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Item D05C ounty of M onroe {f `° " rel BOARD OF COUNTY COMMISSIONERS n Mayor David Rice, District 4 The FlOnda Key y m 1 �� Mayor Pro Tem Sylvia J. Murphy, District 5 Danny L. Kolhage, District 1 George Neugent, District 2 Heather Carruthers, District 3 County Commission Meeting July 18, 2018 Agenda Item Number: D.5 Agenda Item Summary #4375 BULK ITEM: Yes DEPARTMENT: Building TIME APPROXIMATE: STAFF CONTACT: Mark Boone (305) 289 -2505 N/A AGENDA ITEM WORDING: Approval to submit Hazard Mitigation Grant Program (HMGP) application for Elevation and Reconstruction Projects in the amount of up to $4,000,000.00 for properties owned by private individuals, using Community Development Block Grant funding as 25% match. ITEM BACKGROUND: Following Hurricane Irma, Monroe County is eligible to apply for HMGP funding for mitigation activities in support of creating a more resilient community. This application is specifically for the mitigation technique of Elevation with an estimated budget of $3 Million from HMGP and $1Million from CDBG. Attached is the County's application and supporting documentation along with two example properties who voluntarily agreed to participate in the program. Staff is working with multiple property owners (200+ property owners have expressed interest in participation in this program but many will be eligible for CDBG DR Funding) throughout the County who are interested in elevating their homes due to Irma impacts as well as future flooding risk. Projects include elevating an existing flood -prone structure. One method of elevation includes rebuilding non - compliant structures, which could include the delivery and setup of smaller, compliant structures. The property owner must maintain flood insurance and the property must remain compliant perpetually. If approved, the County will implement a program to prioritize elevations in accordance with risk of future flooding as well as other comprehensive plan priorities of each affected jurisdiction. PREVIOUS RELEVANT BOCC ACTION: CONTRACT /AGREEMENT CHANGES: N/A STAFF RECOMMENDATION: DOCUMENTATION: Monroe County Emergency Management sample -lms- project- submission - letter 122 127 132 142 BARON - ACKNOWLEDGEMENT OF CONDITIONS BARON - DECLARATION AND RELEASE BARON - DUPLICATION OF BENEFITS BARON - NOTICE OF VOLUNTARY INTEREST FIRM 12087C1337K hmgp- application -final -LYNN hmgp- application -final - BARON FIRM MAP 12087C 1528K 001 004 005 IMG_0083 LYNN - Acknowledgement of Conditions LYNN - DECLARATION AND RELEASE LYNN - DUPLICATION OF BENEFITS LYNN - NOTICE OF VOLUNTARY INTEREST Elevation projects cost worksheet example FINANCIAL IMPACT: Effective Date: Expiration Date: Total Dollar Value of Contract: Total Cost to County: Current Year Portion: Budgeted: Source of Funds: CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: If yes, amount: Grant: County Match: Insurance Required: Additional Details: hI W TA 1 X117.1.6 Mark Boone Completed Assistant County Administrator Christine Hurley 06/29/2018 Peter Morris Completed Bob Shillinger Completed Budget and Finance Completed Maria Slavik Completed Kathy Peters Completed Board of County Commissioners Pending 1:25 PM 06/29/2018 12:16 PM Completed 06/29/2018 2:59 PM 07/02/2018 4:14 PM 07/03/2018 9:22 AM 07/03/2018 9:25 AM 07/03/2018 5:04 PM 07/18/2018 9:00 AM (On agency letterhead) Mr. Miles Anderson, State Hazard Mitigation Officer Florida Division of Emergency Management 2555 Shumard Oak Boulevard Tallahassee, Florida 32399 -2100 Re: Hazard Mitigation Grant Program (HMGP) applications for FEMA 4337- DR -FL, Hurricane Irma Dear Mr. Anderson: The County Local Mitigation Strategy (LMS) working group has approved by vote and prioritized the following projects for HMGP funding from this disaster. These projects align with our LMS goals and objectives as noted, and with the State's mitigation goals and objectives (in accordance with the Code of Federal Regulations 44 §201.6). The County LMS group therefore presents the projects below (or in the attachment' meat' in the order that they are to be considered for funding. FEMA 4337 -DR -FL Hurricane Irma Funding Priority Project Name or Description Applicant Goal /Objective Implemented Estimated Total Project Cost Estimated Federal Share 1. Project name Applicant 3. B. j $000,000 $000,000 2. PrQje .t name Applicant 1. `t $000,000 $000,000 3. Project name Applicant 2. . j $000,000 $000,000 E tc e era For further information or inquiry, please contact me at insert phone number and email Sincerely, LMS Chair County LMS IN Acknowledgement of Conditions For Mitigation of Property in a Special Flood Hazard Area With FEMA Grant Funds Property Owner Terry Baron and Sharon Baron Street Address 31349 Avenue C City Big Pine Key State FL Zip Code 33043 Subject Property Address 31349 Avenue C Big Pine Key, FL Deed Dated 2/1/1974 Recorded OR581 -125 Tax Map 00302910 Block BK 24 LT 5 SANDS SUB Parcel PB1 -65 Base Flood Elevation at the site is 8 feet (NGVD) Map Panel Number 12087C1337K Effective Date 02/18/2005 As a recipient of Federally- funded hazard mitigation assistance under the Hazard Mitigation Grant Program, as authorized by 42 U.S.C. §5170c / Pre - Disaster Mitigation Program, as authorized by 42 U.S.C. §5133 / Flood Mitigation Assistance Program, as authorized by 42 U.S.C. §4104c the Property Owner accepts the following conditions: That the Property Owner has insured all structures that will not be demolished or relocated out of the SFHA for the above - mentioned property to an amount at least equal to the project cost or to the maximum limit of coverage made available with respect to the particular property, whichever is less, through the National Flood Insurance Program (NFIP), as authorized by 42 U.S.C. §4001 et seq., as long as the Property Owner holds title to the property as required by 42 U.S.C. §4012a. 2. That the Property Owner will maintain all structures on the above - mentioned property in accordance with the flood plain management criteria set forth in Title 44 of the Code of Federal Regulations (CFR) Part 60.3, the Florida Building Code and any local ordinance standards as long as the Property Owner holds title to the property. These criteria include, but are not limited to, the following measures: i. Enclosed areas below the Base Flood Elevation will only be used for parking of vehicles, limited storage, or access to the building; ii. All interior walls and floors below the Base Flood Elevation will be unfinished or constructed of flood resistant materials; iii. No mechanical, electrical, or plumbing devices will be installed below the Base Flood Elevation; and iv. All enclosed areas below Base Flood Elevation must be equipped with vents permitting the automatic entry and exit of flood water, For a complete, detailed list of these criteria, see the Florida Building Code and any local ordinance standards. 3. The above conditions are binding for the life of the property. To provide notice to subsequent purchasers of these conditions, the Property Owner agrees to legally record with the county or appropriate jurisdiction's land records a notice that includes the name of the current property owner (including book/page reference to record of current title, if readily available), a legal description of the property, and the following notice of flood insurance requirements: "This property has received Federal hazard mitigation assistance. Federal law requires that flood insurance coverage on this property must be maintained during the life of the property regardless of transfer of ownership of such property. Pursuant to 42 U.S.C. §5154a, failure to maintain flood insurance on this property may prohibit the owner from receiving Federal disaster assistance with respect to this property in the event of a flood disaster. The Property Owner is also required to maintain this property in accordance with the flood plain management criteria of Title 44 of the Code of Federal Regulations Part 60.3, The Florida Building Code and any pertinent local ordinance." 4. Failure to abide by the above conditions may prohibit the Property Owner and/or any subsequent purchasers from receiving Federal disaster assistance with respect to this property in the event of any future flood disasters. If the above conditions are not met, FEMA may recoup the amount of the grant award with respect to the subject property, and the Property Owner may be liable to repay such amounts. This Agreement shall be binding upon the respective parties' heirs, successors, personal representatives, and assignees. HOMEOWNER/PROPERTY OWNER SIGNS HERE: Name of Property Owner: Terry Baron and Sharon Baron--- NOW kilvw&eiagu xrf,ld KELLYA. CUMMINGS 2' Wic - State of Florida -, I Notary 11 Commission # GG 159W My Comm, Expires Nov 11 2021 B3rded:h rough Nannai Notar - ... Q�A LUMMInas Printed 4me of Notary J 10 DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY D ECLARATION L O.M.B. No. 96617 -0002 Expires August 39, 2093 DECLAR.I,TON AND RELEASE In order to be eligible to receive FEMA Disaster Assistance, a member ofthe household must be a citizen, non- citizen national or qualified alien of the United States. Please read the form carefully, sign the sheet and return it to the Inspector, and show him /her a current form of photo identification. Please feel tree to consult v ith an attorney or other immigration expert if you have any questions. 