Name on Determination:
Physical address:
Email:
Subdivision:
Lake County participates in the National Flood Insurance Program (NFIP). The NFIP makes federally backed flood insurance
available for all buildings (whether inside of outside of a floodplain). Flood insurance covers direct losses caused by surface flooding,
including a river flowing over its banks, a lake or ocean storm, and local drainage problems.
Lake County recommends all structures be elevated 18 inches above the B.F.E., even those outside the FEMA determined
Special Flood Hazard Area.
Number Street
Block:
Telephone No.:
* PLEASE PRINT &: ______________________________ SIGN ________________________________________
Stormwater Section Lake County Public Works - 323 N. Sinclair Ave., Tavares, FL 32778 Phone 352-253-9081 / Revised June 9, 2015
Unincorporated Lake County
Floodplain Determination Request Form
Are you in the process of pulling permits:
Fax No.:
Mailing Address:
City, State, Zip:
Lot
Please check how you would like this Determination received:
Alt Key or Parcel I. D. Number:
BELOW THIS LINE TO BE COMPLETED BY STORMWATER / PUBLIC WORKS / LAKE COUNTY, FLORIDA
PLEASE ALLOW 24 HOURS
Lake County Base Flood Elevation Determinations of "A" zones may be used for development activities not requiring commercial /
subdivision site plan approval and which are less than five (5) acres or fifty (50) lots. Reference Lake County Land Development Code
Chapter IX & IV and Title 44 CFR Sec. 60.3.
If different than physical address
If yes; permit for:
Note, if pulling a permit, a site plan approved by the Planning & Community Design
Division is required. Please include a copy of the Property Record Card.
As of October 1, 2014 there is a $15.00 fee charged for each flood determination. Please complete this form and mail/deliver to,
323 N. Sinclair Ave., Tarares, FL 32778 (P O Box 7800, Tavares, FL 32778) along with the fee (checks made payable to the
L. C. B. of C. C.). For additional information on flood zones in Unincorporated Lake County you may call 352-253-9081,
fax to 352-253-6016 or email: flood@lakecountyfl.gov. *
For addition information please visit www.lakecountyfl.gov
$15.00 Flood Determination PWFD:
Transaction Number
Flood Zone:
Screen enclosure with kick plate or knee wall?
BFE : Floodplain Construction Permit No.
$25.00 Floodplain Permit PWFCA:
Transaction Number
Date of Last Determination:
Additional Comments:
Date Reviewed:
Staff Initials:
* IF YOUR PROPERTY HAS A FEMA DESIGNATED FLOOD ZONE LOCATED ON IT, YOU MAY BE REQUIRED TO HAVE
A FLOODPLAIN CONSTRUCTION AUTHORIZATION PERMIT ISSUED AS PART OF YOUR PERMITTING PACKAGE.
FAX
EMAILMAIL PICK-UP
Yes No
City, State, Zip:
Date:
