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from Section A. Copy both sides of this Elevation Certificate for )eorr(1) community official, (2) Insurance agent/company, and (3) building owner. fir, Comments e (�� Ar JF;U%c ror cones AG and A (without BFE), complete Items E1 -E5. If the CertiflCale 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. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation Information 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, crawlspaoe, or enclosure) Is ❑ feet ❑ meters b) Top of bottom floor (including basement, crawlspace, or enclosurefeet ❑stars E3the is ❑ above or ❑ below Me NAG. above or ❑ below LAO, F2. For Building Dlagreme 8-9 wait permanent flood openings provided in Section A Items 6 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of stab) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top ofplatform of machinery and/or equipment servicing the building is _._ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AG only: If no flood depth number is available, Is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown The local official must cewly 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, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address city complete and G of this Elevation Certificate. Complete the applicable item(s).and sign below Checkpiain e the measurement u managementld In Ite snG8 and Ga. Sections A, B. C (or E), G1. ❑ The information in Section C was taken from other documentation that has been signed and mated by a licensed surveyor, engineer, or architect who Is authorized by law to certify 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 FEMA -Issued or community -Issued BFE) or Zone AO. G3. ❑ The following information (items G4 -G9) is provided for community floodplain management purposes. G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-buik lowest floor onduding basement) of the building:_-_ ❑ feet ❑ meters (PR) Datum. Ga. BFE or (in Zone Ac) depth of flooding at the building site: _ G10. Community's design flood _ El feet meters (PR) Datum "Wd'Deportment of Public V"-1 ❑ fent ❑ meters (PR) Datum Local Official's Nanta IvlS Gn CS revlewe Title Name recommend 81-31, Mar 09 mi' Replaces all previous editions