1 hereby declare, under penalty of perjury that (check one). I am a citizen or non- citizen national of the United States. I ann a qualified alien of the United States. o Print full name and age of minor child:I am the parent or guardian of a manor child who resides urith in and who is a citizen, non- citizen national or qualified alien of the United States. Pri nt full name and age of minor child: By my signature I certily that: Only one application has been submitted for any household. * All information I have provided regarding my application for FEMA,, disaster assistance is true and correct to the best of my knowledge. I will return any disaster aid money I received from FEMA or the State if t receive insurance or other money for the same loss, or if'I do riot use FEINIA disaster aid money for the purpose for which it vas intended. I understand that. ill intentionally make false statements or conceal any information in an attempt to obtain disaster aid, it is a violation of federal and State laws, which carry severe criminal and civil penalties, including a tine tip to $250,000, imprisonment, or both (18 U.S.C. §§ 287, 1001- and 3571). I understand that the information provided regarding my application for FEMA disaster assistance may be subject to sharing within the Department of Homeland Security (DFIS) including, but not limited to, the Bureau of Immigration and Custom Enforcement. I authorize FENIA to verify all information given by me about my property /place of residence, income, employment and dependents in order to determine my eligibility for disaster assistance; and I authorize all custodians of records of in) insurance, employer, any public or private entity, bank financial or credit data service to release information to FEMA and/or the State upon request. NAME (print) SIGNATURE I DATE OF BIRTH DATE SIGNED Terry Baran d�z�� x4ti. 1 191'3� C' -!K- /F INSPECTOR ID NO. FEMA APPLIC N NO. DISASTER O. ADDRESS OF DAMAGED PROPERTY CiTY STATE ZIP CODE 31349 Avenue C Big Pine Key L 33043 PRIVACY` ACT STATE.NIEN'r AUTI3C)Rl'I 'Y: The Robert]'. Stafford Disaster Rehz f and Emergency Assistance Act as amended, 42 U.S.C. k 5121 -5207 and Reorganization Plan No. 3 of 1978, 4 U.S.C. §§ 2904 and 2306; 4 C_F.IZ. § 206,2(a)(27); the Personal Responsibility and Work Opportunity Reconciliation Act of 1995 (Pub. L. 104 -193) and Executive Order 1341 1. DHS asks for your SSN pursuant to the Debt Collection Improvement Act of 1996, 31 U.S.C. § 3325(d) and § 7701(c) (1). PRINCIPAL PURPOSE(S): ']'his information is being collected for the primary purpose of determining eligibility and administering financial assistance under a Presidentially - declared disaster. Additionally, information may be reviewed internally within FEMA for quality control purposes. ROUTINE USE(S): The information on this form may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes usine this information as necessary and authorized by the routine uses published in DI4SIFEMA - 008 Disaster Recovery Assistance files System of Records (September 2�4. 2009, 74 FR 48763) and upon written request, by agreement, or as required by late. DISCLOSURE: The disclosure of information on this form is voluntary- however, failure to provide the information requested may delay or prevent the individual frown receiving disaster assistance. PAPERWORK ORk BURDEN DISCLOSURE NOTiCE Public reporting burden fir this data collection is estimated to average 2 Minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources- gathering and maintaining the data needed, and complcting and submitting this forma. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this fora. Send comments regarding the accuraev of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Manageiment Agency, 1800 South Bell Street, Arlinmon, VA 20598 -3005. Paperwork Reduction Project (1660 - 0002) NOTE: Do not send your completed form to this address. of :l ■ FEM:A Form II09 -4 -3, AUG 2010 REPLACES ALL PREVIOUS FEMA Farm 90-69B DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY DE CLARA TI ON DECI ARATON AND RELEASE In order to be eligible to receive FEMA Disaster Assistance, a member of the household must be a citizen, non citizen national or qualified alien of th United States. Please react the form carefully, sign the sheet and return it to the Inspector, and show hire /her a current form of photo identification. Please feel free to consult with an attorney or other immigration expert if you have any questions. I hereby declare_ tinder penalty of perjury that (check one): E] 1 arty a citizen or non- citizen national of the United States. 1 ant a qualified alien of the United States. O Print full name and age of minor child am the parent or guardian ofa minor child who resides with me and who is a citizen, non - citizen national or O LIalified alien of the United States. Print Rill narne and age of minor child: By my signature I certify that: * Only one application has been submitted for my household. * All information I have provided regarding my application .far FEMA disaster assistance is true and correct to the best of my knowledge. * I N ill return any disaster aid money l received from FEULA or the State if l receive insurance or other money for the saute loss. or if I do not use FEMA disaster aid money for the purpose for which it was intended. I understand that, if I intentionally make false statements or conceal any information in an attempt to obtain disaster aid. it is a violation of federal and Mate Laws, which carry severe criminal and civil penalties. including a fine up to 5250.000, imprisonment, or both (18 U.S.C. s s`§ 287, 100 1. and 3571), 1 understand that the information provided regarding my application for FEMA disaster assistance may be subject to sharing within the Department of l- lomeland Security (DHS) including, but not limited to, the Bureau of Immigration and Custom Enforcement. I authorize FEMA to verify all information given by me about my property/place of residence, income, employment and dependents in order to determine my eligihititti for disaster assistance; and I authorize all custodians of records of my insurance. employer, any public or private entity, bank financial or credit data service to release: information to FEMA and/or the State upon request, NAME (print) SIGNATURE DATE OF BIRTH DATE SIGNED Sharon Baron - °-z-�. Q - ) A r INSPECTOR ID NCI. FEMA APPLICATION DISASTER NO. ADDRESS OF DAMAGED PROPERTY CITY STATE ZIP CODE 31349 Avenue C Big Pine Key Fl_ 33043 PRIVACY Acr STATEMENT AUPHCIRITY: The Robert T. Stafford Disaster Relief and Emergency Assistance Act as amended, 42 U.S.C. 5121 -5207 and Reorganization Plan No. 3 of 1973; 4 U.S.C. tiff 2904 and 29()6; 4 C.P.R. § 2062(x1(27); the Personal Responsibility and Work opportunity Reconciliation Act of 1996 (Pub. L. 104 -193) and Executive Order 13411. DI TS asks for your SSN pursuant to the Debt Collection Improvement Act of 1996, 31 U.S.C. § 3325(d) and § 7701(c) (1). PRINCIPAL PURPOSE(S). This information is being collected for the primary purpose ot'determining eligibility and administering financial assistance Linder a Presidentially- declared disaster. Additionally, information Fitly be reviewed internally within FEMA for quality control purposes. ROUTINE USE(S): Tile information on this torn may be disclosed as generally permitted under U.S.C. § 552a(b) of the Privacy Act of 1974, as amended This includes using this information as necessary Lind authorized by the routine uses published in DHSIFEMA - 003 Disaster Recovery Assistance Files System of Records (September 24- 2009, 74 FR 43753) and upon written request, by agreement, or as required by lacy. DISCLOSURE: The disclosure of mformauon on this form is voluntary; hotivever, failure to provide the information requested may delay or prevem the individual from receiv nM disaster assistance. PAPERWORK BURDEN DISCLOStIRE NOTICE Public reporting burden for this data collection is estimated to average 2 minutes per response. The burden estimate includes the time for revtewina instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20593- 30015, Paperwork Reduction Protect (1660- 0002) 'NOTE: Do not send your completed form to this address. FEMA Form 009 -0 -3, AUG 2010 REPLACES ALL PREVIOUS FEMA Form 90 -65B Duplication of Benefits The Federal Emergency Management Agency has adopted a policy that prohibits duplication of benefits in the Hazard Mitigation Assistance Program that includes Flood Mitigation Assistance grants. The policy was developed in response to federal regulations that dictate the use of the primary funds used to mitigate property. The Federal Emergency Agency (FEMA) provides the following specific instructions in the Hazard Mitigation Assistance Program Guidelines for mitigation projects. In the administration of Hazard Mitigation Grant Program (HMGP) grants, FEMA and the grantee should avoid any duplication of benefits with other forms of assistance. FEMA's policy on duplication of benefits for individuals and families is mandated by Section 312 of the Stafford Act and is set forth in 44 CFR 206.191. This Section of the FEMA regulations delineates a delivery sequence establishing the order in which the disaster relief agencies and organizations provide assistance to individuals and families. Programs listed later in the sequence are responsible for ensuring that they do not duplicate assistance which should be provided by a program listed earlier on the list (the program with primary responsibility). In the case of flood- damaged property programs (Section 1362, Section 404, etc.), they are not listed in the delivery sequence, and therefore are positioned after the eight listed programs. This means that all eight programs listed in the sequence at 44 CFR 206.191 (d) are "primary programs" in relation to mitigation grant programs. The Hazard Mitigation Grant Program is required to ensure that it does not duplicate assistance which should be provided by any of the eight primary assistance programs. Certification of Funds Used Receipt of or pending receipt of the following benefit amounts must be disclosed to the State of Florida 1. SBA Loans - A property owner who has an SBA loan on the property being acquired will either be required to rep y the loan to SBA, or roll it over to a new property at closing. Yes F7_ No 2. Flood Insurance for Structure Repairs - That portion of a flood insurance payment that a property owner has received or is eligible to receive intended to cover structural repairs to the property being acquired will be deducted from the purchase price of the property being acquired. If flood insurance funds have been reinvested into repairs to the property, this amount will not be deducted. Proof of reinvestment can be supplied through receipts for and/or labor, or through on -site verification. Amount reinvested is $ 1. 3. Increased Cost of Compliance -The NFIP increased Cost of Compliance (ICC) clai payment from a flood event may be used to contribute to the non-Federal cost-share requirements so long as the claim is made within the timelines allowed • the NFIP. ]CC payments can only be used for costs that are eligible for ICC benefits; for exampl ICC cannot pay for property acquisition, but can pay for structure demolition or relocation. In addon, Federal funds cannot be provided where ICC funds are availabl if the ICC payment exceeds the required non-Federal share, the Federal funding awar r t 1 1 will be reduced to the difference between the cost of the activity and the [CC payment, Have you received ICC payments? O'D If so, how much ICC funds have you received? 