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AN',: the State from Section A. Place For Insurance Company Use: SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Unit on the South side of the dwell February 11, 2008 BUILDING ELEVATION IN MION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE1 For Zones AO and A (without BFE), complete Items E1 -E5. 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 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, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or 1:1 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure Is ❑ ❑ ❑ below the LAG. _ ❑ feet meters above or E2. For Building Diagrams 6-8 with permanent flood openings provided in SectigO� Items 8 nd/or9 (see a e 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is _ ❑teat LJ meters a❑ above or �trelow the HAG. E3. Attached garage (top of slab) is _ ❑ feel ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building B _ ❑ feel ❑ meters ❑ above or ❑ below the HAG. E5. 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? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION 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 stafements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name ZIP SECTION G - COMMUNITY INFORMATION (OPTIONAL) he local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), A G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9. 1. ❑ The information in Section C was taken from. other documentation that has been signed and sealed 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.) 2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone A0. 3. ❑ The following Information (Items G4. -G9.) is provided for community floodplain management purposes. lNumbw G5. G6. Date I 7. This permit has been issued for: ❑New Construction ❑Substantial Improvement S. Elevation of as-bulft lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum 3. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum -owl Official's Name Title :ommunity Name Telephone signature ne,e ❑ Check 1--- If ata mems =MA Form 8131, February 2006 Replaces all previous editions