Application To Develop In A Floodplain Area Form - Teton County Page 2

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DESCRIPTION OF WORK
•
Proposed development description:
New Building
Roads, Bridges or Culverts
Filling
Manufactured Home
Storage
Improvements
Altering Stream Channels
Other______________________________________
•
Site plan showing location and size of proposed development:
•
Note Special Hazard Area (Zone A, AE, A1-A30, AH or AO)
Zone________ Panel Number___________
•
List other permits obtained:
•
Proposed development is within:
Floodplain
Flood way
•
Attach No. Rise Certification with supporting data:
II.
COMPLETE FOR NEW STRUCTURES AND BUILDING SITES
•
Base Flood Elevation:
•
Required lowest floor elevation (including basement):
•
Elevation to which all attendant utilities, including all heating and electrical equipment
will be protected from flood damage:
III.
COMPLETE FOR ALTERNATIONS, ADDITIONS OR IMPROVEMENTS TO
EXISTING STRUCTURES
•
Estimated market value of the existing structure:
•
Cost of the proposed construction:
(If cost of the proposed construction equals or exceeds 50% of the market value of the structure,
then the substantial improvement provisions shall apply.)
IV.
COMPLETE FOR NON-RESIDENTIAL FLOOD PROOFED CONSTRUCTION
•
List type of flood proofing method used:
•
The required flood proofing elevation in feet:
•
Attach flood-proofing certification by a registered Idaho Engineer:
VI.
COMPLETE FOR SUBDIVISIONS AND PLANNED UNIT DEVELOPMENTS:
•
Clearly identify base flood elevations:
•
Delineate the 100-year Floodplain and Flood way:
VII.
ORDINANCE AND STANDARDS USED IN EVALUATION OF THIS APPLICATION:
This application is being reviewed under the provisions of Title 12, Flood Control Ordinance of
Teton County, Idaho, as applicable. The above checklist is self-explanatory as to the requirements
that are necessary to grant approval of this application.
Signature:
Date:
Application to Develop in a Flood Plain
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