FEMA Form 086-0-22 (MT-EZ) at a glance
What it is: This is the Department of Homeland Security, Federal Emergency Management Agency application form for single residential lot or structure amendments to National Flood Insurance Program Maps.
Who signs: Section A may be completed by the property owner or by the property owner's agent. Section B must be completed by a registered professional engineer or licensed land surveyor.
Where and when to file: Mail your request to: LOMC CLEARINGHOUSE 7390 COCA COLA DRIVE, SUITE 204 HANOVER, MD 21076 Attn.: LOMA Manager
This form should be used to request that the Department of Homeland Security's Federal Emergency Management Agency (FEMA) remove a single structure or legally recorded parcel of land or portion thereof, described by metes and bounds, certified by a registered professional engineer or licensed land surveyor, from a designated Special Flood Hazard Area (SFHA), an area that would be inundated by the flood having a 1%-chance of being equaled or exceeded in any given year (base flood), via Letter of Map Amendment (LOMA).
Section A may be completed by the property owner or by the property owner's agent.
Section B must be completed by a registered professional engineer or licensed land surveyor.
What to bring and attach to FEMA Form 086-0-22 (MT-EZ)
"In addition to this form (MT-EZ), please complete the checklist below. ALL requests must include one copy of the following:"
Copy of the effective FIRM panel on which the structure and/or property location has been accurately plotted.
Copy of the Subdivision Plat Map (with recordation data and stamp of the Recorder's Office) OR Copy of the Property Deed (with recordation data and stamp of the Recorder's Office), accompanied by a tax assessor's map or other certified map showing the surveyed location of the property relative to local streets and watercourses.
The map should include at least one street intersection that is shown on the FIRM panel. Please include a map scale and North arrow on all maps submitted.
Please do not submit original documents. Please retain a copy of all submitted documents for your records.
A filled-in FEMA Form 086-0-22 (MT-EZ) example: a homeowner fills out Section A
How to fill out FEMA Form 086-0-22 (MT-EZ), box by box
Fill and legal description
"Has fill been placed on your property to raise ground that was previously below the BFE?" If Yes, STOP!! You must complete the MT-1 application forms.
"Fill is defined as material from any source (including the subject property) placed that raises the grade to or above the Base Flood Elevation (BFE)."
Enter the Legal description of Property (Lot, Block, Subdivision or abbreviated description from the Deed) and street address of the Property (required).
Flood zone determination requested for
Check one: A structure on your property? What is the date of construction? (MM/YYYY)
Check one: A portion of your legally recorded property. A certified metes and bounds description and map of the area to be removed, certified by a registered professional engineer or licensed land surveyor, are required.
Check one: Your entire legally recorded property.
Applicant's Name, Mailing Address and Signature
Enter the Applicant's Name (required), the Mailing Address (include Company name if applicable) (required) and the Daytime Telephone No. (required). The Fax No. is optional.
The E-mail address is optional. By checking here you may receive correspondence electronically at the email address provided.
All documents submitted in support of this request are correct to the best of my knowledge.
Enter the Signature of Applicant (required) and the Date (required).
Determination requested in Section B
If the request is to have a flood zone determination completed for the structure, and an Elevation Certificate has been completed for this property, it may be submitted in lieu of Section B.
If the request is to have a flood zone determination completed for the entire legally recorded property, or a portion thereof, the lowest elevation on the lot or described portion must be provided in Section B.
Determination Requested For (check one): Structure located on natural grade (LOMA). Elevation Information Required: Lowest Adjacent Grade to the structure (the elevation of the lowest ground touching the structure including attached patios, stairs, deck supports or garages).
Determination Requested For (check one): Legally recorded parcel of land, or portion thereof (LOMA). Elevation Information Required: Elevation of the lowest ground on the parcel or within the portion of land to be removed from the SFHA.
This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation information.
More rules for FEMA Form 086-0-22 (MT-EZ)
In order to process your request, all information on this form must be completed in its entirety, unless stated as optional.
Incomplete submissions will result in processing delays.
Common questions about FEMA Form 086-0-22 (MT-EZ)
Where do I file it?
Mail your request to: LOMC CLEARINGHOUSE 7390 COCA COLA DRIVE, SUITE 204 HANOVER, MD 21076 Attn.: LOMA Manager
Is there a penalty?
I understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001.
When is this form not the right one?
It shall not be used for requests submitted by developers, for requests involving multiple structures or lots, for property in alluvial fan areas, for property located within the regulatory floodway, or requests involving the placement of fill. (NOTE: Use MT-1 forms for such requests).
Sources
[1] FEMA Form 086-0-22 (FEB 11), Application Form for Single Residential Lot or Structure Amendments to National Flood Insurance Program Maps, Department of Homeland Security, Federal Emergency Management Agency (the Official source link on this page).