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Copy both skies of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner. Garage has a family room above. Only a portion of the structure Is in VE zone, balance of structure is in Wl-]V-011141 For Zones AO and A (without SFE), 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 Et -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. Et. Provide elevation Infarna0on for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (Including basement, crawlepace, or enclosure) Is _ _ ❑Teel ❑mewre❑above orbelow the HAG. b) Top of bottom floor (Including basement, crowlepace, or enclosure) Is _ _ []W []motors❑above or ®below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings providetup, SocUQCLA Items 8 juror 9 (see ggges 8.9 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is LJ feet U meters U above or U below the HAG. E3. Attached garage (top of slab) Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E8. Zone AO onl : If no flood depth number is available, Is the top of the bottom floor elevated In accordance with the oommunitys floodplain management ordinance? Yee ❑ No ❑ Unknown. The local official must certify this Information In Section G. SECTION F • PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner or owners authorized representative who completes Section A, B. and E for Zone A (without a FEMA -issued or community -Issued SFE) or Zone AO must sign here. The statements In Sections A, B, and E ere correct to the beat of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments Omolal who 18 authorized by law or ordinance to aammistar the oommunitya h00aplaln management oromance Can complete a this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used In Items 08 and G9. G1. ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or arohkecl who is authorized by law to certify elevation Information. (Indicate the source and data 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 FEMA-lesued or community-lesued BFE) or Zone A0. G3. ❑ The following Information (Items 04-G9) Is provided for community floodplain management purposes. 04. Permit Number I G6. Date Permit Issued I G8. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement Ga. Elevation of as -built lowest floor (Including basement) of the building ❑ feet ❑ metere(PR) Datum G9. SFE or (in Zone AO) depth of flooding at the building site ❑ feet ❑ meters (PR) Datum G10. Community's design flood a WAlobapartment of Public Ors , — ❑ feet ❑ meters (PR) Datum LoealOfficial's Name Waoineering Division has reviewed Toe does hot) recommend 09