Floodplain Zoning Permit Application Form - City Of Claremont
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1City of Claremont, New Hampshire
FLOODPLAIN ZONING PERMIT APPLICATION
Date: _________________________________
Location: Tax Map: ___________ Lot #: ____________
Address: _________________________________________________________________________________
Owner: _______________________________ Address: ________________________ Phone: ____________
Applicant: _____________________________ Address: ________________________ Phone: ____________
Contractor: _____________________________ Address: _______________________ Phone: ____________
General explanation of proposed development: ___________________________________________________
_________________________________________________________________________________________
FLOODPLAIN DETERMINATION
Map __________ Panel #1 __________ Effective Date _____________________________________________
Indicate what flood zone the lot is located in by referring to the NFIP Flood Insurance Rate Map (FIRM), the
Floodway Map (FBFM)) or the Flood Hazard Boundary Map (FHBM):
B, C or X ________ = Structure is not located in a Special Flood Hazard Area (SFHA).
A _______ AE or A1-30 _______ AO _______ AH _______ A99______ V zone ______ VE or V1-30 ______
Market value of existing structure, if applicable: $________.
Estimated value of improvements: $________
The following should correspond with the Elevation Certificate submitted with application:
Elevation of first fully enclosed Floor:
__________ ft.
Base Flood Elevation:
__________ ft.
Is the proposed development in a Floodway?
Yes _____
No _____
Is the proposed development in a Streambank District?
Yes _____
No _____
ADDITIONAL INFORMATION REQUIRED
1.
Elevation Certificate (residential) and Flood-proofing Certificate (non-residential).
_____
2.
Site plan showing the location of all existing and proposed structures, 100-year floodplain
boundary, and floodway boundary if appropriate.
_____
3.
Development plans, drawn to scale, including where applicable: details for anchoring
structures, elevation of lowest floor (including basement), detail of flood-proofing of utilities
located below the first floor and details of enclosures below the first floor.
_____
4.
If the subdivision is greater than 50 lots or 5 acres, the applicant must provide the Base Flood
Elevation in the subdivision plans.
_____
5.
Plans showing the extent of watercourse relocation and/or landform alteration.
_____
APPROVED / DENIED by: _____________________________________ Date: _______________________
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