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IMPORTANT: In thbse spaces, col Building Street Address (including Apt., U 203 KOvVLOW City FF(lo r_ SECTION D OR from Section Code both sides of this Elevation Ce1186C41e for (1) community official, (2) Insurance agentleomparry, and (3) building owner. lents Lt1ndA0v Ti✓umr O.IO�rn�i.wn ti ted., Q fir NOT U-1 Use: For Zones AO and A (without BFE), complete Items E1 -E8. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Cheek the measurement used. In Puerto Rico only, enter maters. Ell. Provide elevation IMormatlon ler the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (NAG) and the lowest adjacent grade (LAG). a) Top of bottom floor pncluding basement, crawl space, or enclosure) Is _, ❑feet ❑ meters ❑above or ® below the HAG. Ela b) Top of bottom floor (Including basement, crawl space, or enclosure) Is _ _ ❑ fast ❑ meters bove or below On LAG. E2. For Building Diagrams 64 with pemsnenl flood openings provided In Sectitr Items a e (see PAP s of Instructions). the next higher floor (elevation C2.b In the diagrams) of the building Is — ❑ feet IJ motors above or U below the HAG. E3. Attached garage (top of slab) Is _ ❑feet ❑maters ❑above or [:1 below the HAG. U. Top of elation of machinery ander equip menl servicing the building le _ ❑feet meters ❑above or 0 below the HAG. E5. Zone AO o If no flood depth number Is available, is the lop of the bottom floor elevated In accordance with the communitys floodplain management ordinance? El Yea ❑ No ❑ Unknown. The local official must certify this Information In Section G. F - The property owner or owner's authorized representative who Completes Sections A. B, and E for Zone A (without a FEMA -Issued or community -Issued BFE) or Zone AO must sign here. The statements In Sections A, S, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Code Comments and G of this Elevation Certiflcale. Complete the applleable Ilem(s) end sign below. Check the a se measurement used In Items G8.complete end Ge. re A, B, C (or E), GI. ❑ The Information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer. or archtieelwho Is authorized by law to CoNy elevation Information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located In Zone A (without a FEMA4ssued or Communiy-Issued BFE) or Zone AO. G3. ❑ The following Information (Items G4. -Ge.) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G8. Date Certificate Of Complianoe/Oecupancy Issued GT. This permit hes been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum GO. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum Local 08idal's Name Title Community Name - Telephone Signature Date FEMA Form 81-31, February 2006 Replaces all previous editions