Property Acquisition Worksheet by CTDU87yv

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									        VERMONT EMERGENCY MANAGEMENT  HAZARD MITIGATION GRANT PROGRAM  REQUIRED DATA

Property Acquisition Worksheet                                             Acquisition Projects Only
   NOTE: Participation in an acquisition project must be voluntary on the part of the property owner.

   A. Prepare separate worksheet for each individual property to be acquired.

        Include three or more color photographs (2 copies of each) 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. Street Address (including city, state, zip code, latitude/longitude, and county) or Physical/Legal
      Location: (Also attach an Elevation Certificate for each structure)


   2. Flood Zone Designation (check all zones applicable for the property ):
                           VE or V 1-30
                           AE or A 1-30
                           AO or AH
                           A (no base flood elevation given)
                           B or X (shaded)
                           C or X (unshaded)
                           Floodway
                                    CBRA Zone (Federal regulations strictly limit Federal funding for projects in
                               this Zone; please coordinate with your state agency before submitting an
                               application for a CBRA Zone project )
                                     Other (describe)

   The data for numbers 3 & 4 of this section and all of Section E is not required if the property is
   located in the Floodway OR was substantially damaged in the most recent disaster and is
   located in 100-year Floodplain,. If the property is substantially damaged, attach substantial
   damage certificate from the local flood plain manager or building inspector.

   3.         Substantial Damage Certificate Attached

   3. Base Flood Elevation of Property:

   4. Lowest (Finished) Floor Elevation of Principal Structure:                  , (Attach a Copy of the Elevation
      Certificate)
            OR Depth of water in the structure                      inches for   day(s) and
   5. Level of event causing flooding:        year flood.
                               (10, 25, 50, 100, 500)




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    VERMONT EMERGENCY MANAGEMENT  HAZARD MITIGATION GRANT PROGRAM  REQUIRED DATA

C. Structure Information:
1. Date of Construction

2. Foundation Type:  Slab on grade                       Pier on beam     Perimeter Wall      Other

3. Building Type: (check one)
    1-story w/o basement      2-story w/o basement      Split-level w/o basement
    Split level with basement        1-story with basement      2-story with basement
    Mobile Home                      Other

4. Building Use (check all that apply)
   Primary Residence          Rental Property                    Secondary Residence          Commercial Property
   Public Building            House of Worship                         Multi-Family           Other

5. Construction Type
   Wood Frame                             Concrete Block         Other

6. Are there sub-floor utilities? Describe:

7. Total Square Footage of Principal Structure
8. Estimated Cost to Replace Principal Structure (if known – do not use tax assessor’s value):
   $     / square foot
9. Are there accessory or out buildings on the property?                   Yes        No   If Yes,   Attached
          Detached      Please describe (location, type of structure, age, value):
     If insured - NFIP Policy #:              NFIP RL #:


D. Project Cost Information:
1. Pre-Disaster Fair Market Value                       $                  Source:
2. Estimated Cost for Demolition                        $
3. Estimated Appraisal Cost                             $        (Attach a copy of the Appraisal)
4. Estimated Closing Cost                     $
5. Is the property currently occupied by renter(s)?                  Yes      No--If No, skip # 6
6. Rental Relocation Assistance               $             x     (number of families occupying property) = $

7. Total Cost to Acquire Property (sum of items 1 through 6)                      $




Attach any continuations or additional items to this page                                                 Page 2 of 3
4d4c7089-effa-4865-827f-dc7eeb0ad7e8.doc Acquisition Worksheet
    VERMONT EMERGENCY MANAGEMENT  HAZARD MITIGATION GRANT PROGRAM  REQUIRED DATA



E. History of Hazards / Damages to the Property being acquired
List past damages to the property. Include damage from declared disaster events AND other
hazard events that did not result in a presidential declaration. NOTE: This data is not required if
the property is located in the Floodway or Floodplain and a Substantial Damage Certificate (for
most recent disaster) is attached.

If insured, please attach proofs of loss for structure.


 Date           Level of Event                   Description of Damages          Cost of
                 (10, 20, 50 yr.                    Depth of Flooding     Repairs/Replacement
                     flood)




F. Maps

           FEMA Firmette (Attach and Identify Property)

           Topographic Map (Attach and Identify Property)

           City/County Map (Attach and Identify Property)

           Parcel Map (Attach and Identify Property)




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4d4c7089-effa-4865-827f-dc7eeb0ad7e8.doc Acquisition Worksheet

								
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