DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY COASTAL ANALYSIS FORM O.M.B No. 1660-0016 Expires February 28, 2014 PAPERWORK REDUCTION ACT Public reporting burden for this form is estimated to average 1 hour per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing, and submitting the form. You are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, U.S. Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington VA 20958-3005, Paperwork Reduction Project (1660-0016). Submission of the form is required to obtain or retain benefits under the National Flood Insurance Program. Please do not send your completed survey to the above address. PRIVACY ACT STATEMENT AUTHORITY: The National Flood Insurance Act of 1968, Public Law 90-448, as amended by the Flood Disaster Protection Act of 1973, Public Law 93-234. PRINCIPAL PURPOSE(S): This information is being collected for the purpose of determining an applicant's eligibility to request changes to National Flood Insurance Program (NFIP) Flood Insurance Rate Maps (FIRM). 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 using this information as necessary and authorized by the routine uses published in DHS/FEMA/NFIP/LOMA-1 National Flood Insurance Program (NFIP); Letter of Map Amendment (LOMA) February 15, 2006, 71 FR 7990. DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may delay or prevent FEMA from processing a determination regarding a requested change to a NFIP Flood Insurance Rate Maps (FIRM). Flooding Source: Note: Fill out one form for each flooding source studied. A. COASTLINE TO BE REVISED Describe limits of study area: B. EFFECTIVE FIS The area being revised in the effective FIS was studied by detailed methods using (check all that apply): 0 Storm surge modeling 0 Wave setup computations 0 Wave height computations 0 Wave runup computations 0 Wave overtopping computations 0 Dune erosion computations 0 Primary Frontal Dune Assessment 0 N/A (area not studied by detailed methods) C. REVISED ANALYSIS 1. Number of transects in revised analysis: 2. Information used to prepare the revision (check all that apply): 0 Wave setup analyses (complete Items 3, 4, and 5 below) 0 Wave overtopping assessment (complete Items 4 and 5) 0 Stillwater elevation determinations (complete Item 3) 0 More detailed topographic information (complete Section E) 0 Erosion considerations (complete Item 4) 0 Shore protection structures (attach completed Coastal Structures Form - Form 5) 0 Wave runup analysis (complete Items 4 and 5) 0 Primary frontal dune assessment (complete Item 5) 0 Wave height analysis (complete Items 4 and 5) 0 Other, attach basis of revision request with explanation 3. Stillwater Elevation Determination a. How were stillwater elevations determined? 0 Gage analysis (If revised gage analysis was used, provide copies of gage data and revised analysis.) 0 Storm surge analysis 0 Other (Describe): b. Specify what datum was used in the calculations: If not the FIS datum, have the calculations been adjusted to the FIS datum? 0 Yes 0 No Conversion factor: c. Was the storm surge analysis revised? 0 Yes 0 No d. If a new storm surge model was used, attach a detailed description of the differences between the current and the revised analyses, and why the revised analysis should replace the current analysis. C. REVISED ANALYSIS (continued) e. If wave setup was computed, attach a description of methodology used. Amount of wave setup added to stillwater elevation: feet 4. Revised Analysis (i.e., erosion, wave height, wave runup, primary frontal dune, and wave overtopping) If DHS-FEMA procedures were utilized to perform the revision, attach a detailed description of differences between the current and the revised analyses, and why the revised analysis should replace the current analysis. If DHS-FEMA procedures were not utilized to perform the revision, provide full documentation on methodology and/or models used; including operational program, detailed differences between methodology and/or models utilized and DHS-FEMA's methodology and/or models. Also, attach an explanation of why new methodology and/or models should replace current methodology and/or models. If revision reflects more detailed topographic information and fill has been/will be placed in a V Zone, and is not protected from erosion by a shore protection structure, provide a detailed description of how the fill has been treated in the revised analysis. 5. Wave Runup, Wave Height, And Wave Overtopping Analysis Wave height analyses along a transect are greatly affected by starting wave conditions that propagate inland. Wave runup and overtopping analyses are typically considered when wave heights and/or wave runup are close to or greater than the crest of shore protection structures or natural land forms. a. Was an analysis performed to determine starting wave height and period for input into WHAFIS? If Yes, attach an explanation of the method utilized. If No, explain why these analyses were not performed. 0 Yes 0 No b. Was wave setup included in wave height analysis and removed for erosion and wave runup analyses? 0 Yes 0 No c. Was an overtopping analysis performed for any coastal shore protection structures or natural land forms that may be overtopped? 0 Yes 0 No If Yes, attach an explanation of the methodology utilized and describe in detail the results of the analysis. If overtopping was not analyzed, attach an explanation for why these analyses were not performed. D. RESULTS 1. Stillwater storm surge elevation: feet Datum 2. Wave setup: feet 3. Starting deep-water significant wave condition: height: period: 4. Maximum wave height elevation: feet 5. Maximum wave runup elevation: feet 6. Estimated amount of maximum overtopping: cfs/feet 7. Has this revision changed the Limit of Moderate Wave Action (LiMWA)? 0 Yes 0 No 0 N/A 8. The areas designated as coastal high hazard areas (V Zones) have: 0 increased 0 decreased 0 both Attach a description where they have increased and/or decreased. 9. As a result of the revised analyses, the V Zone location has shifted a maximum of feet seaward and feet landward of its existing position. 10. Does this revision reflect the location of the primary frontal dune? 0 Yes 0 No 11. The Base Flood Elevations have: 0 increased 0 decreased a. What was the greatest increase? feet b. What was the greatest decrease? feet 12. The special flood hazard area has: 0 increased 0 decreased 0 both Attach a description where it has increased or decreased. E. MAPPING REQUIREMENTS A certified topographic map must be submitted showing the following information (where applicable): effective, existing conditions, and proposed conditions 1%-annual-chance floodplain boundaries, revised shoreline due to either erosion or accretion, location and alignment of all transects, correct location and alignment of any structures, current community easements and boundaries, boundary of the requester's property, certification of a professional engineer registered in the subject State, location and description of reference marks, and the referenced vertical datum (NGVD, NAVD, etc.). Note that the existing or proposed conditions floodplain boundaries to be shown on the revised FIRM must tie-in with the effective floodplain boundaries. Please attach a copy of the current FIRM annotated to show the revised 1%-annual-chance floodplain boundaries that tie-in with effective 1%-annual-chance floodplain boundaries along the entire extent of the area of revision. FEMA Form 086-0-27C, (2/2011) Previously FEMA Form 81-89C MT-2 Form 4 Page 1 of 2