HomeMy WebLinkAboutFlorida State Joint Hazard Mitigation Grant Program & Flood Mitigation App. FEMA Charley
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STA TE OF FLORIDA - JOINT. HAZARD MITIGATION GRANT PROGRAM &
FLOOD MITIGATION ASSISTANCE APPLICATION
THIS SECTION FOR STATE USE ONLY
FEMA- _-DR-FL
o Standard HMGP
o Standard FMA
o 5% Initiative Application
o Initial Submission or
o Application Complete
ORe- Submission
Support Documents
o Conforms wI State 409 Plan
o In Declared Area
o Statewide
Eligible Applicant
o State or Local Government
o Private Non-Proflt (Tax 10 Received)
o Recognized Indian Tribe or TrllJal Organization.
Project Type(s)
o Wind
o Flood
o Other:_
Reviewer Phone#:
Reviewer Fad:
Reviewer E-Mail:
Date Application Received:
Community NFIP Status: (Check all that apply)
o Participating Community 10#:
o In Good Standing 0 Non-Partlclpatlng 0 CRS
State Application 10:
State Reviewer:
Signature:
Date:
This application is for all Federal Emergency Management Agency (FEMA Region IV) Hazard Mitigation Grant Program (HMGP) and Flood
Mitigation Assistance (FMA) proposals. Please complete AIL sections and provide the documents requested. If you require technical
assistance with this application, please contact your State Emergency Management Division at (850) 922-5269.
A. To Fill Out This Application: Complete all sections, which correspond with the type of proposed project
General Application Sections: pp.1-5: All Applicants must complete these sections
Enl'ironmental Rel'iew: pp. 6-9: All Applicants must complete these sections
Maintenance Agreement: p. 10: Any Applications involving public property, public ownership, or management of property
Acquisition Worksheet: pp.II-13: Acquisition Projects only -- one worksheet per structure
Elel'ation Worksheet: pp.14-18: Elevation Projects only -- one worksheet per structure
Drainage Worksheet: p. 19: Drainage Projects only
W"uad Retrofit Worksheet: pp. 20-22: Wind retrofit projects only (HMGP only) -- one worksheet per structure
pp. 23-24: Wind retrofit/shelter projects only (HMGP only) -- one worksheet per structure
Attachment A: FEMA Form 90-49 (Request for Public Assistance): All Applicants must complete, if applicable.
Atklchment B: HMGP!FMA Application Completeness Checklist: All applicants are recommended to complete this
checklist
B. Applicant Information
FEMA-1539-DR-FL DISASTER NAME: Hurricane Charley
Ex.. FEMA-1539-DR-FL: Hurricane Clulrlev
Title / Brief Descriptive Project Summary: Fire Station #24 Hurricane Protection
I. Applicant (Organization): City of Winter Sorine:s
2. Applicant Type:
~ State or Local Government D Recognized Native American Tribe D Private Non-Profit
3. County: Seminole
4. State Legislative District(s): 22.33.34 Congressional Distrlct(s): 7.24
5. Federal Tax I.D. Number: 59-1026364
6. FIPS Code*: 117-78325-00 (*ifyour FIPS code is not known, please fill out FEMA Form 90-49 (Attachment A) so that the
Department may obtain a FIPS code for you)
7. National Flood Insurance Program (NFIP) Community Identification Number (this number can be obtained from the FIRM map for
your area): 120295
8. NFIP Community Rating System Class Number: !
9. NFIP Last Community Assistance Visit Date: 9/18/2002
10. Attach proof of current Flood Insurance Policy (FMA only). Flood Insurance Policy Number: !!
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STA TE OF FLORIDA - JOINT HAZARD MITIGATION GRANT PROGRAM &
FLOOD MITIGATION ASSISTANCE APPLICATION
11. Point of Contact
OMs. ~Mr. OMrs. First Name: Gl'el!orv Last Name: Bishoo
Title: Caoital Proiects Coordinator
Street Address: 1126 East State Road 434
City: Winter Sorinl!S State: Florida Zip Code: 32708
Telephone:407-327-5984 Fax: 4073276695
Email Address (if available ):l!bishoo(Q2wintenorin2sfl.orl!
12. ApplicadonPreparedby: OMs. I8IMr. DMrs. First Name: Grel!orv Last: BishoD
Title: CaoitaI Proiects Coordinator Telephone: 4073275884 Fax: 4073276695
13. Authorized Applicant Agent (proof of authorization authority required)
OMs. ~Mr. OMrs. First Name: John Last Name: Bush
Title: Mavor Telephone: 4073271800 Fax: 4073276686
Street Address: 1126 State Road 434
City: Winter S S: Flori : 32708
Signature: Date:
14. All proposed projec uld be included in the county's Local Mitigation Strategy (IMS).
Attach is a letter of endorsement for the project from the county's local Mitigation Strategy Coordinator. 0 Yes 0 No
Section I. Project Description
A. Hazards to be Mitigated I Level of Protection
1. Select the type of hazards the proposed project will mitigate:
D Flood ~ Wind 0 Storm surge 0 Other (list): _
2. Identify the type of proposed project:
D Elevation and retrofitting of residential or non-residential structure
D Acquisition and relocation 0 Acquisition and demolition
181 Wind retrofit 0 Minor drainage project that reduces localized flooding
D Other (please explain) _
3. List the total number of persons that will be protected by the proposed project: 12
4. Fill in the level of protection and the magnitude of event the proposed project will mitigate.
(e.g. 23 structures protected against the 100-year (1%) flood)
_ structure(s) protected against the _ -year Flood (10,25,50,100, or 500 year)
! structure(s) protected against 110 mile per hour (mph) winds
5. Engineered projects only (e.g. Drainage Improvements), include (attach to this page) ALL engineering
calculations and design plans used to determine the above level of protection.
6. Project will provide protection against the hazard(s) above for 25 years (i.e., what is the useful life of the project)
B. Project Description, Scope of Work, and Protection Provided (Must be Completed in Detail)
Describe, in detail, the existing problem, the proposed project, and the scope of work. Explain how the proposed project will
solve the problem( s) and provide the level( s) of protection described in Part A. Also, if available, attach a vendor's estimate
and/or a contractor's bid for the scope of work. Please ensure that each proposed project is mitigation and not maintenance.
Description of the existing problems-The exisiting fire station windows and large garage doors as they currently exist are not
rated to with stand hurricane force winds. In the event offuilure of the doors or windows, structural integrity of the fire station may result. If
the loss of the structure were to occur, the City of Winter Springs would loose the ability to serve the community with vital fire and rescue
emergency services. Fire Station # 24 has four large garage bay doors to accomidate the fire engines and rescue vehicles, two doors face
east and two doors face west. Due to the age of constrcution, these doors are not up to current standards for wind protection. Additionally
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the entrance doors and windows for the fire station are in need of protection.
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Describe the type(s) ofprot.ection that the proposed project will give-It is proposed that the four garage doors be upgraded to to
withstand more than 110 mile per hour winds and the replacement of eight windows with impact rated glass and the coveing of all other
opening with roll up shutters. The fiberglass panel wall will be replaced with framed and stucco walls on the four comers of the salley port
where the vehicles are parked.
Scope ofW ork (describe in detail, what you are planning to do)- The scope of this project includes the installation of electrically
operated rollup type storm shutters on two (2) entrance doors (main entrance) on the north side of the fire station. These two doors are
considered the main access to the building and are specified to be electrically operated to allow for the shutters to be opened and closed
from within the building. Manually operated rollup type storm shutters will be installed on three (3) other access doors and windows.
These shutters will be closed from outside the building prior to storm conditions. Nine (9) fixed (non-opening) windows will be replaced
with new impact rated frames and glass. The specification for replacement of these windows is due to the size of the opening being
relatively small (48 inches wide by 18 inches high), the limited effectiveness and increased cost of storm shutters is prohibitive compared
to the replacement of the existing windows with impacted rated window frames and glass. The fiberglass wall panels that make up a
portion of the front wall and four comers of the salley port where the fire engines and rescue vehiles are parked will be replaced with a
framed and stucco wall.
Describe any other on-going or proposed projects in the area that may impact, positively or negatively the proposed HMGP or
FMA project-
Section II. Project Location (Fully describe the location of the proposed project.)
A. Site
1. Descn"be the physical location of this project, including street numbers ( or neighborhoods) and zip codes; and if
available, please provide precise longitude and latitude coordinates for the site utilizing a hand-held global positioning
system (GPS) unit or the equivalent: Fire Station 24 is located at 102 North Moss Road, Winter Springs, Florida
32708, Parcel Identification: 34-20-30-507-1500-0010, lAITUDE: N28.42037; lONGITUDE: W8 l.l 8359
2. Title Holder: :Citv oeWinter 8Drin2S. Florida
3. Is the project site seaward of the Coastal Construction Control line (CCCL)? DYES I8INO
4. Provide the number of each structure type (listed below) in the project area that will be affected by the project. That
is, all structures in project area.
D Residential property
(l) 181 Public buildings
D Other
D Businesses/commercial property
D Schoolslhospitalslhouses of worship
B. Flood Insurance Rate Map (FIRM) showing Project Site
181 Attach two (2) copies of the FIRM map, a copy of the panel information from the FIRM, and, ifavailable, the
Floodway Map. FIRM maps are required for this application (ifpublished for your area). Also, all attached maps
must have the project site and structures clearly marked on the map. FIRMs are typically available from your local
floodplain administrator who may be located in a planning, zoning, or engineering office. Maps can also be ordered
from the Map Service Center at 1-800-358-9616. For more information about FIRMs, contact your local agencies or
visit the FIRM site on the FEMA Web-page at httD://www.fema.e:ovlhomelMSClhardcopv.htm
Using the FIRM, determine the flood zone(s) of the project site (Check all zones in the project area).
(see FIRM legend for flood zone explanations) (A Zone must be identified)
D VEorV 1-30 D AE or A 1..30
D AO or AH D A (no base flood elevation given)
0 B or X (shaded) 181 C or X (unshaded)
D Floodway
D Coastal Barrier Resource Act (CBRA) Zone (Federal regulations strictly limit Federal funding for projects in this
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Zone; please coordinate with your state agency before submitting an application for a CBRA Zone project).
o If the FIRM Map for yoar area is not pabUshed, please attach a copy of the Flood Hazard Boundary Map (FHBM)
for your area, with the project site and structures clearly marked on the map.
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(Form No. HMGPIFMA-OO 1, Eff. 10130/04)
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C. City or County Map with Project Site and Photographs
~ Attach a copy of a city or county scale map (large enough to show the entire project area) with the project site
and structures marked on the map.
~ Attach a USGS 1 :24,000 TOPO map with project site clearly marked on the map.
o For acquisition or elevation projects, include copy of Parcel Map (Tax Map, Property Identification Map,
etc.) showing each property to be acquired. The map should include the Tax ID nwnbers for each parcel, if
possible.
~ Attach photographs (at a minimwn 2 photographs) for each project site per application. The photographs should be
representative of the project area, including any relevant streams, creeks, rivers, etc. and drainage areas, which
affect the project site or will be affected by the project For each structure, please include the following angles:
front, back and both sides.
Section III.
Budget/Costs
In this section, provide details of all the estimated costs of the project. As this information is used for the Benefit-Cost Analysis, reasonable
cost estimates are essential. Since project administrative costs are calculated on a sliding scale, do not include them in the budget. Also,
do not include contingency costs in the budget.
A. Materials
Dimension
Cost
B. Labor (Include equipment costs -- please indicate all "soft" or in-kind matches)
Descnntlon
Hours
Rate
Cost
C. Fees Paid Include any other costs associated with the project.
Descrivtion of Task
Hours
Rate
Cost
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Total Estimated Project Cost $61640.00
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D. Funding Sources (round figures to the nearest dollar)
The maximum FEMA share for HMGPIFMA projects is 75%. The other 25% can be made up of State and Local fimds as well as in-kind
services. Moreover, the FMA program requires that the maximwn in-kind match be no more than 12.5% of the total project costs.
HMGPlFMAfimds may be packaged with other Federal fimds, but other Federal fimds (except for Federal fimds which lose their Federal
identity at the State level- such as CDBG, ARS, HOME) may not be used for the State or Local match.
Estimated FEMA Share
$46230.00
75% of Total (maximum of 75%)
Non-Federal Share
Estimated Local Share
$15410.00 25% of Total (Cash)
$_ _% of Total (In-kind.)
$_ _% of Total (Global Match..)
Other Agency Share
$_ _% of Total
(Identify Other Non-Federal Agency and availability date: ->
Total Funding sources from above
$61640.00
100Total8.1o (should equal 100%)
Other Non-FEMA Federal Funds $_ (Do not include in total)
(Identify Other Federal Agency: ->
*Identify proposed eligtble activities directly related to project to be considered for In-kind services. (Note on Page 4 Section B)
**Separate project application must be submitted for each Global Match project.
E. Project Milestones/Schedule of Work
list the major milestones in this project by providing an estimated time-line for the critical activities not to exceed a period of3 years for
performance. (e.g. Designing, Engineering, Permitting, etc.)
Milestone
Number of Davs to ComD/ete
rEx., Demolition of 6 sttuctures and removal of debris 14 daYS]
Installation of Shutters 30 days
Removal and instalation of garasze doors 30 days
Paintinsz 5 days
Stucco aoolication 5 daYS
Removal fibere:lass wall oanels 10 daYS
installion of framin2 wall 5 days
Final Inspection 90 days
State Close out 90 daYS
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Section IV.
Environmental Review and Historic Preservation Compliance
(NOTE: This tIJIP1icatJon cannot be processed if this section is not completetL)
Because the HMGPIFMA are federally fimded programs, all projects are required to undergo an environmental and historic preservation
review as part of the grant application process. Moreover, all projects must comply with the National Environmental Policy Act (NEP A)
and associated Federal, State, Tribal, and Local statutes to obtain funding. NO WORK can be done prior to the NEP A review process.
If work is done on your proposed project before the NEPA review is completed, it will NOT be eligible for Federal funding.
1. The following information is required for the Environmental and Historic Preservation review:
All projects must have adequate documentation to determine if the proposed project complies with NEPA and associated statutes. The State
Environmental Staff provide comprehensive NEP A technical assistance for Applicants, with their consent, to complete theNEPA review. The
type and quantity ofNEPA documents required to make this determination varies depending upon the project's size, location, and complexity.
However, at a minimum, please provide the applicable documentation from this section to facilitate the NEP A compliance process.
~ Detailed project description, scope of work, and budget/costs {Section I (p. 2) and Section m (p. 5) of this application).
~ Project area maps {Section II, part B & C of this application (pp. 3-4)).
~ Project area/structure photographs {Section II, part C of this application (p. 4)).
o Preliminary project plans.
181 Project alternatives description and impacts {Section IV of the application (pp. 6-8)).
181 Please complete the applicable project worksheets. Dates of construction are required for all structures.
o Provide any applicable information or documentation referenced on the Information and Documentation Requirements by Project
Type (page 9 of this application).
2. Alternative Actions
The NEP A process requires that at least two alternative actions be considered that address the same problem/issue as the proposed
project In this section, list two feasible alternative projects to mitigate the hazards faced in the project area. One alternative is the "No
Action Alternative".
1. No Action Alternative
Discuss the impacts on the project area if no action is taken.
The destruction and loss ofFice Station #24 would have signinficant impact on the community of Winter Springs. Fire Station #24 serves
the entire west side of Winter Springs. If the building were to be damaged and rendered inoperable and or the vehilces damaged,
emergency services would be significantly hampered for the west side of the city.
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Section IV. Environmental Review;
Alternative Actions, continued
2. Other Feasible Alternative
Discuss a feasible alternative to the proposed project. This could be an entirely different mitigation method or a significant
modification to the design of the current proposed project. Complete all ofparts a-e (below) and include engineering details (if
applicable).
a. Project Description for the Alternative
Describe, in detail, the alternative project. Also, explain how the alternative project will solve the problem(s) and/or
provide protection from the hazard(s).
An alternative to the installation of shutters and roll up doors would be the replacement of all the windows and frames with
widow frames and glass that are rated and engineered to withstand hurricane force winds.
b. Project Location of the Alternative (describe briefly)
o Attach a map or diagram showing the alternative site in relation to the proposed project site
o Photographs (2 copies) of alternative site
Project location is not changed.
c. Scope of Work for Alternative Project
The alternative scope of work for Fire Station # 24 involves the replacement of all exisitng window glass and frames
with higher wind rated frames and glass capable of withstand hurricane force winds up to 110 miles per hour. This
will include the removal of all existing fraDles and engineering design and drawings for installation of new frames
within the existing CMU openingswith an approved fastening system to meet or exceed current building codes and
installation of glass or Lenn windows of sufficient thickness to withstand hurrincane force winds and projectiles up
to 110 miles per hour.
10
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(Fonn No. HMGPIFMA-OOI, Eft: 10/30/04)
Page 10 of 28
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Section IV.
Environmental Review;
Alternative Actions, continued
d. Impacts of Alternative Project
Below, discuss the impact of this alternative on the project area. Include comments on these issues as appropriate:
Environmental Justice, Endangered Species, Wetlands, Hydrology (Upstream and Downstream surfuce water Impacts),
FloodplainlFloodway, Historic Preservation and Hazardous Materials.
e. Estimated Budget/Costs for Alternative Project
In this section, provide details ofall the estimated costs of the alternative project (round figures to the nearest dollar).
2. Labor (Include equipment costs -- please indicate all "soft" or in-kind matches)
DescriDtion
Hours
Rate
Cost
3. Fees Paid Include any other costs associated with the project.
Descrintion of Task
Hours
Rate
Cost
Total Esdmated Project Cost $_76713.00_
11
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(Form No. HMGPIFMA.oo I, Elf. 10130/04)
Page 11 of 28
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HMGPIFMA ENVIRONMENTAL REVIEW
Information and Documentation Requirements by Project Type
Retrofits to Existing Facilities/Structures
Elevations
Acquisitions with Demolition
./ Dates of Construction
./ Concurrence from State Historic Preservation Officer if structure is 50 years or
older or if work to be done is outside the existing footprint.
Drainage Improvements
./ Engineering plans/drawings
./ Permit or Exemption letter to address any modifications to water bodies and
wetlands
o Department of Environmental Protection
o Water Management District
o U.S. Army Corps of Engineers
./ Letter from State Historic Preservation Office addressing archeological impacts.
./ Concurrence from U.S. Fish and Wildlife addressing any impacts to wildlife,
particularly endangered and threatened species and their habitats.
./ If the project is in coastal area, attach a letter from the National Marine Fisheries
Service addressing impacts to marine resources.
./ Concurrence from Natural Resource Conservation Service if project is located
outside city limits and may impact prime or unique farmland.
.
Note: This is a general guideline for most projects. However, there wiQ be exceptions.
Consult with environmental staff on project types not listed.
12
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(Form No. HMGPIFMA-OOI, EfT. 10/30/04
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Section V.
Maintenance Agreement
All applicants whose proposed project involves the retrofit or modification of existing public property or
whose proposed yroject would resuh in the public ownership or management of property, structures, or
facilities, must Jlrst sign tlte foUowing agreement prior to submitting their appliClltion to FEMA.
(NOTE: Those applicants whose project only involves tlte retrofitting, elevation, or other modification to
private property where the ownership will remain private after project completion DO NOT have to complete
this form.) .
The Ci~ of Winter S~rin2s of Seminole. State of Florida, hereby agrees that
( Uy. Town. CmmlY.
if it receives any Federal aid as a result of the attached project application, it will accept resyonsibility, at its own
expense if necessary, for the routine maintenance of any real property, structures. or facilities acquired or
constructed as a result of such Federal aid. Routine mamtcnance shall include, but not be limited to, such
responsibilities as keeping vacant land clear of debris, ~arbage. and vermin; keeping stream channels, culverts, and
storm drains clear of obstructions and debris; and keepmg detention ponds free of debris, trees, and woody growth.
The pu.rp<?se of this agreement is to make clear the Subgrantee's maintenance responsibilities following project
award and to show the Sub~tee's acceptance of these responsibilities. It does not replace, supercede, or add to
any. other maintenance responsibilities imposed by Federal18.w or regulation and which are in force on the date of
prOject award.
Signed by Ronald McLemore the duly authorized representative
(printed 01" typed name of signing official)
Citv Mana2er,
(title)
-/1 i/(~~~ ~
this ~ (day) of ~ (month),~.> (year).
Signature* ~. 'C.,.J;"/ c-./.' '--;7"'1
. I
/.
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*Please note: The above signature must be by an individual with legal signing autltority for the
respective local government or county (e.g., the Chairperson, Board of County Commissioners or the
County Manager, etc.)
Page 11 of
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(Form No, HMGPIFMA.oOl. Eff.lO/30/04)
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Property Acquisition Worksheet
Acquisition Projects Only
A. Prepare a separate worksheet for each individual Drooertv to be acquired. Please note: Participation in an acquisition
project must be voluntary on the part of the property owner.
D Include at a minimum four (4) color photographs showing a front view, a side view, and a back view of each structure
to be acquired. Attach photographs to the worksheet for that property
B. Site Information:
1. Owner's Name:
Social Security Number: _ (needed for duplication of bene fits (DOB) determination)
Spouse's name (if applicable): _
Spouse's Social Security Number: _ (needed for duplication of benefits (DaB) determination)
2. Street Address (including city, state and zip code) or Physical/Legal Location:
3. If the structure is located in a Special Flood Hazard Area (SFHA) and was substantially damaged (i.e., greater than 50%) you
must obtain a Substantial Damage CertifICate signed by the Local Building Official (prefurably using FEMA's Residential
Substantial Damage Estimator (RSDE) software).
Please Note: The data for numbers 4,5, and 6 of this part of the application and all of Section D are not required if the structure is
located in the SFHA and a Substantial Damage Certif"lCate is attached.
4. Base Flood Elevation of Property: _
5. Lowest (Finished) Floor Elevation of Principal Structure: _
6. Depth of water in the structure _ inches, for _ day(s) and level of event causing flooding _ year flood.
(10,25,50,100,500)
7. Post Mitigation Property Use:
c. Structure Information
1. Attach a copy of the local government Tax Assessor's record for the subject property; and, if available, a tax map.
2. Building Type: (check one)
o I-story w/o basement 0 2-story w/o basement 0 Split-level w/o basement 0 Split level with basement
o I-story with basement 0 2-story with basement 0 Mobile Home 0 Other: _
3. Building Use: (check all that apply)
o Primary Residence 0 Rental Property
o Public Building 0 House of Worship
o Secondary Residence
o Multi-Family
o Commercial Property
o Other: _
4. Construction Type:
o Wood Frame
o Concrete Block
o Brick
o Other: _
14
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(Form No. HMGPIFMA..()O I, Eff.1 0/30/04)
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Property Acquisition Worksheet continued
Acquisition Projects Only
5. Date of Construction for the structure: (ifstructure is older than 50 years, attach letter from State Historic Preservation Officer):
6. Total Square Footage of Principal Structure (heated and cooled areas only): _
7. Estimated Cost to Replace Principal Structure (ifknown): $-1 square foot.
8. Are there accessory or out buildings on the property? 0 Yes 0 No If Yes, 0 Attached 0 Detached
Please describe (location, type of structure, age, value):
9. If the project involves the acquisition of a commercial property you must complete a Hazardous Materials Questionnaire for that
property. If applicable, please contact the HMGPIFMA Environmental Section at (850) 922-5779 for a copy of the questionnaire.
D. History of Hazards /Damages (to the Property being acquired)
list all current and past damages to the property (including damages to the structure, its contents, and any displacement costs). Include
damage from declared disaster events AND other hazard events that did not result in a presidential declaration. NOTE: These data are not
required if the property is located in the Floodway or if a Substantial Damage Certificate (for most recent disaster) is attached.
Date Level of Flooding Event Description of Damages Cost of
(e.g., 10, 20, 50 yr. flood) Depth of Flooding RepairslReplacement/
Displacement/Structure!
Content
.
Note regarding damage estimates: the date, level of event, description of damages, cost of repairs/replacement must be specific to
ONLY the building under consideration. County wide damage estimates (e.g., Hurricane Irene, 1999 caused 2 million dollars damage)
cannot be used. Additionally, vague information is not useful or acceptable in lieu of specific building damage estimates. The property
damages can be a homeowner's estimate; however, please include a contractor's itemized repair estimate, if possible.
15
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(Form No. HMGPIFMA-OO I, Eff.1 0130/04)
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Property Acquisition Worksheet continued
Acquisition Projects Only
E. Acquisition Cost Worksheet
Please fUl out a separate Acquisition Cost Worksheetfor each prop~ to be acquired (If your project involves the acquisition of
'.' . .
Project Cost Infonnatloll . C08ts
Owner's FoUName: - NA
Spouse's Fun Name (if applicable): _ NA
Mailing Address: NA
City, State, ZIP: NA
Property Address: NA
Tax Parcel Identification Number: NA
Year Built: NA
Square footage of the building (heated and cooled areas only): NA
Pre-Disaster Fair Market Value** (Identify Source: ----.J S
Estimated Cost of Demolition S
Estimated Appraisal Costs S
Property Survey Costs S
Closing Costs (usually handled by a title company) S
Relocation Assistance S
Other S
. Total CosUo Acq_Property S
several properties, you may wish to develop a single spreadsheet that lists each prop~. The spreadsheet should contain all of the
information fields in the Acquisition Cost Worksheet below).
**Please note: The community may determine the pre-disaster fair market value by using either the local tax assessed
value (plus a percentage to approximate market value) or a State Certified Property Appraisr's estimate. In either case,
the market value must be based on pre-disaster conditions. Also, if a local tax assessed value is used, a letter from the
Local Property Appraiser must accompany the application.
16
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(Form No. HMGPIFMA..{)O I, Eff.1 0/30/04)
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Elevation Worksheet
Elevation Projects Only
NOTE: Recommended elevation for Coastal Areas is at least one foot above the Base Flood Elevation.
Recommended elevation for Riverine Areas is at least two feet above the Base Flood Elevation (BFE). Please provide
damage history for the structure under consideration only. Also, an entire HMGPIFMA application must be completed
for each structure to be elevated.
D Include at a minimum four (4) color photographs showing a front view, a side view, and a back view of the
structure to be elevated. Attach photographs to the property worksheet.
A. Site Informadon:
1. Owner's Name:
Social Security Number: _ (needed for duplication of benefits (OOB) determination)
2. Spouse'sName(ifapplicable):_
Spouse's Social Security Number: _ (needed for duplication of benefits (OOB) determination)
3. Street Address (including city, state and zip code) or PhysicallLegal Location:
B. Structure Information:
1. Building Type: (check one)
o I-story w/o basement 0 2-story w/o basement 0 Split-level w/o basement
o I-story with basement 0 2-story with basement 0 Mobile Home
o Split level with basement
o Other:_
2. Building Use (check all that apply)
o Primary Residence 0 Rental Property
o Public Building 0 House of Worship
o Secondary Residence 0 Commercial Property
o Multi-Family 0 Other: _
3. Construction Type: 0 Wood Frame
o Concrete Block
o Other: _
o Block Foundation
o Other: _
4. Foundation Type:
o Slab on Grade
o Crawl Space
5. Date of original construction for the structure: _
6. Date of modification/upgrade to the structure (ifapplicable):_
7. What is the pre-disaster value of the building? _ (Provide a copy of Tax Assessor's record, or certified appraisal)
8. What is the total value of the contents of the building? _ (If uncertain, a value of$20,000 or 30% of the
Building Replacement value, which ever is greater)