4 &_ Do you plan on receiving ICC payment? & 1 6__ If so, how much ]CC funds do you plan on receiving? 4. FEMA individual Family Grant and Emergency Minimal Repair Grant (EMR) - That portion of an I FG grant that a property owner has received or is eligible to receive intended to cover structural repairs to the property being acquired will be deducted from the purchase price of the property, Additionally, grants received from FEMA as part of Temporary Housing Assistance Program to quickly repair or restore owner-occupied primary residences to habitable and safe condition will be deducted from the purchase price of the property. If the funds have been reinvested into repairs to the property, this amount will noit be deducted. Proof of reinvestment can be supplied through rWeipts for materials and/or labor, or through on-site verification. Amount received: - Cl -- OwnerName: Property Address: 4 134• Avenue C Big Pine Key, FIL 33043 Notice of Voluntary Interest Monroe County, Florida Please complete this form if you are interested in being included in the Monroe County application to the FEK4A Hazard Mitigation Grant Program to mitigate your home. Signing this does not commit you to any action. Property Address: 31349 Avenue C, Big Pine Key, FL 33043 Qvvner/s\ Mailing Address: 32349 Avenue (, Big Pine Key, FL 33043 Owner(s) Name(s): Terry Baron and Sherry Baron Contact Telephone Number: 305-240-3824 qj ZO 2 FEK4A Individual Assistance Registration 4 THIS SECTION FOR STATE USE ONLY FEMA- -DR -FL ❑ Standard HMGP ❑ 5% Initiative Application ❑ Application Complete ❑ Initial Submission or ❑ Re- Submission Support Documents Eligible Applicant Project Type(s) ❑ Conforms wl State 409 Plan ❑ State or Local Government ❑ Wind ❑ In Declared Area ❑ Private Non - Profit (Tax ID Received) ❑ Flood ❑ Statewide ❑ Recognized Indian Tribe or Tribal Organization ❑ Other: Community NFIP Status: (Check all that apply) LMS Ranking: ❑ Participating Community ID #: County: ❑ In Good Standing ❑ Non - Participating ❑ CRS State Application ID: This application is for all Federal Emergency Management Agency (FEMA Region IV) Hazard Mitigation Grant Program (HMGP) proposals. Please complete ALL sections and provide the documents requested. If you require technical assistance, please contact the Florida Division of Emergency Management at DEM HazardMitigationGrantProgram @em.myflorida.com. Section I — Applicant A. Applicant Instruction: Complete all sections that correspond with the type of proposed project Application Sections 1 -IV: Environmental Review: Maintenance Agreement. Flood Control — Drainage Improvement Worksheet: Generator Worksheet: Tornado Safe Room Worksheet: Hurricane Safe Room Worksheet: Wind Retrofit Worksheet: Wildfire Worksheet: Drought Worksheet: Request for Public Assistance Form: Acquisition Forms: Application Completeness Guidance/ Checklist: All Applicants must complete these sections All Applicants must complete these sections Any Applications involving public property, public ownership, or management of property Acquisition, Elevation, Dry Flood proofing, Drainage Improvements, Flood Control Measures, Floodplain and Stream Restoration, and Flood Diversion — one worksheet per structure Permanent, portable generators, and permanent emergency standby pumps New Safe Room, Retrofit of existing structure, Community Safe Room, Residential Safe Room New Safe Room, Retrofit of existing structure Wind Retrofit projects only — one worksheet per structure Defensible Space, Hazardous Fuels Reduction, Ignition Resistant Construction, other Aquifers, other FEMA Form 90 -49 (Request for Public Assistance): All applicants must complete, if applicable. If project type is Acquisition, these forms must be completed. (Only one of the two Notice of Voluntary Interest forms is necessary.) Model Statement of Assurances for Property Acquisition Projects Declaration and Release Notice of Voluntary Interest (Town Hall Version) Notice of Voluntary Interest (Single Site Version) Statement of Voluntary Participation FEMA Model Deed Restriction Language All applicants are recommended to complete this checklist and utilize the guidance for completing the application. [Attach any additional items and note Section] B. Applicant Information: FEMA- 4337 -DR -FL DISASTER NAME: Hurricane Irma Title /Brief Descriptive Project Summary: Elevation and retrofit residential structure 1. Applicant (Organization): Monroe County BOCC 2. Applicant Type: ® State or Local Government ❑ Native American Tribe ❑ Private Non - Profit ❑ Special District 3. County: Monroe 4. State Legislative Senate District(s): 36; State Legislative House District(s): 120 ; Congressional House District(s): 26 House 5. Federal Tax I.D. Number: 59- 6000749 c 6. Data Universal Numbering System (DUNS): 073876757 M > 7. Federal Information Processing Standards (FIPS) Code *: 12087 ( *if your FIPS code is not known, see guidance) L 8. National Flood Insurance Program (NFIP) Community Identification Number: 125129 0 (this number can be obtained from the FIRM map for your area) 9. Point of Contact: (Person serving as the coordinator of project) ®Ms. ❑Mr. First Name: Michele Last Name: Lynn CL CL Title: Owner of Residence Address: 12A 12th Avenue City: Key West State: FL Zip Code: 33040 Telephone: 305 - 890 -6365 Email: pirateheadcove @gmail.com 0 10. Application Prepared by: CL CL ❑Ms. ®Mr. First Name: Mark Last Name: Boone CL T itle: Sr. Administrator, Floodplain Program LD Telephone: 305- 289 -2505 Email: boone- mark @monroecounty- FL.gov 11. Authorized Applicant Agent (proof of authorization authority required) ❑Ms. ®Mr. First Name: David Last Name: Rice Title: Monroe County BOCC Mayor Address: 9400 Overseas Highway Suite 210 City: Marathon State: FL Zip Code: 33050 c Telephone: 305 - 289 -6000 Email: boccdis4 @monroecounty - fl.gov CL CL Signature CL Date: 12. Local Mitigation Strategy (LMS) Compliance a. All proposed projects must be included in the county's Local Mitigation Strategy (LMS) Project List, and on file with FDEM's Mitigation Bureau Planning Unit. Does your jurisdiction have a current FEMA Approved Mitigation Plan and this project is listed? ® Yes ❑ No b. Attached is a letter of endorsement for this project from the county's LMS Coordinator. ® Yes ❑ No Ensure the LMS endorsement letter contains both the Total Estimated Projects Cost (Section IV. D.), along with the Estimated Federal Share (Section IV. E.1.) allocated to this project. c. The LMS project list and endorsement letter both have an estimated cost column and Federal Share amount that is within $500.00 between the two ® Yes ❑ No 13. Has this project been submitted under a previous disaster event? ® No ❑ Yes, please provide the disaster number and project number (as applicable) 2 [Attach any additional items and note Section] Section II - Project Description A. Hazards to be Mitigated / Level of Protection 1. Select the type of hazards the proposed project will mitigate: ® Flood ® Wind ® Storm surge ❑ Wildfire ❑ Other (list): 2. Identify the type of proposed project: ® Elevation and retrofitting of residential or non - residential structure ❑ Acquisition and Relocation ❑ Acquisition and Demolition ❑ Wind retrofit ❑ Drainage project that reduces localized flooding ❑ Generator ❑ Other (please explain) 3. List the total number of persons that will be protected by the proposed project (include immediate population affected by the project only): 2 4. List how many acres of "Total Impacted Area" is to be protected by the proposed project (include immediate area affected by the project only): .25 acre 5. 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 storm event (1 % chance) 1 structure(s) protected against the 100 -year storm event (10, 25, 50, 100, or 500 year storm event) 1 structure(s) protected against 180 mile per hour (mph) winds 6. Check all item(s) the project may impact: ❑ Wetlands ❑ Water Quality ❑ Previously Undisturbed Soil ® Floodplain ® Coastal Zone ❑ Toxic or Hazardous Substances ❑ Historic Resources ❑ Fisheries ❑ Threatened & Endangered Species ❑ Vegetation Removal ❑ Public Controversy ❑ Potential for Cumulative Impacts ® Health & Safety ❑ Other 7. Engineered projects: If your project has been already designed and engineering information is available, please attach to your application ALL calculations, H &H study and design plans (e.g. Drainage Improvement, Erosion Control, or other special project types). ® No ❑ Yes If so, see Attachment #(s) 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. 1. Describe the existing problems: Residential strucutres throughout Monroe County were built prior to adoption of Floodplain regulations. These structures are nearly always located well below base flood elevation, posing considerable danger to occupants, property, and onsite services, including first responders. 2. Describe the type(s) of protection that the proposed project will provide: Proposed protect will elevate home, property and occupants above base flood elevation and protect home from wind damage up to 180mph. 3. Scope of Work (describe in detail what you are planning to do): Elevate and retrofit existing structures to above base flood elevation utilizing engineered plans and approved contractors. Each structure will be surveyed for capacity, including structural integrity, engineered foundations, access ability, neighborhood and local ordinances, and compliance to FL Building Code. Structures will be raised to minimum of 1' freeboard for structures within AE zone and Tabove BFE for VE zone structures. [Attach any additional items and note Section] 4. Describe any other on -going or proposed projects in the area that may impact, positively or negatively, the proposed HMGP Project: Projects considered have been evaluated to comply with planning -goals for each community. Elevation technique was chosen over the idea of repair, demolition or other retrofit. 