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In City or MW Insurance Company Use: ac�I Ivn U • AUKVt:yOR ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Ropy both sides of this Elevation Certificate for (1) community official, (2) Insurance egenVcompany, and (3) building owner. Comments.. RL'FR 14 ' h rB,* 70 R . &HAA -eh 04aG 1.5 ,q Gy15sr,Uovsao.v /--P s Plotz. Signature05 _ Date D .. .__._ .. .. ._ _._ .. _.. .. 1. ❑ check here If attachments SECTION E BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRE FOR ZONE AO AND ZONE A (WITHOUT BFEI Fer Zones AO and A (without BFE), complete Items E1 -E6. If the CerBflcate Is Intended to Support a LOMA or LOMR-F request, complete Sections A, 8, un.1 r. Fnr aero• Ft.Ft „•• w•....eh•.-. :r _..:,_>:,, .-i__r. • _ �;r�wnuiciw uiuy: nuinr mnlnra. EI_.P.wAda_elevation.(nfomtatlonixthe.following.and..check the appropriate boxes to -show whether the elevation Is above or below the highest adjacent grade (HAG) a owesi adjacent grade (LAG). a) Top of bottom floor (Including basement, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑above or ® below the HAG. b) Top of bottom floor (Including basement, crawl space, or enclosure) Is _. _ feet ❑ meters ❑ above or below the LAG. E2. For Building Diagrams e-9 with permanent flood,openings provided Irt SeCtIMA Items 8@�Mr 9 (see ggga 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of ft building Is 0 toot U meters („J above or LJ below the HAG. E3. Attached garage (top of slab) Is . _ ❑ feel ❑ metes ❑ 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 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? ❑ Yea ❑ No ❑ Unknown. The local official must certify this Information In Section G. -PROPERTY The property owner or owner's authorized representative who completes Sections A. B, and E for Zone A (wllhout a FEMA -Issued or community -issued BFE) Or Zone AO must sign here. The statements /n Sedffoas A, A and E are correct to Ne beef of my browbdge. al and G of tics Elevation Cer9ficate. Com ate tire -..-- •- ......_..a•y pl applicable--.fiem(sw).anti..- dgna:,belo,,w,w. used In fMms G8. and G1. ❑ The Information in SeWon C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who Is authorized bylaw to oeNfy elevation Information. (Indicate the source and data of the etevatlon dab In the Comments area below.) G2. ❑ A community official completed Section E for a building located In Zone A (withoida FEM44Nwed or community -Issued BFE) or Zone AO. G3. ❑ The following Information (Items G4.49.) Is provided for community floodpill fleanapNtront pteptsm. G4. Permfi Number GS. Data Permit Issued Gil. Dab Certificate Of Complianpe/Ocaupancy Issued G7. This permit has been Issued for. ❑ New Construction ❑ Substantial Improvemerd G8. Elevation of as -bush lowest floor pnduding basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building she: ❑ bet ❑ meters (PR) Datum Local Umdel a Namef" gi*crh"W Of wofft Title Community Ndme • �rvttg Ota di PS W@ Telephone vale Replaces all previosr�;