Floodplain Permit Application Borough of St. Clair, Schuylkill County, Pennsylvania Permit No. Section 1. Permit Application Conditions: 1. The permittee is responsible to meet all requirements as set forth in the floodplain ordinance, and this form is not all inclusive. 2. No work of any kind may start until a floodplain permit is issued. 3. The permit may be revoked, penalties assessed and all work must cease until permit is re-issued if false statements are made herein. 4. Development shall not be used or occupied until Final Approval is issued. 5. The permit will expire if no work is commenced within 180 days or complete within twelve months of permit issuance. 6. Applicant gives consent to the Floodplain Administrator or his/her representative to make reasonable inspections required to verify compliance. Section 2. Contact Information (to be completed by Applicant) Applicant Name: Address: Phone: Email: Property Name: Owner Address: UPI No.: Phone: Email: *The UPI number may be obtained from the Schuylkill Parcel Locator. Contractor Name: Address: Phone: Email: Section 3. Project Information (to be completed by Applicant) Is the project in the floodplain? No Yes (See Section 6 for additional submittals) FEMA Community Number: 420786 Firm Panel Number(s): 4207860001B Firm Effective Date: 6/2/1995 Base Flood Elevation (NAVD88): Proposed Structure (check all applicable boxes): New Structure Residential Reconstruction Non-Residential Renovation Combined Residential and Non-Residential Repair Manufactured Home Expansion Accessory to a Principal Building Alteration Recreational Vehicle Floodplain Permit Application Page 1 of 5 Rev 11/6/2014 Section 3. Project Information (continued) (to be completed by Applicant) Market value of the structure (prior to flood damage if applicable): $ Estimated cost of proposed work: $ Increase in market value (%6): Other development activities (check all applicable boxes): Filling Grading Excavation Road, street or bridge construction Utilities (specify type: Mining Dredging Drilling operations Storage of equipment or materials Subdivision of land Decription of Proposed Work: Section 4. Plan Requirements For initial permit determination, the floodplain permit application must be accompanied by a drawing that shows the foilowing: 1. North arrow, scale (1"=100' maximum) and date 2. Topographic contour lines (if available) 3. Location of all existing and proposed buildings, structures and other improvements, including the location of any existing or proposed subdivision and development. 4. Location of all existing streets, drivewayss and other access ways. 5. Location of existing bodies of water or watercourses, identified floodplain areas, and, if available, information pertaining to the floodway, and the flow of water including direction and velocities. The Applicant may delineate all proposed work on a FIRMette from the FEMA Map Service Center, GIS mapping platform, or other system that provides the above information. Section 5. Applicant Signature (to be completed by Applicant) As the applicant, I certify that am either the owner or authorized agent of the owner and that all statements and attachments to the application are, to the best of my knowledge, true and accurate, and I acknowledge non-compliance with the current floodplain ordinance is subject to the penalties as defined in the ordinance. Applicant Name: Signature: Date: Floodplain Permit Application Page 2 of 5 Rev11/6/2014 Section 6. Additional Submittals (to be completed by Applicant) Ift the proposed work is in the floodplain, the following items may be required: Included 1. Plans of all proposed buildings, structures and other improvements, drawn at a suitable scale showing the following: a. Proposed lowest flood elevation of any proposed building (NAVD88) b. Elevation of the base flood. C. Supplemental information per 34 PA Code and the Uniform Construction Code, 2. Detailed floodproofing information 3. Flood depths, pressures, velocities, impact & uplift forces for base flood; and Floodway area when combined with all other existing and proposed development, will not increase the base flood elevation at any point. 4. Documentation, certified by a registered professional engineer or architect, to show the cumulative effect of any proposed development will comply with the base flood elevation requirements of the ordinance. Zone A: Supporting analysis and documentation must be provided in accordance with the Zone A Manual: Managing Floodplain Development in Approximate Zone A Area (FEMA 265/July 1995) or latest revisions therof. Detailed Floodplain: Supporting analysis and documentation must be provided in accordance with the Flood Insurance Study Guidelines and Specifications for Study Contractors (FEMA 37/1995) or latest revisions Bridge, culvert or other water encroachments: Supporting analysis and documentation must be provided in accordance with PennDOT Design Manual Part 2 (Publication 13M), Chapter 10 "Drainage Design and Related Procedures" or latest revisions therof. 