5. Describe the purpose and need for the proposed project: Many structures in Monroe County were built prior to floodplain regulations. Occupants could be harmed in future storm events. Funding for this protect is intended to retrofit existing non - compliant structures in preparation for future storms. Each structure chosen for this project has been identified as eligible to participate in this project, including engineering specifications, local ordinance, and future compliance with floodplain regulations. Owners from each structure have agreed to deed restrictions requiring NFIP flood insurance for the life of the deed. [Attach any additional items and note Section] Section III — PrOlect Location (Fully describe the location of the proposed project.) A. Site 1. Describe the physical location of this project, including street numbers (or neighborhoods) and project site zip code(s). Provide precise longitude and latitude coordinates for the site utilizing a hand -held global positioning system (GPS) unit or the equivalent: Location: Monroe County, Florida Address(s): 12A 12t' Avenue, Key West, Florida GPS coordinates (decimal degree format): 24.564854,- 81.743471 Project Zip Code(s): 33040 2. Title Holder: Jeffrey S Lynn and Michele Touchette -Lynn 3. Is the project site seaward of the Coastal Construction Control Line (CCCL)? ❑ Yes ® No 4. Provide the number of each structure type (listed below) in the project area that will be affected by the project. Include all structures in project area. ® Residential property: ❑ Public buildings: ❑ Businesses /commercial property: ❑ Schools /hospitals /houses of worship: ❑ Other: B. Flood Insurance Rate Map (FIRM) Showing Project Site 1. ® Attach one (1) copy of the FIRM map, a copy of the panel information from the FIRM, and, if available, the Floodway Map. FIRM maps are required for this application (if published 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 https: / /msc.fema.gov /portal 2. 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) ❑ 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) ❑ Floodwa ❑ ❑ Coastal Barrier Resource Act (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). 3. ❑ If the FIRM Map for your area is not published, 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. 4. ® Attach a copy of a Special Flood Hazard Area Flood Insurance Assurance(s). C. City or County Map with Project Site and Photographs 1. ❑ 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. 2. ❑ Attach a USGS 1:24,000 TOPO map with project site clearly marked on the map. 3. ❑ For acquisition or elevation projects, include copy of Parcel Map (Tax Map, Property Identification Map, etc.) showing each property to be acquired or elevated. Include the Tax ID numbers for each parcel, and Parcel information — including year built and foundation. 4. ❑ Attach photographs (at a minimum 4 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 that affect the project site or will be affected by the project, and labeled. For each structure, please include the following angles: front, back and both sides. [Attach any additional items and note Section] Section IV - 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. Contingency Cost should be included as a line item in the budget section and justified. Recommended range is 1 to 5 %. Avoid the use of lump sum costs. A. Materials Description Hours Rate Cost General contractor estimates $65 /sf to elevate includes foundation 1 $72,800.00 $72,800.00 Pre-mitigation survey 5 $100.00 $500.00 Asbestos Inspection 8 $150.00 $1,200.00 Title Search 1 $450.00 $450.00 Bid preparation 8 $100.00 $800.00 Termite Inspection 5 $100.00 $500.00 Post-mitigation survey 5 $300.00 $1,500.00 Tern relocation 1 $15,000.00 $15,000.00 Sub -Total $92,750.00 C. Fees Paid Include any other costs associated with the project. Description of Task Hours Rate Cost Feasibility analysis 1 $3,000.00 $3,000.00 Engineering 1 $7,000.00 $7,000.00 Building Inspection 1 $2,000.00 $2,000.00 5% Project Management Fee 1 $99,750.00 $4,988.00 Sub -Total $16,988.00 FBI Total Estimated Project Cost $119,738.00 Note: To be eligible for HMGP funding, pre -award costs must be identified as separate line items in the cost estimate of the application. This must be done in addition to filling out the HMGP Pre -Award Cost Request Form, submitted with application. Mark each Pre -Award cost with an asterisk ( *); and In -kind services with double asterisk ( * *); All In -kind match must be identified in the Section IV.B and D — Funding Sources). [Attach any additional items and note Section] Labor Include equipment costs. Please indicate all "soft' or in -kind matches ( * *). E. Funding Sources (round figures to the nearest dollar) The maximum FEMA share for HMGP projects is 75 %. The other 25% can be made up of State and Local funds as well as in -kind services. HMGP funds may be packaged with other Federal funds, but other Federal funds (except for Federal funds that lose their Federal identity at the State level, such as CDBG, and certain tribal funds) may not be used for the Non - Federal share of the costs. 1. Estimated Federal Share 2. Non - Federal Share 3. Estimated Local Share 4. 5. 6. Other Agency Share (Identify Non - Federal Agency and availability date) $89,803.00 $29,935.00 7. Total Funding sources from above $119,738.00 75 % Of Total (Maximum 75 %) % of Total (Cash) % of Total (In- Kind * *) % Of Total (Global Match * * *) 25 % of Total 100.00% Total (Equals 100 %) **E1 Identify proposed eligible activities directly related to project to be considered for In -Kind services in Section IV.B. Labor * ** ❑Separate project applications must be submitted for each Global Match project. Global Match Project Number and Title: F. Project Milestones /Schedule of Work List the major milestones in this project by providing an estimate time -line for the critical activities not to exceed a period of 3 years of performance. (e.g. Designing, Engineering, Permitting, etc.) Milestone(s) Number of Days to Complete Pre-mitigation survey, feasibility, title search, inspections, Permitting 90 Engineering 60 Relocation 90 Construction 120 Inspections, CO 30 Total 390 Days 7 [Attach any additional items and note Section] Section V. Environmental Review and Historic Preservation Compliance (NOTE. This application cannot be processed if this section is not completed.) Because the HMGP is a federally funded program, 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 (NEPA) and associated Federal, State, Tribal, and Local statutes to obtain funding. NO WORK can be done prior to the NEPA review process. If work is done on your proposed project before the NEPA review is completed, it will NOT be eligible for Federal funding. A. 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 NEPA technical assistance for Applicants, with their consent, to complete the NEPA review. The type and quantity of NEPA 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 NEPA compliance process. 1. ® Detailed project description, scope of work, and budget/costs (Section II and Section IV of this application). 2. ® Project area maps (Section III, part B & C of this application) 3. ❑ Project area /structure photographs (Section III, part C of this application). 4. ❑ Preliminary project plans. 5. ❑ Project alternatives description and impacts (Section V of the application). 6. ❑ Please complete the applicable project worksheets. Documentation showing dates of construction are required for all structures. 7. ❑ Environmental Justice —Attach documents regarding evaluation (required) and satisfactory resolution (if necessary) of Environmental Justice issues (Highly Disproportionate, Adverse Impact (effects) on Minority or Low Income Population). Documents can include public meeting records, media reports letters from interested persons and groups, studies on population, ethnic groups, quality of life, housing, economics, transportation, public services, schools, public health, recreation, voting, etc. 8. ❑ Provide any applicable information or documentation referenced on the Information and Documentation Requirements by Project Type below. B. Executive Order 12898; Environmental Justice for Low Income and Minority Population: 1. Are there low income or minority populations in the project area or adjacent to the project area? ® No ❑ Yes; please describe any disproportionate and adverse effects to these populations: 2. To help evaluate the impact of the project, please indicate below any other information you are providing. ❑ Description of the population affected and the portion of the population that would be disproportionately and adversely affected. Please include specific efforts to address the adverse impacts in your proposal narrative and budget. N/A 3. ® Attached materials or additional comments: Please include pdf documentation from the US Census Quick Facts and American Factfinder's website of the project area ( http: / /www.census.gov /) . N/A M A 8 [Attach any additional items and note Section] C. Tribal Consultation (Information Required) Section 106 of the National Historic Preservation Act (NHPA) requires federal agencies to take into account the effect of their undertakings on historic properties. The NHPA requires that agencies must complete this process prior to the expenditure of any Federal funds on the undertaking. A Tribal Consultation is required for any project disturbing ground or moving soil, including but not limited to: drainage projects; demolition; construction; elevation; communication towers; tree removal, utility improvements. 1. Describe the current and future use of the project location. A land use map may be provided in lieu of a written description. Project area is and will remain residential use. 2. Provide information on any known site work or historic uses for project location. No known uses. ❑ Attach a copy of a city or county scale map (large enough to show the entire project area) with the horizontal limits (feet) and vertical depths (square feet) of all anticipated ground disturbance of 3 inches or more. D. Alternative Actions (Information Required) The NEPA 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. Structures not mitigated will continue to endure flooding and damage from flooding, risk to human life will continue (including residents, visitors and first responders), flood damage claims will persist. 