9. What was the depth offlooding in the building? _ inches
10. How long was the building flooded? _ days
11. Provide the level of the flooding event: _ (e.g., 10-year event, 25-year flood, etc.)
17
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(Form No. HMGPIFMA-OO I, Eft: 10/30/04)
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Elevation Worksheet continued
Elevation Projects Only
12. Elevation Information
Total Square Footage of Principal Structure (heated and cooled areas only): _
Lowest (Finished) Floor Elevation of Principal Structure (above sea level): _
Proposed Elevation Height (above sea level) minimum of2 feet offree board above BFE is required:
Feet Inches
Proposed Foundati9n Type for Elevated Structure:
o Columns
o Pilings
o Other:_
C. Required information for elevation projects located in a V-zone or numbered A-zone:
1. What is the elevation of the lowest livable floor of the building? _ (A copy of the surveyor or engineer's Elevation Certijkate
for the building is required)
2. What is the Base Flood Elevation (BFE) at the building site? _
3. What is the local code requirement regarding elevation? _ ( e.g., BFE + 1.0', etc. provide a copy of the applicable local code
language/section)
4. From the FEMA Flood Insurance Study (FIS), which includes the project site, fill out the appropriate table below:
*Please Note: FISs can be ordered from the Map Service Center at 1-800-358-9616. For more information about
PISs, contact your local agencies or visit the PIS site on the FEMA Web-page at htto:/Iwww.fema.s!OvIMSC/fis.htm
If located in a Riverine Flood Zone (numbered A-zone or AE zone) fill in the foUowine table:
Flood Frequency Peak Discharge (CFS) Flood Depth
10-year
50-year
100-year
500-year
If located in a Coastal Flood Zone (V -zone or A-zone subject to storm suree) fill in the fOUOWin2 table:
Flood Frequency Flood Depth
10-year
50-year
100-year
500-year
18 Page 18 of
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(Form No. HMGPIFMA-OOI, Eff.lO/30/04)
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Elevation Worksheet continued
Elevation Projects Only
D. History of Hazards /Damages (to the structure being elevated)
List all current and past damages to the structw"e (including its contents). Damages must be fully documented (i.e., you may be asked to
produce supporting evidence for any claimed damages). Include damage from declared disaster events AND other hazard events which did
not result in a presidential declaration.
Note regarding damage estimates: the date, type of event, and description of damages must be specific to ONLY the building under
consideration. Countywide damage estimates (e.g., Hurricane Irene, 1999 caused 2 million dollars damage) cannot be used.
Additionally, vague information is not useful or acceptable in lieu of specific building damage estimates.
Date N~eofEvent;TypeofEvent Damage Cost to Structure Damage Cost to Content
(e.g., storm surge, closed basin flooding, etc.)
Ex. 1999 Hurricane Irene; Storm Surge $36,000.00 $15,000.00
Note: Flood Insurance Policies must be purchased for all structw"es that are part of a FEMA elevation project. For more information
contact the Floodplain Administrator in your area or visit the National Flood Insurance Program Web Page at (htto:/Iwww.fema.e:ov/nfio)
19
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(Form No. HMGPIFMA-OO I, Effl 0130/04)
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Elevation Worksheet continued Elevation Projects Only
E. Elevation Cost Information
Use the Elevation Cost Worksheet below to develop a detailed cost estimate, which must include all project costs. Any project costs that do not clearly fall
under the specified categories should be submitted to the Department for review and determination of funding eligibility under the HMGP and the FMA
program. For straight elevtltlon the structure must be retroj1Jted to the wind IHd requirements (i.e. storm shutters, hurricllne clips, etc.). Complete
pages 20-22 of the Wind Retroftt Worksheet.
Description Explanation of costs Total Costs
Estimate costs for aU applieable Items I (eog., 12 Items @$40 each)
PermittingIRecordinglLegal Fees
Demolition Pennit $
Building Pennit( s) $
Plumbing, Electrical, Mechanical Pennits $
Recording Fees $
Legal Fees $
Planning and Design
Surveying and Site Layout $
Elevation Certificate( s) $
Engineering Design for Elevated Structure $
Site Preparation
Structural Demolition $
Lot Clearing $
Debris Removal and Disposal $
ExcavationIFill for Grading I $
RetrofittinglElevation of an Existing Structure
Concrete & Block Work; Masonry Work $
Drilling & Installation of Piers, Columns, or Piles $
Beams and Columns $
Embedment and Sealant $
Foundation Walls $
Structural Steel Work $
Bracing and Anchoring $
Ufting/JackinglElevating $
Elevation Cost Worksheet
20
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(Fonn No. HMGPIFMA-OO I, EfIl 0130/04)
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Description Explanation of costs Total Costs
Estimate costs for aU applieable Items (e.g., 12 Items @$40each)
Backfilling $
Detachment and Reattachment (of elements affixed to slJucture) $
I
Elevation Worksheet continued
Sub-Total for Page I $ I
Elevation Projects Only
21
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(Form No. HMGPIFMA-OO I, Eff.1 0/30/04)
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Sub- Total from previous page S
Descripdon Explanation of costs Total Costs
Estimate eosts for aU appUeable items (e.g., n items @54O each)
New Construction
Sub-flooring $
Wall and Roof Framing and Shell Construction $
Exterior Doors and Windows, Insulation $
Hurricane Clipstries $
PorcheslDecks (if pre-existing) $
Stairs and Railings $
Plwnbing Rough-in (for supply and drain, waste and vent) $
Electrical Rough-in (main circuit panel, junction boxes and outlets) $
Installation of ductwork for, ventilation, and air conditioning $
Final Clean-up $
Systems Extensions (for elevated buildings only not for new construction)
Electrical Service $
PlwnbinglWater Service $
Sewer/Septic System $
HV AC and Ductwork; Elevating Mechanical Equipment $
Additional Insulation $
Roof and Foundation Drainage Systems $
Soil Stabilization/Retaining Walls $
Landscape Replacement/Restoradon (for landscaping disturbed by construcdon)
.
Evaluated on a case-by-case basis $
Displacement Costs
Moving Costs $
Temporary Storage Costs $
Temporary living Facilities Costs $
Other Eligible Costs (list additional costs to be determined by the Department for eligibility under the HMGPIFMA programs)
Other(s): _ $
Total Eligible Project Costs $
22
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(Form No. HMGPIFMA-OOI, Eff.l0I30/04)
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DRAINAGE PROJECT WORKSHEET
DRAINAGE PROJECTS ONL Y
Municipality/County: _
Project Title: _
The following information must be provided for completion of the Technical Review:
1. Plot the project area on a Flood Insurance Rate Map (FIRM), include the front page of map displaying the Community
Identification Number.
