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4-/ <br />state <br />96778 <br />Copy both aides of this Elevation Certificate for (1) community official, (2) Insurance agentloompeny, and (3) building owner. <br />rymmmente <br />EL.rLVA_tQAS 9)SOD ST-A9USJ4" Ear 1MA7A 4 ASSOG 4,Pa5 DA:TjS0 7/l/O9 <br />For Zones AO and A (without BFE), complete Items E1 -E6. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B, <br />and C. For hems E1 -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. <br />El. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent <br />grade (HAG) and the lowest adjacent grade (LAO). <br />a) Top of bottom floor (Including basement, crawispaoe, or enclosure) is _ _ ❑feet❑meters ❑above or Bbelow the HAG. <br />b) Top of bottom floor (including basement, crawlapaos, or enclosure) Is _ _ ❑Feet ❑meters ❑above or below the LAG. <br />E2. For Building Diagrams 6-9 with permanent flood openings pmNded iE SWUMA Items 9 6gQ/or 9 (ase gpgas"of Instructions), the next higher floor <br />(elevation C2.b in the diagrams) of the building Is LJ teat LJ meters LJ sinus or LJ below the HAG. <br />E3. Attached garage (top of slab) Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />E4. Top of platform of machinery and/or equipment servicing the building Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />E8. Zone AO only: If no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the community's floodplain management <br />ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Information In Section O. <br />SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION <br />The property owner or owner's authorized represenlative who completes Sections A B, and E for Zone A (witllout a FEMA -Issued or cormnunityassued BFE) <br />orZone AO must algn here. The statements M Sections A, A and E are correct to the beat of my Iaowdedge. <br />Properly Owner's or <br />n enepnons <br />and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. <br />01. ❑ The Information In Section C was taken from other documentation that has been signed and seeded by a licensed surveyor, engineer, or architect who <br />Is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data In the Comments area below.) <br />G2. ❑ A community official completed Beldon E or a building located In Zone A (without a FEMA -Issued or oommun8y4med BFE) or Zone AO. <br />G3. ❑ The following Information (Name G4 -G9) is provided or community floodplain management purposes. <br />G4. Permit Number G8. Dao Pam* Issued G6. Date Certificate Of Complianoe/Occupency Issued <br />G7. This permit has been Issued or: ❑ New Construction ❑ Substantial Improvement <br />G8. Elevation of as -built lowest floor (including basement) of the building ❑ feet ❑ meters(PR) Datum <br />G9. BFE or (in Zara AO) depth of flooding at the building site ❑ feet ❑ meters (PR) Datum <br />G10. Community's design flood elevation _c ❑ feet ❑ meters (PR) Datum <br />Loral Official's Name 1, Il-(''�,.._ Title <br />__.._....... ....... ,any,.. <br />Signature A -t. _.-- -_ Data <br />y . <br />- - -• ❑ Check here If attachments <br />FEMA Form 8131, Mer 09 Replaces all previous editions <br />