2. Other Feasible Alternative Describe a feasible alternative project that would be the next best solution if the primary alternative is not accomplished. This could be an entirely different mitigation method or a significant modification to the design of the current proposed project. Please include a Scope of Work, engineering details (if applicable), estimated budget and the impacts of this alternative. Complete all of parts a -e (below). a. Project Description for the Alternative Describe, in detail, the alternative project, and explain how the alternative project will solve the problem(s) and /or provide protection from the hazard(s). Also, provide pros and cons for this alternative and a reason for why it was not selected. Buyout/Acquisition/Demolition Includes fair market value purchase of property and demolition resulting in open space. Pro: permanent solution. Con: fair market value represents $500,000. b. Project Location of the Alternative (describe briefly, if different from proposed project) Same ❑ Attach a map or diagram showing the alternative site in relation to the proposed project site (if different from proposed project) c. Scope of Work for Alternative Project Buyout/Acquisition /Demolition of existing structure and return exposed land to open space. d. Impacts of Alternative Project 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 Surface Water Impacts), Flood plain /Floodway, Historic Preservation and Hazardous Materials. Impacts environmentally are positive, while economically hurt the surrounding community with loss of tax base and potential loss of contributing citizens. [Attach any additional items and note Section] e. Estimated Budget/Costs for Alternative Project In this section, provide details of all the estimated costs of the alternative project (round figures to the nearest dollar). A lump sum budget is acceptable. Materials: $500,000.00 Labor: Fees: $30,000.00 Total Estimated Project Cost: $530,000.00 10 [Attach any additional items and note Section] HMGP ENVIRONMENTAL REVIEW Information and Documentation Requirements by Project Type Retrofits to Existing Facilities /Structures Elevations Acquisitions with Demolition ✓ Dates of Construction ✓ Ground disturbance map for projects with 3 inches or more of ground disturbance ✓ Structure photographs 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 ✓ Ground disturbance map for projects with 3 inches or more of ground disturbance. ✓ 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 a 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. ✓ Concurrence from your Local Floodplain Manager — if project is located in a floodplain. Note: This is a general guideline for most projects. However, there will be exceptions. Consult with state environmental staff on project types not listed. 11 Section VI — Maintenance Agreement All applicants whose proposed project involves the retrofit or modification of existing public property or whose proposed project would result in the public ownership or management of property, structures, or facilities, must first sign the following agreement prior to submitting the application to FEMA. (NOTE. Those applicants whose project only involves the 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 of , State of Florida, hereby agrees that if it receives any Federal aid as a result of the attached project application, it will accept responsibility, 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 maintenance shall include, but not be limited to, such responsibilities as keeping vacant land clear of debris, garbage, and vermin; keeping stream channels, culverts, and storm drains clear of obstructions and debris; and keeping detention ponds free of debris, trees, and woody growth. The purpose of this agreement is to make clear the Sub - recipient's maintenance responsibilities following project award and to show the Sub - recipients acceptance of these responsibilities. It does not replace, supersede, or add to any other maintenance responsibilities imposed by Federal law or regulation and which are in force on the date of project award. Signed by (title) (printed or typed name of signing official) e duly authorized representative This (day) of Signature *, *Please Note: The above signature must be by an individual with legal signing authority for the respective local government or county (e.g., the Chairperson, Board of County Commissioners or the County Manager, etc.) (month), (year). 12 THIS SECTION FOR STATE USE ONLY FEMA- -DR -FL ❑ Standard HMGP ❑ 5% Initiative Application ❑ Application Complete ❑ Initial Submission or ❑ Re- Submission Support Documents Eligible Applicant Project Type(s) ❑ Conforms wl State 409 Plan ❑ State or Local Government ❑ Wind ❑ In Declared Area ❑ Private Non - Profit (Tax ID Received) ❑ Flood ❑ Statewide ❑ Recognized Indian Tribe or Tribal Organization ❑ Other: Community NFIP Status: (Check all that apply) LMS Ranking: ❑ Participating Community ID #: County: ❑ In Good Standing ❑ Non - Participating ❑ CRS State Application ID: This application is for all Federal Emergency Management Agency (FEMA Region IV) Hazard Mitigation Grant Program (HMGP) proposals. Please complete ALL sections and provide the documents requested. If you require technical assistance, please contact the Florida Division of Emergency Management at DEM HazardMitigationGrantProgram @em.myflorida.com. Section I — Applicant A. Applicant Instruction: Complete all sections that correspond with the type of proposed project Application Sections 1 -IV: Environmental Review: Maintenance Agreement. Flood Control — Drainage Improvement Worksheet: Generator Worksheet: Tornado Safe Room Worksheet: Hurricane Safe Room Worksheet: Wind Retrofit Worksheet: Wildfire Worksheet: Drought Worksheet: Request for Public Assistance Form: Acquisition Forms: Application Completeness Guidance/ Checklist: All Applicants must complete these sections All Applicants must complete these sections Any Applications involving public property, public ownership, or management of property Acquisition, Elevation, Dry Flood proofing, Drainage Improvements, Flood Control Measures, Floodplain and Stream Restoration, and Flood Diversion — one worksheet per structure Permanent, portable generators, and permanent emergency standby pumps New Safe Room, Retrofit of existing structure, Community Safe Room, Residential Safe Room New Safe Room, Retrofit of existing structure Wind Retrofit projects only — one worksheet per structure Defensible Space, Hazardous Fuels Reduction, Ignition Resistant Construction, other Aquifers, other FEMA Form 90 -49 (Request for Public Assistance): All applicants must complete, if applicable. If project type is Acquisition, these forms must be completed. (Only one of the two Notice of Voluntary Interest forms is necessary.) Model Statement of Assurances for Property Acquisition Projects Declaration and Release Notice of Voluntary Interest (Town Hall Version) Notice of Voluntary Interest (Single Site Version) Statement of Voluntary Participation FEMA Model Deed Restriction Language All applicants are recommended to complete this checklist and utilize the guidance for completing the application. [Attach any additional items and note Section] B. Applicant Information: FEMA- 4337 -DR -FL DISASTER NAME: Hurricane Irma Title /Brief Descriptive Project Summary: Elevation and retrofit residential structure 1. Applicant (Organization): Monroe County BOCC 2. Applicant Type: ® State or Local Government ❑ Native American Tribe ❑ Private Non - Profit ❑ Special District 3. County: Monroe 4. State Legislative Senate District(s): 36; State Legislative House District(s): 120 ; Congressional House District(s): 26 House 0 5. Federal Tax I.D. Number: 59- 6000749 6. Data Universal Numbering System (DUNS): 073876757 7. Federal Information Processing Standards (FIPS) Code *: 12087 ( * if your FIPS code is not known, see guidance) 0 8. National Flood Insurance Program (NFIP) Community Identification Number: 125129 (this number can be obtained from the FIRM map for your area) u 9. Point of Contact: (Person serving as the coordinator of project) _ CL CL ®Ms. ❑Mr. First Name: Terry Last Name: Baron Title: Owner of Residence Address: 31349 Avenue C D City: Big Pine Key State: FL Zip Code: 33043 Telephone: 305 - 240 -3824 Email: terrybaron3 @gmail.com CL CL 10. Application Prepared by: CL ❑Ms. ®Mr. First Name: Mark Last Name: Boone LD Title: Sr. Administrator, Floodplain Program Telephone: 305- 289 -2505 Email: boone- mark @monroecounty- FL.gov 11. Authorized Applicant Agent (proof of authorization authority required) ❑Ms. ®Mr. First Name: David Last Name: Rice Title: Monroe County BOCC Mayor Address: 9400 Overseas Highway Suite 210 City: Marathon State: FL Zip Code: 33050 0 Telephone: 305 - 289 -6000 Email: boccdis4 @monroecounty - fl.gov u CL Signature CL CL Date: 12. Local Mitigation Strategy (LMS) Compliance a. All ' ro osed projects must be included in the county's Local Mitigation Strategy LMS Project p p J Y g gY( ) List, and on file J with FDEM's Mitigation Bureau Planning Unit. Does your jurisdiction have a current FEMA Approved Mitigation Plan and this project is listed? ® Yes ❑ No b. Attached is a letter of endorsement for this project from the county's LMS Coordinator. ® Yes ❑ No Ensure the LMS endorsement letter contains both the Total Estimated Projects Cost (Section IV. D.), along with the Estimated Federal Share (Section IV. E.1.) allocated to this project. c. The LMS project list and endorsement letter both have an estimated cost column and Federal Share amount that is within $500.00 between the two ® Yes ❑ No 13. Has this project been submitted under a previous disaster event? ® No ❑ Yes, please provide the disaster number and project number (as applicable): 2 [Attach any additional items and note Section] Section II - Project Description A. Hazards to be Mitigated / Level of Protection 1. Select the type of hazards the proposed project will mitigate: ® Flood ® Wind ® Storm surge ❑ Wildfire ❑ Other (list): 2. Identify the type of proposed project: ® Elevation and retrofitting of residential or non - residential structure ❑ Acquisition and Relocation ❑ Acquisition and Demolition ❑ Wind retrofit ❑ Drainage project that reduces localized flooding ❑ Generator ❑ Other (please explain) 3. List the total number of persons that will be protected by the proposed project (include immediate population affected by the project only): 2 4. List how many acres of "Total Impacted Area" is to be protected by the proposed project (include immediate area affected by the project only): .25 acre 5. 