approval
to the Zoning Division staff.
Applicant Signature: ____________________________________________________ Date: ____________________
Subscribed and sworn to before me on this ______ day of ________________, 20______.
State of _________________ County of __________________
Stamp or Seal
Notary Public Signature: _______________________________________________
NOTARY
NOTARY
Page 4 of 7|FLOODPLAIN USE|REV.4.24.17
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ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
ELEVATION CERTIFICATE FORM
Supplement to Floodplain Use Permit Application
THIS FORM MUST BE RETURNED TO THE ZONING DIVISION OF THE
CITY OF GAHANNA AFTER THE STRUCTURE HAS BEEN BUILT FOR
COMPLIANCE WITH FEDERAL GUIDELINES.
This form should be completed by a professional surveyor and submitted to the City of Gahanna Zoning Division after the
structure has been built. It can be used by the property owner to certify that the completed construction meets the flood
elevation standards of the community. For communities participating in the Federal Insurance Administration Community
Rating System, the NFIP “ELEVATION CERTIFICATE” (O.M.B. No. 3067-0077) must be used to record as-built lowest floor
elevation data.
I, the undersigned, do hereby certify to the following elevation at the referenced property as required by
Chapter 1191 of the Codified Ordinances of the City of Gahanna.
Site Location/Address: ____________________________________________ Permit No. __________________
Community – Panel Number of FEMA Map: _______________________________________________________
(obtained from the Zoning Division of the City of Gahanna)
Date of Construction Completion: _______________________________________________________
Lowest Floor Elevation* Feet Above Mean Sea Level: ______________________________________________
(obtained by the surveyor)
*”Lowest Floor” means the lowest floor of the lowest enclosed area (including basement). An unfinished or flood resistant enclosure, useable
solely for parking of vehicles, building access or storage in an area other than a basement area is not considered a buildings lowest floor;
provided, that such enclosure is not built so as to render the structure in violation of the applicable design requirements for enclosed areas
below the lowest floor.
Name of Surveyor: __________________________________________________________________________
Signature of Surveyor: _____________________________________________ Date: _____________________
Professional Seal:
RECEIVED: ________
DATE: ____________
Page 5 of 7|FLOODPLAIN USE|REV.4.24.17
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ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
FLOODPLAIN USE ADMINISTRATIVE USE ONLY – LOCAL FLOODPLAIN ADMINISTRATOR
Note: All references to elevations are in feet mean sea level (MSL). The term base flood elevation means the same as the 100 year elevation.
1. The proposed development is in:
An identified floodway.
A hydrologic and hydraulic engineering analysis accompanies the application
The analysis has a certification that flood heights will not be increased
Is the analysis certified by a Registered Professional Engineer
A flood hazard area where base flood elevations exist with no identified floodway.
A hydrologic and hydraulic engineering analysis accompanies the application
The analysis has a certification that flood heights will not be increased less than the height designated in the
community’s flood damage reduction regulations (in no case will this be more than one foot)
Is the analysis certified by a Registered Professional Engineer
An area within the floodplain fringe.
An approximate flood hazard area (Zone A).
Within the banks of a watercourse.
The analysis demonstrating that the flood carrying capacity has not been diminished accompanies the
application
Base flood elevation (100-year) at proposed site _______________________________ feet m.s.l.
Elevation in relation to mean sea level of the lowest floor, including basement, of all proposed structures located in special
flood hazard areas where base flood elevation data are utilized _______________________
Elevation in relation to mean sea level to which any proposed structure will be floodproofed in accordance with Section
1191.02(b) where base flood elevation data are utilized __________________
Data source ___________________________________________________________________________
Map effective date Community-Panel No. _________________________
2. Does proposed development meet NFIP and local “Use and Development Standards” of your regulations?
Permitted Use.
Water and wastewater systems standards met.
Subdivision standards met (All public utilities and facilities safe from flooding, adequate drainage, flood elevations
generated where applicable.
Residential/non-residential structures standards met. Lowest floor elevation ______________ feet m.s.l.
Substantial improvement / substantial damage
Anchored properly (manufactured home affixed to permanent foundation)
Utilities protected against flooding
Construction materials below flood protection elevation resistant to flood damage
Lowest floor elevated to or above flood protection elevation (BFE + freeboard)
Has an enclosure below lowest floor (crawl space, walkout basement)
Enclosure have proper number and area of openings
Enclosure unfinished and only used for parking, materials storage or entry
Accessory structure standards met (square footage, use, foundation openings).
Recreational vehicle standards met.
Above ground gas or liquid storage tank anchored.
Flood carrying capacity maintained for floodway development, areas where FEMA has provided BFE data but no
floodways, or for alterations of a watercourse.
3. The proposed development triggers a requirement to submit a Letter of Map Revision or Conditional Letter of Map Revision
4. COMPLIANCE WITH APPLICABLE FLOODPLAIN STANDARDS:
COMPLIANT - permit issued on: ________________
NOT-COMPLIANT - permit denied on:
___________
Note: All structures must be build with the lowest floor, including the basement, elevated or floodproofed to or above the base flood elevation
(100 year) unless a variance has been granted. Only non-residential structures may be floodproofed.
5. EXEMPTION:
The proposed development is EXEMPT from the floodplain standards per Section 1191.14 of the Regulatory Flood
Hazard Area Chapter 1191
Page 6 of 7|FLOODPLAIN USE|REV.4.24.17
ZONING DIVISION
200 S. Hamilton Road
Gahanna, Ohio 43230
614-342-4025
zoning@gahanna.gov
www.gahanna.gov
INTERNAL USE
FLOODPLAIN USE PERMIT APPROVAL
In accordance with Section 1191 of the Codified Ordinances of the City of Gahanna, Ohio, I hereby certify that the
project, as stated on the submitted application, was approved by _________________________________ on
__________________. The applicant shall comply with any conditions approved and shall comply with all building,
zoning and landscaping regulations of the City of Gahanna.
Site Location/Address: _______________________________________________ Permit No. ____________________
CONDITIONS: ___________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
The permittee understands and agrees that:
• An as-built Elevation Certificate will be submitted to the Floodplain Administrator after the first floor of a new,
substantially improved, or substantially damaged, residential or non-residential structure is constructed;
• A final Letter of Map Revision will be obtained where a Conditional Letter of Map Revision was required as part
of the permit application;
• The permit is issued on the representations made herein and on the application for permit;
• The permit may be revoked because of any breach of representation;
• Once a permit is revoked all work shall cease until the permit is reissued or a new permit is issued;
• The permit will not grant any right or privilege to erect any structure or use any premises described for any
purposes or in any manner prohibited by the codes or regulations of the community;
• The permittee hereby gives consent to the Floodplain Administrator to enter and inspect activity covered under the
provisions of the Floodplain Management Regulations;
• The permit form will be posted in a conspicuous place on the premises in plain view;
• The permit will expire if no work is commenced within one year of issuance; and
AN ELEVATION CERTIFICATE FORM MUST BE COMPLETED AND RETURNED TO THE ZONING DIVISION OF THE CITY OF
GAHANNA AFTER THE STRUCTURE HAS BEEN BUILT FOR COMPLIANCE WITH FEDERAL GUIDELINES.
Local Floodplain Administrator/
Planning & Zoning Administrator Signature: _________________________________________ Date: _____________
Page 7 of 7|FLOODPLAIN USE|REV.4.24.17
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Form 20576 Floodplain Use* (City of Gahanna)

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Completed 14 July 2020

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