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ZIP Code 1pI�bpy both aides of Mofficial, Elevation Certificate for (1) community otial, (2) Insurance agent/compeny, and (3) building owner. Comments ^ LI / RIA •A- I^ ^^^^ ! Y L_J Photos of the exterior of the residence are attached e lowest LlectricalEquipment Is a Water Heater located In the Northwest corner ot the Uarage Ei��IL•7:140-]MIll•117M44AMI dr-lAi"11•1:7'r_� 'L�];IEPl 'L31 L•yi1�•lrll��]li•1 �311�L•LLI•ti•7 I II'il►1:I�1r1iZ-7i�� For Zones AO and A (without SFE), complete hems Et -E8. If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A, S, and C. For Items E t{4, use natural grade, If avallable. Check the measurement used. In Puerto Rloo only, enter meters. Et. Provide stevation Information for the following and check dw appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (HAG) and the lowest s*oanl grade (LAO). e) Top of bottom floor (including basement crewfepece, or enclosure) Is—. _ ❑feet ❑meters Clabove orbelow the HAG. bot b) Top of tom floor (Including basement crawlapooe, or enclosure) Is — _ [3W ❑meters or ®below the LAG. E2. For Building Diagrams 8.9 with permanent flood openings provMedJh, Seetlgp,N Items 8 �/or 9 (see ggpea 8A of IneWdlane). Me next higher door (elevation C2.b In the diagrams) of the building Is LJ feet LJ meters U above or U below Me HAG. E3. Attached garage Bop of slab) Is _ ❑ fast ❑ metere ❑ above or ❑ below the HAG. E4. Top of platform of machinery andfor equipment servicing the building Is ' _ ❑ feet ❑ maters ❑ above or ❑ below the HAG. E5. Zone AO onIf no flood depth number Is avertable, Is the top of the bottom door elevated In eccordamx with the community's floodplain management ordinance? b yes ❑ No ❑ Unknown. The local official must certify this Information In Section G. SECTION F • PROPERTY OWNER IOR OWNER'S REPRESENTATIVEI CERTIFICATION The property owner or owners ouMoliBd representative who completes Sections A, 8, and E for Zone A (without a FEMA4seusd or communtty-leaued BFE) or Zone AO must sign here. The statements In Sections A, A and E are consof to the beat of my knowledge. ' Property Owners or Owner's Authorized Representative's Name Address Cly State ZIP Code lure Date Telephone Carthame and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Checli the measurement used In Items 08 and 09. 01. ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or mchllect who Is authorized by low to owdy elevation Information. (Indicate the source and date of the elevation date In the Comments area below.) G2. ❑ A community official completed Section E for a building looted In Zone A (without a FEMMasued or oommunily-lesued 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 -bunt lowest Noor (Including basement) of the building ❑ feel ❑ meters (PR) Datum 09. SFE or (in Zone AO) depth of flooding at the building alta ❑ feet ❑ meters(PR) Datum — G10. Community's design flood OVAISIoDepartment of Public W-6 ❑ feet ❑ meters(PR) Datum Local Official's Name fij._. The Signature 7/2-7/0 FEMA Form 8141,