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 storm event (1 % chance) 1 structure(s) protected against the 100 -year storm event (10, 25, 50, 100, or 500 year storm event) 1 structure(s) protected against 180 mile per hour (mph) winds 6. Check all item(s) the project may impact: ❑ Wetlands ❑ Water Quality ❑ Previously Undisturbed Soil ® Floodplain ❑ Coastal Zone ❑ Toxic or Hazardous Substances ❑ Historic Resources ❑ Fisheries ® Threatened & Endangered Species ❑ Vegetation Removal ❑ Public Controversy ❑ Potential for Cumulative Impacts ❑ Health & Safety ❑ Other 7. Engineered projects: If your project has been already designed and engineering information is available, please attach to your application ALL calculations, H &H study and design plans (e.g. Drainage Improvement, Erosion Control, or other special project types). ® No ❑ Yes If so, see Attachment #(s) 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. 1. Describe the existing problems: Residential strucutres throughout Monroe County were built prior to adoption of Floodplain regulations. These structures are nearly always located well below base flood elevation, posing considerable danger to occupants, property, and onsite services, including first responders. Hurricane Irma substantially damaged and destroyed the structure on this parcel. Elevation- Reconstruction is the best possible mitigation solution. 2. Describe the type(s) of protection that the proposed project will provide: Proposed protect will consist of construction of an improved, elevated building on the same site where existing building has been partially or completely demolished or destroyed. Protect will elevate home, property and occupants above base flood elevation and protect home from wind damage up to 180mph. 3. Scope of Work (describe in detail what you are planning to do): Elevate new code compliant construction above base flood elevation utilizing engineered plans and approved contractors. Pre - construction ♦ Site preparation ♦ Foundation construction ♦ Structural shell construction ♦ Interior finishes ♦ Construction completion [Attach any additional items and note Section] 4. Describe any other on -going or proposed projects in the area that may impact, positively or negatively, the proposed HMGP Project: Projects considered have been evaluated to comply with planning -goals for each community. Elevation technique was chosen over the idea of repair, demolition or other retrofit. 5. Describe the purpose and need for the proposed project: Many structures in Monroe County were built prior to floodplain regulations. Occupants could be harmed in future storm events. Fundina for this proiect is intended to replace and elevate non - compliant structures in preparation for future storms. A structure chosen for this proiect has been identified as eligible to participate in this proiect, including engineering specifications, local ordinance, and future compliance with floodplain regulations. Owners have agreed to deed restrictions requiring NFIP flood insurance for the life of the deed. UJI L C u CL CL C 2 L a) CL CL CL L [Attach any additional items and note Section] Section III — PrOlect Location (Fully describe the location of the proposed project.) A. Site 1. Describe the physical location of this project, including street numbers (or neighborhoods) and project site zip code(s). Provide precise longitude and latitude coordinates for the site utilizing a hand -held global positioning system (GPS) unit or the equivalent: Location: Monroe County, Florida Address(s): 31349 Avenue C, Big Pine Key, Florida GPS coordinates (decimal degree format): 24.671072, - 81.34311059999999 Project Zip Code(s): 33043 2. Title Holder: Terry and Sharon Baron 3. Is the project site seaward of the Coastal Construction Control Line (CCCL)? ❑ Yes ® No 4. Provide the number of each structure type (listed below) in the project area that will be affected by the project. Include all structures in project area. ® Residential property: ❑ Public buildings: ❑ Businesses /commercial property: ❑ Schools /hospitals /houses of worship: ❑ Other: B. Flood Insurance Rate Map (FIRM) Showing Project Site 1. ® Attach one (1) copy of the FIRM map, a copy of the panel information from the FIRM, and, if available, the Floodway Map. FIRM maps are required for this application (if published 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 https: / /msc.fema.gov /portal 2. 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) ❑ 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) ❑ Floodwa ❑ ❑ Coastal Barrier Resource Act (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). 3. ❑ If the FIRM Map for your area is not published, 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. 4. ❑ Attach a copy of a Special Flood Hazard Area Flood Insurance Assurance(s). C. City or County Map with Project Site and Photographs 1. ❑ 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. 2. ❑ Attach a USGS 1:24,000 TOPO map with project site clearly marked on the map. 3. ❑ For acquisition or elevation projects, include copy of Parcel Map (Tax Map, Property Identification Map, etc.) showing each property to be acquired or elevated. Include the Tax ID numbers for each parcel, and Parcel information — including year built and foundation. 4. ❑ Attach photographs (at a minimum 4 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 that affect the project site or will be affected by the project, and labeled. For each structure, please include the following angles: front, back and both sides. [Attach any additional items and note Section] Section IV - 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. Contingency Cost should be included as a line item in the budget section and justified. Recommended range is 1 to 5 %. Avoid the use of lump sum costs. A. Materials Item Unit Quantit Cost per Unit Cost Constructed and delivered code - compliant residential modular 1 1 $115,000.00 $115,000.00 Structure. Sub -Total 1 $115,000.00 B. Labor Include equipment costs. Please indicate all "soft" or in -kind matches(**) Descrintion Hours Rate Cost General contractor labor for en ineerin ,installation and make-ready 1 $25,000.00 $25,000.00 Pre-mitigation survey 5 $100.00 $500.00 Asbestos Inspection 8 $150.00 $1,200.00 Title Search 1 $450.00 $450.00 Bid preparaion 8 $100.00 $800.00 Termite Inspection 5 $100.00 $500.00 Post-mitigation survey 5 $300.00 $1,500.00 Demolition /Removal of non-compliant structure 1 $15,000.00 $15,000.00 Sub -Total $44,950.00 C. Fees Paid Include any other costs associated with the project. IC Note: To be eligible for HMGP funding, pre -award costs must be identified as separate line items in the cost estimate of the application. This must be done in addition to filling out the HMGP Pre -Award Cost Request Form, submitted with application. Mark each Pre -Award cost with an asterisk ( *); and In -kind services with double asterisk ( * *); All In -kind match must be identified in the Section IV.B and D — Funding Sources). 6 [Attach any additional items and note Section] Total Estimated Project Cost $170,298.00 E. Funding Sources (round figures to the nearest dollar) The maximum FEMA share for HMGP projects is 75 %. The other 25% can be made up of State and Local funds as well as in -kind services. HMGP funds may be packaged with other Federal funds, but other Federal funds (except for Federal funds that lose their Federal identity at the State level, such as CDBG, and certain tribal funds) may not be used for the Non - Federal share of the costs. 1. Estimated Federal Share $127,723.00 75 % of Total (Maximum 75% 2. Non - Federal Share 3. Estimated Local Share $42,575.00 25 % of Total (Cash) c 4. % of Total (In- Kind * *) M 5. % of Total (Global Match * * *) LU L 6. Other Agency Share % of Total (Identify Non - Federal Agency and availability date) u CL CL 7. Total Funding sources from above $170,298.00 100.00% Total (Equals 100 %) L ** ❑Identify proposed eligible activities directly related to project to be considered for In -Kind services in Section IV.B. Labor. * ** ❑Separate project applications must be submitted for each Global Match project. L CL Global Match Project Number and Title: CL CL F. Project Milestones /Schedule of Work List the major milestones in this project by providing an estimate time -line for the critical activities not to exceed a period of 3 years of performance. (e.g. Designing, Engineering, Permitting, etc.) Milestone(s) Number of Days to Complete Pre-mitigation survey, engineering, title search, inspections, Permitting 90 Demolition 60 Delivery, Setup, Tiedown, Make-ready 60 Inspection, CO 30 Total 240 Days c LIT c u CL CL CL tM c U 7 [Attach any additional items and note Section] Section V. Environmental Review and Historic Preservation Compliance (NOTE. This application cannot be processed if this section is not completed.) Because the HMGP is a federally funded program, 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 (NEPA) and associated Federal, State, Tribal, and Local statutes to obtain funding. NO WORK can be done prior to the NEPA review process. If work is done on your proposed project before the NEPA review is completed, it will NOT be eligible for Federal funding. A. 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 NEPA technical assistance for Applicants, with their consent, to complete the NEPA review. The type and quantity of NEPA 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 NEPA compliance process. 1. ® Detailed project description, scope of work, and budget/costs (Section II and Section IV of this application). 2. ® Project area maps (Section III, part B & C of this application) 3. ® Project area /structure photographs (Section III, part C of this application). 4. ❑ Preliminary project plans. 5. ® Project alternatives description and impacts (Section V of the application). 6. ® Please complete the applicable project worksheets. Documentation showing dates of construction are required for all structures. 7. ❑ Environmental Justice —Attach documents regarding evaluation (required) and satisfactory resolution (if necessary) of Environmental Justice issues (Highly Disproportionate, Adverse Impact (effects) on Minority or Low Income Population). Documents can include public meeting records, media reports letters from interested persons and groups, studies on population, ethnic groups, quality of life, housing, economics, transportation, public services, schools, public health, recreation, voting, etc. 8. ❑ Provide any applicable information or documentation referenced on the Information and Documentation Requirements by Project Type below. B. Executive Order 12898; Environmental Justice for Low Income and Minority Population: 1. Are there low income or minority populations in the project area or adjacent to the project area? ❑ No ® Yes; please describe any disproportionate and adverse effects to these populations: No adverse affects. 