2. City or CoWlty Scale Map identifying the entire project area.
3. Topographical Map and FIS study of the affected area with appropriate flood elevations for 1,10,50,100 & 500 Year Flood
Depths and Peak Discharges.
4. Provide attachment to verify the total number of repetitive loss structures within the affected basin. (Homeowner name, address,
type of home, content damage, structure damage). The following should also be provided:
· Depth offlooding inside each structure.
· Elevation Certificate for each structure.
· For each structure provide one of the following: Uniform Residential Appraisal Report (URAR) or
Summary Appraisal from Realtor or Means Cost Estimate or Marshal & Swift cost estimate.
· Verification of the "Frequency of Event" which caused the damage to the property i.e., 10- Year, 25- Year,
50- Year 1 00- Year etc. (Information must be obtained from USGS, NWS, NOAA, or
HydrauliclHydrology Engineer or Rainfilll totals for specific date, month & ~ i.e. how many inches in
what period of time).
· Verification of losses due to repetitive minor flood events (e.g.. 1, 2,..5 Year Frequency) indicate name of
event, date of incident and amoWlt ofloss per structure building and content.
5. Economic loss per day for loss of function of bridge or road.
· Estimated number of one-way trips.
· Detour & delay time per one-way trip (hours, days).
6. Verification of the total number of structures that will benefit from the mitigation project.
7. Photographs of the damaged infrastructure property. (Ditches, Culverts, Swales, DetentionlRetention Basins and Ponds).
8. Preliminary or final Engineering Design Plans and a line item breakdown of the Total Project Cost.
9. A Summary Report from: the consultant or Professional Engineer describing the problem and the proposed solution with the
necessary supporting Engineering Calculations for the project/solution. The report should also certify the level of protection and
the magnitude of event the completed scope of work will mitigate. (Example: 40 homes will be protected against a 1 00 Year
Flood Event.) Finally, the report should provide an estimate of damages that is anticipated for events beyond the mitigation
efforts. (Example: The 40 homes can anticipate 15% structural damages for 250 Year Event and 30% structural damages for a
500 Year Flood Event).
10. A Letter of Map Revision (WMR) may be needed for this project. Any changes to the FIRM need to be reflected on the flood
maps, which is accomplished through the WMR process. The construction of this project may lower the 100-year flood elevation
and thus, possibly lower the flood insurance rates for structures in the project area. If the WMR process is applicable to the
proposed project, please contact the Department for assistance at (850) 922-5269.
Additional Comments:
23
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(Form No. HMGPIFMA-OOI, EffIO/30/04)
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Wind Retrofit Worksheet. HMGP only
WIND RETROFrr PROJECTS ONLY
Please fill out this worksheet completely. A separate worksheet is required for each structure to be wind retrofitted.
~ Attach photographs ( two copies) of each side of the building to be retrofitted.
o Provide evidence that the shutter system complies with the Dade County Specifications. The best evidence of this is a
certificate issued by the Dade County Building Department stating that the proposed shutter products have been tested,
approved, and comply with the Dade County Specifications. Non-certified shutters or products cannot be used.
Fill out the table below. NOTE: All shaded line items are re uired to
I A. Project Information
(9) Analyst
r B. Bunding nata
(1) Select Building Type
o Non-Engineered Wood - Wood buildings do not receive specific engineering attention. Examples include single
and multi-fiunily residences, some one- or two- story apartment units, and some smaIl commercial buildings.
o Non-Engineered Masonry - These masonry buildings do not receive specific engineering attention. Examples
include single and multi-fiunily residences, some one- or two- story apartment units, and some small commercial
buildings.
o Manufactured BuDding - These buildings are typically light metaI structures or manufilctured housing units
(e.g., mobile homes). Manufilctured buildings are produced in large nUlIlbtn of identical or similar units.
~ Lightly Engineered - These buildings may combine masonry with steel framing, open-web steel joists, wood
fiaming, and wood rafters. Some parts of the building receive engineering attention while others do not. Examples
include motels, commercial, and light industrial buildings.
o FuDy Engineered - Usually these buildings are designed fur a specific site and thus receive specific,
individualized design attention from professional architects and engineers. Examples include high-rise office and hotel
buildings, hospitals, and most public buildings.
o Other - These buildings do not fit into any of the descriptions listed above.