5. Documentation, certified by a registered professional engineer or architect, which states that the proposed construction or development has been adequately designed to withstand the pressures, velocities, impact and uplift forces associated with the base flood. 6. Detailed information needed to determine compliance with "Storage" and "Development Which May Endanger Human Life" requirements. 7. Applicable component of the Pennsylvania Department of Environmental Protection Planning Module for Land Development. 8. Erosion and sedimentation control plan. 9, Other federal, state and/or local permits 10. Other: Applicant shall submit a minimum of three (3) copies of all documents to the municipality, and all necessary copies to other reviewing agencies as applicable. Transmit electronic copies if available. Floodplain Permit Application Page 3 of 5 Rev 11/6/2014 Section 7. Initial Permit Determination (to be completed by Floodplain Administrator) The project site... is NOT located in the floodplain, and no floodplain permit is required. is partially located in the floodplain, but buliding/development is not, and no floodplain permit is required. .is located in the floodplain. FIRM: zone designation: Regulatory BFE (NAVD88): .is located in the floodway, Name: Signature: Date: Section 8. Permit Determination (to be completed by Floodplain Administrator) have determined that the proposed activity... Is Is not in conformance with the provisions of the floodplain ordinance, and the floodplain permit is issued subject to the following conditions: Name: Signature: Date of Permit Issuance: Construction must begin prior to: Construction must be complete prior to: APPEALS: Permit decision appealed? yes No Hearing date: Appeals Board Decision - Approved? Ves No Reasons/Conditions: Floodplain Permit Application Page 4 of 5 Rev 11/6/2014 Section 9. As-Built Elevations (to be completed by. Applicant) The following information must be provided for structures that are part of this application. The as- built elevation data must be certificated by a registered professional engineer or a licensed land surveyor. 1. Elevation (NAVD88) of the top of the lowest floor, including basement, is: ft 2. Elevation (NAVD88) of floodproofing protection is: ft - certify that the information in this section of the floodplain permit represents the elevation information collected on the subject site by means of field survey techniques. Signature: Date: (Apply Professional Sea!) Section 10. Inspections (to be completed by Floodplain Administrator) The floodplain administrator or their designee will complete this section based on inspections of the project at the start of construction, after the first floor is constructed, and after construction to ensure compliance with the municipal floodplain ordinance. Date: By: Deficiencies? Ves No Comments: Date: By: Deficiencies? Yes No Comments: Date: By: Deficiencies? Yes No Post Construction Elevation Certificate (FEMA Form 086-0-33) provided? Yes No Floodproofing Certificate (FEMA Form 086-0-34) provided? Yes No Comments: Section 10. Final Approval (to be completed by Floodplain Administrator) Final approval issued: Name: Signature: Date: Floodplain Permit Application Page 5 of 5 Rev 11/6/2014 RESOLUTION NO. A RESOLUTION OF THE BOROUGH OF ST. CLAIR, COUNTY OF SCHUYLKILL, COMMONWEALTH OF PENNSYLVANIA, ESTABLISHING THE FEE STRUCTURE FOR FLOODPLAIN PERMITS WITHIN THE BOROUGH OF ST. CLAIR. WHEREAS, the St. Clair Borough Council recognizes the need to appoint and update the floodplain permit fee structure for the Borough of St. Clair; and WHEREAS, in order to comply with the necessary regulations of the Federal Emergency Management Agency and the Pennsylvania Flood Plain Management Act of 1978, it is necessary that all construction and development work within the Borough of St. Clair be reviewed by the Floodplain Administrator or their designee for compliance with the floodplain ordinance: BE IT RESOLVED, that the Borough Council of St. Clair, Schuylkill County, Pennsylvania, hereby establish the attached fee schedule which is to remain in full force and effect until such time as the Borough Council of St. Clair, by subsequent resolution, may adopt a new or additional schedule of fees and costs. This resolution is hereby enacted this day of ,20 Borough of St. Clair By: By: By: Attest: Roland Price, Jr. St. Clair Borough Secretary