2. To help evaluate the impact of the project, please indicate below any other information you are providing. ❑ Description of the population affected and the portion of the population that would be disproportionately and adversely affected. Please include specific efforts to address the adverse impacts in your proposal narrative and budget. N/A 3. ® Attached materials or additional comments: Please include pdf documentation from the US Census Quick Facts and American Factfinder's website of the project area ( http: / /www.census.gov /) . N/A M 11 8 [Attach any additional items and note Section] C. Tribal Consultation (Information Required) Section 106 of the National Historic Preservation Act (NHPA) requires federal agencies to take into account the effect of their undertakings on historic properties. The NHPA requires that agencies must complete this process prior to the expenditure of any Federal funds on the undertaking. A Tribal Consultation is required for any project disturbing ground or moving soil, including but not limited to: drainage projects; demolition; construction; elevation; communication towers; tree removal, utility improvements. 1. Describe the current and future use of the project location. A land use map may be provided in lieu of a written description. Project area is and will remain residential use. 2. Provide information on any known site work or historic uses for project location. No known uses. ❑ Attach a copy of a city or county scale map (large enough to show the entire project area) with the horizontal limits (feet) and vertical depths (square feet) of all anticipated ground disturbance of 3 inches or more. D. Alternative Actions (Information Required) The NEPA 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. Structures not mitigated will continue to endure flooding and damage from flooding, risk to human life will continue (including residents, visitors and first responders), flood damage claims will persist. 2. Other Feasible Alternative Describe a feasible alternative project that would be the next best solution if the primary alternative is not accomplished. This could be an entirely different mitigation method or a significant modification to the design of the current proposed project. Please include a Scope of Work, engineering details (if applicable), estimated budget and the impacts of this alternative. Complete all of parts a -e (below). a. Project Description for the Alternative Describe, in detail, the alternative project, and explain how the alternative project will solve the problem(s) and /or provide protection from the hazard(s). Also, provide pros and cons for this alternative and a reason for why it was not selected. Repair and bring structure into compliance with FL codes. Pros: could allow occupant faster return to structure and could allow resident access to structure during construction activities. Con: economically not feasible and nearly impossible to retrofit an older model mobile home. b. Project Location of the Alternative (describe briefly, if different from proposed project) Same ❑ Attach a map or diagram showing the alternative site in relation to the proposed project site (if different from proposed project) c. Scope of Work for Alternative Project Repair existing mobile home and bring into compliance, including wind codes and elevations. d. Impacts of Alternative Project 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 Surface Water Impacts), Flood plain /Floodway, Historic Preservation and Hazardous Materials. No adverse impacts known. [Attach any additional items and note Section] e. Estimated Budget/Costs for Alternative Project In this section, provide details of all the estimated costs of the alternative project (round figures to the nearest dollar). A lump sum budget is acceptable. Materials: $150,000.00 Labor: $75,000.00 Fees: $25,000.00 Total Estimated Project Cost: $250,000.00 10 [Attach any additional items and note Section] HMGP ENVIRONMENTAL REVIEW Information and Documentation Requirements by Project Type Retrofits to Existing Facilities /Structures Elevations Acquisitions with Demolition ✓ Dates of Construction ✓ Ground disturbance map for projects with 3 inches or more of ground disturbance ✓ Structure photographs 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 ✓ Ground disturbance map for projects with 3 inches or more of ground disturbance. ✓ 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 a 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. ✓ Concurrence from your Local Floodplain Manager — if project is located in a floodplain. Note: This is a general guideline for most projects. However, there will be exceptions. Consult with state environmental staff on project types not listed. 11 Section VI — Maintenance Agreement All applicants whose proposed project involves the retrofit or modification of existing public property or whose proposed project would result in the public ownership or management of property, structures, or facilities, must first sign the following agreement prior to submitting the application to FEMA. (NOTE. Those applicants whose project only involves the 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 of , State of Florida, hereby agrees that if it receives any Federal aid as a result of the attached project application, it will accept responsibility, 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 maintenance shall include, but not be limited to, such responsibilities as keeping vacant land clear of debris, garbage, and vermin; keeping stream channels, culverts, and storm drains clear of obstructions and debris; and keeping detention ponds free of debris, trees, and woody growth. The purpose of this agreement is to make clear the Sub - recipient's maintenance responsibilities following project award and to show the Sub - recipients acceptance of these responsibilities. It does not replace, supersede, or add to any other maintenance responsibilities imposed by Federal law or regulation and which are in force on the date of project award. Signed by (title) (printed or typed name of signing official) e duly authorized representative This (day) of Signature *, *Please Note: The above signature must be by an individual with legal signing authority for the respective local government or county (e.g., the Chairperson, Board of County Commissioners or the County Manager, etc.) (month), (year). 12 � y � w� s :z� v -. .. . , >� >� �. . °- �® «� � d ??? . �� : m� \�� «\:� � a >� »�. © . . Acknowledgement of Conditions For Mitigation of Property in a Special Flood Hazard Area With FEMA Grant Funds Property Owner Jeff and Michele Lynn Street Address 12A 12th Avenue City Key West Subject Property Address Deed Dated 9/3/2009 Tax Map Base Flood Elevation at tf• Map Panel Number 12087C1528k State FL Zip Code 33040 12A 12th Avenue Recorded Bk 2430 Pg 351 Block BK LTA Parcel 00132331- 001200 ie site is 9 feet (NGVD) Effective Date 2/18/2005 As a recipient of Federally- funded hazard mitigation assistance under the Hazard Mitigation Grant Program, as authorized by 42 U.S.C. §5170c / Pre - Disaster Mitigation Program, as authorized by 42 U.S.C. §5133 / Flood Mitigation Assistance Program, as authorized by 42 U.S.C. §4104c the Property Owner accepts the following conditions: That the Property Owner has insured all structures that will not be demolished or relocated out of the SFHA for the above - mentioned property to an amount at least equal to the project cost or to the maximum limit of coverage made available with respect to the particular property, whichever is less, through the National Flood Insurance Program (NFIP), as authorized by 42 U.S.C. §4001 et seq., as long as the Property Owner holds title to the property as required by 42 U.S.C. §4012a. 2. That the Property Owner will maintain all structures on the above- mentioned property in accordance with the flood plain management criteria set forth in Title 44 of the Code of Federal Regulations (CFR) Part 60.3, the Florida Building Code and any local ordinance standards as long as the Property Owner holds title to the property. These criteria include, but are not limited to, the following measures: i. Enclosed areas below the Base Flood Elevation will only be used for parking of vehicles, limited storage, or access to the building; ii. All interior walls and floors below the Base Flood Elevation will be unfinished or constructed of flood resistant materials; iii. No mechanical, electrical, or plumbing devices will be installed below the Base Flood Elevation; and iv. All enclosed areas below Base Flood Elevation must be equipped with vents permitting the automatic entry and exit of flood water. For a complete, detailed list of these criteria, see the Florida Building Code and any local ordinance standards. 3. The above conditions are binding for the life of the grope . To provide notice to subsequent purchasers of these conditions, the Property Owner agrees to legally record with the county or appropriate jurisdiction's land records a notice that includes the name of the current property owner (including book/page reference to record of current title, if readily available), a legal description of the property, and the following notice of flood insurance requirements: "This property has received Federal hazard mitigation assistance. Federal law requires that flood insurance coverage on this property must be maintained during the life of the property regardless of transfer of ownership of such property. Pursuant to 42 U.S.C. §5154a, failure to maintain flood insurance on this property may prohibit the owner from receiving Federal disaster assistance with respect to this property in the event of a flood disaster. The Property Owner is also required to maintain this property in accordance with the flood plain management criteria of Title 44 of the Code of Federal Regulations Part 60.3, The Florida Building Code and any pertinent local ordinance." 