(5) Historic Building Controls
24
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(Form No. HMGPIFMA-OO I, Effl 0130/04)
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. , C. Building Size and Use
Wind Retrofit Worksheet. HMGP only
I D. Building Value
WIND RETROFIT PROJECTS ONL Y
I F. Displacement Costs Due to Wind
(1) Rental Cost of Temporary Building Space ($/sf7month) 0.00
(2) Other Displacement Costs ($/month) 0.00
I G. Value of Public Non-Profit Service
(3) Post Disaster Continuity Premium ($/day)
I H. Rent and Business Income
(1) Total Monthly Rent from all Tenants ($/month) 0.00
(2) Estimated Net Income of Commercial Businesses ($/month) 0.00
I I. Mitigation Project Data
25 Page 25 of
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II I. Mitigation Project Data
II
I J. Temporary Relocation Costs I
(1) Relocation Time Due to Project (months) 0
(2) Rental Cost During Occupant Relocation ($/month) 0
(3) Other Relocation Costs ($/month) 0
- ------ -- - - -
I
I
I
Wind Retrofit Worksheet - HMGP only
WIND RETROFrr PROJECTS ONLY
26
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28
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(Form No. HMGPIFMA-OO I, Eff.1 0/30/04)
...,.,.~+,. ;~w;,,~~_~_,. _
Wind Retrofit Worksheet - HMGP only
WIND RETROFrr PROJECTS ONLY
Shelter Retrofit Project Only
Benefit Cost Data Collection Form
A. Project Information
Complete
Is a separate worksheet attached for each structure? 0 Yes 0 No
Are photographs of all elements of the building to retrofit attached? 0 Yes 0 No
Is there an Engineer's certification for level of protection proposed attached? 0 Yes 0 No
Are a completed I1IDM Table and Survey Checklist attached? 0 Yes 0 No
B. Building Data
Select Building Type (Before Mitigation)
o lightly Engineered
o Fully Engineered
Building Site (Miles Inland)
Number of Stories above Grade
Construction Date
Historic Building Controls
Disaster Number
C. Building Size and Use
Describe the normal day-to-day function 6fthe facility: _
Total floor area: _ (sf)
Area occupied by owner or Public/Non-profit Agencies: _ (sf)
For the following enter the square
feet for the a licable
BuDding
Existin S
Critical Facili
Host Shelter
Hurricane Evacuation Shelter HES
Host Shelter
27
Page 27 of
28
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(Form No. HMGPIFMA-OO I, Eff.1 0/30/04)
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Recovery Shelter
Refu2e
Risk Shelter
Secondarv Host Shelter
Other (attach exolanation)
Wind Retrofit Worksheet - HMGP only
Shelter Retrofit Project Only
D. Building Value
Building Replacement Value: _
E. Building Contents
Contents Description: _
Total Value of Contents:
F. Value of PubHc Non-Profit Services
Description of Services Provided
Number ofPenons Served by Facility or
Ca ad
G. Mitigation Project Data
Project Description: _
Project Useful Life (Years):_
Mitigation Project Costs: _
Base Year of Costs:
Annual Maintenance Costs ($/year): _
Notes and Additional Information:
28
Attach any continuations or additional items to this page
WIND RETROFrr PROJECTS ONLY
;""'--:p;~'''!;_~'''~~;if~':lj~/'ii:;-~~~-fo~\l:~:~~
Benefit Cost Data Collection Form (Continued)
Existin
Pro osed
(Form No. HMGPIFMA-OOI, EfII0I30/04)
Page 28 of
28
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EdwanlJ Kane
Perfomlance Contractcn Corporation (Pet)
Central FIoI1dII..... Manager
direct line (407) 247 ~'38
35l ..2+'&' 1./'{,1
1/29/05
To: Skip Lazlo
From.: Edward ICane
Re: Hunican ~on on fire station #24 102 North Moss, Winter SpriDgs, Florida
AJ a licensed and insured general contractor we feel We can provide more service to our
customers. The knowledge of the constructl.on Industry and the ability to work as a
CODf1'8ctor allows us tho floxibility to offer a larger product line to our customers.
Providing to the customer c:Ii1fereot options for your security end safety.
Wrth this stlUcture being used as a seconda1y emergency building, we xecommend the
fonowing estimate. Securing the fi1cUity from severe weather with the least intrusive look
and 1he lowest 8m.oum: of time spent securing.
A drawina of the structure is attached. as wen to correspond top the openings called out.
!!II: remDlmeitdaticm b as (fn,ws: .
.. -+> Replacecnent ofwiri.dows in openings numbered 1-6, number 8~ and 14 with
impact rated windows.
)- InstaUat10n of a manual roIIup shutter on opening number 7
> InstaUat10n of a menua1 rollup shutter on opening number 10
)- Ootloll A or oDtio B
A. Elcc1rlcal rollup on opening number 11 with a manual rollup on number 12
B. Manual roUup shutter on opening number t3
)- Installation of electrical rollup shutter on door opening number 15
)> Installation of electrical rollup s1mtter on opening 11
Other options are available and are represented in the pricing estimate.
The use of all manual ron up shutters
Impact doors and impact sliding glass doors can be used. They will keep the same look of
the structure and have no added time or labor to secute the building. Prices repment
labor and parts to remove and ~ the new product.
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01/30/2885 20:35 3522422468 KANE
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Shutter Price Sheet
Station #24: 102 North Moss, Winter Springs FI- Alternate Project Cost
Opening Accordion roll up (manual) add for electric Impact window Impact s1ldr Impct door PCC RECOMMENDS
#1 $195.00 $337.50 $1,400.00 $900.00 #1 $337.50 $900.00
#2 $195.00 $337.50 $1,400.00 $900.00 #2 $337.50 $900.00
#3 $195.00 $337.50 $1,400.00 $900.00 #3 $337.50 $900.00
#4 $195.00 $337.50 $1,400.00 $900.00 #4 $337.50 $900.00
#5 $195.00 $337.50 $1,400.00 $900.00 #5 $337.50 $900.00
#6 $195.00 $337.50 $1,400.00 $900.00 #6 $337.50 $900.00
#7 $780.00 $1,350.00 $1,400.00 $3,600.00 #7 $1,350.00 $3,600.00
#8 $195.00 $337.50 $1,400.00 $900.00 #8 $337.00 $900.00
#9 $195.00 $337.50 $1,400.00 $900.00 #9 $337.00 $900.00
#10 $780.00 $1,350.00 $1,400.00 $3,600.00 #10 $1,350.00 $3,600.00
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#12 $728.00 $1,260.00 $1,400.00 $3,360.00 #12 $1,260.00 $3,360.00
#13 $2,574.00 $4,455.00 $1,400.00 #13 $0.00 $0.00
#14 $330.46 $571.95 $1,400.00 $1,525.20 #14 $571.00 $1,525.50
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#16 $2,080.00 $3,600.00 $1,400.00 #16
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#18
#19 shutters impact
#20 $16,884.40 $45,448.50
#21
#22
#23
#24
#25
$12,792.78 $22,141.35 $33,400.00 $19,285.20 $11,520.00 $14,643.20
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Performance Contractors
Edward J Kane
(407) 247-6938