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1-4-068:076
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Last modified
2/25/2015 9:29:58 AM
Creation date
3/17/2014 2:35:06 PM
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Document Description
Date
4/19/2011
Type
Elevation Certificate
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E <br />• <br />• <br />--r, -- ••-w• we I -wuuen wemrirate tor(I) oommunity Omdei, (2) Ineurence agenuoompany, and (3) buliding owner. <br />- . we -she ✓ i d✓ye ✓ Li a ✓e 47eev) e -e PwoVe�. <br />4)clte✓ hasb efi rep/ac'Pei u�i� <br />_ u via //Iv� vdr�t� [[ash -ex,44 <br />(� rdA /e / et` . ha ✓p.. �... ac�cQi9e s s .— . _, <br />E <br />For Zones AO and A (wfihout BFE), cemplau Items SI.Ea., dthe Cer"cals Is intended lo support a LOMA or LOMR-F request, complete Section# A, B, <br />and C. For gems El -I use naluml grade, d available. Cheek the measu dement used. In Puerta Fdm onI enter meters. <br />Et. Provide elevation Information for the following and check the Appropriate boxes to show whether the elevation 19 above or below the highest adjacent <br />grade (NAG).and the lowest adjacent gratia (LAO). <br />A) Top of bottom floor (Including beseman4 aawdspece, or enclosure)11 �_. Ofast Omaters aboveor fSbelow the HAG. <br />b) Top of bottom floor (including basement, ormviepace, of enclosure) p _ _ fast []maters uabove a i-Jbelow the LAG. <br />E2. For Building Diagrams 8.8 with pemrenent flood openings provided In Socll � Items a nVor 9 (see Ogee "of InstnrWons), the next higher now <br />(elevation C2.b in the diagrams) of the building is _ ❑ feel LJ meter (,.J above or EJ below the HAG, <br />E8. Atiarhed pampa (top of slab) I# _,_. _ Q root [J meters C1 above or [3 below the HAG, <br />E4. Top of pladann of machineryandror equipment servicing the building Is_._ Q feet O nI [] above cr [] below the HAG. <br />E9. Zone AO only. It noflood depth number Is avafleble, Is the top of the bottom floor euvated In accordance with the aommunWs floodplain management <br />ordinence? 0 Yes ❑ No ❑ Unknown. The local official must oertiy this hdamutlon in Section G. <br />• SECTION F • PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION <br />The property owner or owners authorized representative Who completes Sections A. Be and E for Zone A (without a FEMAdssued or commu ity-Issu�B- <br />or Zone AO must sign here. ?Ito stetemants m Ssdnuu A Be enolE ere oared to the bele s/myknoaiedoe. <br />and G of This Elevation Certlflwro. Compleb the ePPlicebla Item(#) r), - <br />no sign below. Cheek the memureemme°nnt used Iorcinsn IIttem G8 ancan d G� anon! A, 9, C (or <br />01. The imomnation In SeWon C was taken from other documentation that has been signed and sealed by s #tensed surveyor, engineer, or archttaol who <br />Is authorized by law to cerWyalevalron Information. (indicate the source and date of the elevation date In the Comments ares below.) <br />02 Q AooptmudHy ollfpisl compyjsd 3ebuon Etw.A bNlding.PobeladInZpme A,(tyFUiou(aFfMA-iasugd,0(oormnuhtty",,;d BFE)or2Dhs A0. <br />r'ts4p, C0Mrgrfny6 <br />c,-NaLoialmast <br />rommu"` came <br />da�.s <br />recoll.irriena <br />r / <br />FEMA Form 81 -3 1. Mar r•r- <br />oe r <br />a. ,2011 <br />Repleces all previous <br />
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