4. Failure to abide by the above conditions may prohibit the Property Owner and/or any subsequent purchasers from receiving Federal disaster assistance with respect to this property in the event of any f uture f lood disasters. If the above conditions are not met, FEMA may recoup the amount of the grant award with respect to the subject property, and the Property Owner may be liable to repay such amounts. This Agreement shall be binding upon the respective parties' heirs, successors, personal representatives, and assignees. Name of Property Owner: STATE OF FLORIDA COUNTYOF MecM DEBORAH SHEPPARD State of Florida -Notary Public Corn # GG 57999 My Commission Expires ��Il I11 iii November 11, 2020 Printed Name of Notary 2 DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY DECLARATION L SE DECLARATON AND RELEASE In order to be eligible to receive FEMA Disaster Assistance.. a member ofthe household must be a citizen, non- citizen national or qualified alien of tht United States. Please read the form carefully, sign the sheet and return it to the Inspector, and show him /her a current form of photo identification. Please feel free to consult with an attorney or other immigration expert ifyou have any questions. I hereby declare, under penalty of perjury that (check one): L EE i arm a citizen or non - citizen national of the United States. lain a qualified alien of the United States. Ll Print full name and age of minor child :I ain the parent or Ruardian of a minor child who resides with me and vvho is a citizen, non- citizen national or qualified alien of the United States. Print bill name and age of minor child: By my signature I certify that: • Only one application has been submitted for my household. • All information I have provided regarding my application for FEMA disaster assistance is trite and correct to the best of my knowledge. • I will return any disaster aid money I received from FEMA or the State if I receive insurance or other money for the same loss„ or ifl do not use F .NIA disaster aid money for the purpose for which it was intended. I understand that, if I intentionally make false statements or conceal any information in an attempt to obtain disaster aid. it is a violation of federal and State laws, which carry severe criminal and civil penalties, including a line up to $20,000, irnprisomnent, or both (18 U.S.C. ti 2117, 1001, and 3571). I understand that the information provided regarding my application for FEMA disaster assistance may be subject to sharing within the Department of Homeland Security (DEIS) including, but not limited to, the Bureau of Immigration and Custom Enforcement. 1 authorize FEMA to verify all information riven by me about my property /place of residence, income. employment and dependents in order to determine my eligibility for disaster assistance, and O.M.B. No. 1660 -0002 Expires August 31, 2013 i authorize all custodians of records of my insurance, employer, any public or private entity, bank financial or credit data service to release information to FEMA and /or the State upon request. NAME (prim[) D OF BIRTH DATE SIGNED Michele Lynn f t , j/ & rc INSPECTOR ID NO. TION NO. DISASTER NO. ADDRESS OF DAMAGED PROPERTY CITY STATE ZIP CODE PRIVACY ACT STATEMENT AUTHORITY: The Robert T. Stafford Disaster Relief and. Emergency Assistance Act as amended, 42 U.S.C. § S121 -5207 and Reorganization Plan No. 3 of 1978. 4 U.S.C. §§ 2904 and - 1 906 - ,4 C.F.R. § 206.2(a)(27); the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. 104 -193) and EXMRive Order 13411. DEIS asks for your SSN pursuant to the Debt Collection Irmprovement Act of 1996, 31 U.S.C. § 3325(d) and § 7701(e) (1). PRINCIPAL PURPOSE(S): This information is being collected for the prin -ary purpose ofdeternining eligibility and administering financial assistance under a Presidentially- declared disaster. Additionally, information may be reviewed internally within FEMA for quality control purposes. RCIuTI VE USE(S); The information on this form nrav be disclosed as generally permitted under 5 U S.C. § »2a(b) of the Privacy Act of 1974. as amended. This includes trsing this intimmation as necessary and authorized by the routine uses published in D ISIFEMA - 008 Disaster Recovery Assistance Files Systern of Records (September 24, 2009, 74 FR 411763) and upon vvrinen request, by agreement, or as required by law. DISCLOSURE: The disclosure of information on this form is voluntary: however„ failure to provide the information requested may delay or prevent the individual from receiving disaster assistance. PAPEI2°wi`ORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 2 minutes per response. The burden estimate includes the time for reviewing Instructions, searching existing data sources, _ *athering and maintaining the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid ONIB control number is displayed on this form_ Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Cmeraency Management Agency, 1 800 South Bell Street, Arlington, ``v'A 20538 -3005, Paperwork Reduction Project (1660 -00 02) NOTE: Bo not send your completed Form to this address, FEMA Form 003 -0 -3, AUG 2010 REPLACES ALL PREVIOUS FERIA Farm 90 -69B Duplication of Benefits The Federal Emergency Management Agency has adopted a policy that prohibits duplication of benefits in the Hazard Mitigation Assistance Program that includes Flood Mitigation Assistance grants. The policy was developed in response to federal regulations that dictate the use of the primary funds used to mitigate property. The Federal Emergency Agency (FEMA) provides the following specific instructions in the Hazard Mitigation Assistance Program Guidelines for mitigation projects. In the administration of Hazard Mitigation Grant Program (HMGP) grants, FEMA and the grantee should avoid any duplication of benefits with other forms of assistance. FEMA's policy on duplication of benefits for individuals and families is mandated by Section 312 of the Stafford Act and is set forth in 44 CFR 206.191. This Section of the FEMA regulations delineates a delivery sequence establishing the order in which the disaster relief agencies and organizations provide assistance to individuals and families. Programs listed later in the sequence are responsible for ensuring that they do not duplicate assistance which should be provided by a program listed earlier on the list (the program with primary responsibility). In the case of flood- damaged property programs (Section 1362, Section 404, etc.), they are not listed in the delivery sequence, and therefore are positioned after the eight listed programs. This means that all eight programs listed in the sequence at 44 CFR 206.191 (d) are "primary programs" in relation to mitigation grant programs. The Hazard Mitigation Grant Program is required to ensure that it does not duplicate assistance which should be provided by any of the eight primary assistance programs. Certification of Funds Used Receipt of or pending receipt of the following benefit amounts must be disclosed to the State of Florida 1. SBA Loans - A property owner who has an SBA loan on the property being acquired will either be required to repay the loan to SBA, or roll it over to a new property at closing. Yes El Nom 2. Flood Insurance for Structure Repairs - That portion of a flood insurance payment that a property owner has received or is eligible to receive intended to cover structural repairs to the property being acquired will be deducted from the purchase price of the property being acquired. If flood insurance funds have been reinvested into repairs to the property, this amount will not be deducted. Proof of reinvestment can be supplied through receipts for materials and /or labor, or through on -site verification. Amount reinvested is $ 3, Increased Cost of Compliance - NFIP Increased Cost of Compliance (ICC) claim payment from a flood event may be used to contribute to the non-Federal cost-share requirements so long as the claim is made within the timelines allowed by the NFIP. ICC payments can only be used for costs that are eligible for ICC benefits; for example, ICC cannot pay for property acquisition, but can pay for structure demolition or relocation. in addition, Federal funds cannot be provided where ICC funds are available; if the ]CC payment exceeds the required non-Federal share, the Federal funding award will be reduced to the difference between the cost of the activity and the ICC payment. Have you received ICC payments? If so, how much !CC funds have you received? Do you plan on receiving ICC payment? If so, how much ICC funds do you plan on receiving? 4. FEMA Individual Family Grant and Emergency Minimal Repair Grant (EMR) - That portion of an I FG grant that a property owner has received or is eligible to receive �PMA 4 0-t4 ft-1 the purchase price of' the property. Additionally, grants received from FEMA as part of Temporary Housing Assistance Program to quickly repair or restore owner-occupied primary residences to habitable and safe condition will be deducted from the purchase price of the property. If the funds have been reinvested into repairs to the property, this amount will not be deducted. Proof of reinvestment can be supplied through receipts for materials and/or labor, or through on-site verification. Amount received4 _..L 5 FEMA Disaster Mousing - FEMA Disaster Housing money received by the property owner will not be deducted if the property owner has used the grant for housing related expenses. These can include: transient accommodations while an existing home is being elevated or relocated; combining it with other funds to make more substantial home repairs, minor home repairs made to make a home more livable prior to a buyout offer; down payments toward the purchase of a new home; moving expenses; closina costs; insurance; and deposits. Amount received: Owner Name: Property Address: A/ C ) ' I- _I_Z� i - �1 j El(� LY& J A) /,�2 E-, S I hereby certify that the SBA Loans, Flood Insurance for Structure Repairs, FEMA Individual and Family Grant, Emergency Minimal Repair Grant (EMR) and FEMA Disaster Housing benefits defined above have been accurately reported and that the not used for the purposes identified above have been fully disclosed. Yi g Sig D ate Monroe County, Florida Please complete this form iF you are interested im being included im the Monroe County application tothe FEK4A Hazard Mitigation Grant Program to mitigate your home. Signing this does not commit you to any action. Property Address: 12A m Avenue, Key West, FL 33040 Owner(s) Mailing Address: same as above OvYmer(s) 0arne(s): Jeff and Michele Lynn FEMA Individual Assistance Registration # u Date LZ Date