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FEDERAL EMERGENCY MANAGEMENT AGENCY <br />NATIONAL FLOOD INSURANCE PROGRAM <br />FLOODPROOFING CERTIFICATE <br />FOR NON-RESIDENTIAL STRUCTURES <br />O.M.B. NO. 3067-0077 <br />Expires July 31, 2002 <br />The floodproofing ofnan residential bur7dings maybe permrited as an aRemative to elevating to orabove the Base Flood Elevatron; however, a <br />floodpr0ofing design certificetan Is required This form is to be used for that certification. F/oodproofing of a residential budding does not alter a <br />commundy s floodplain management elevation requirements or affect the insurance rating unless the community has been Issued an exception by <br />FEMA to allow floodproofed residential basements The permitting of a floodproofed n:sidential basement requires a separate certification specifying <br />that the design complies write the local floodplain management oriinance. <br />I / FOR INSURANCE COMPANY USE <br />M • r POLICY NUMBER <br />Ss ?Z /Cyak/ni gtwy- <br />RESS (Incl Unit Suite, and/or Bldg. NumberpR PP..O. 1 UTE A BOX NUMBER <br />,r . Z COMPANY NAIC NUMBER <br />RIPTIONand Numbers. etc) • <br />v - 4i ova, �,4 VA 96 7 <br />-7 �C `00 S 1 b � STATE ZIP CODE <br />U SECTION I FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br />Provide the following from the proper FIRM: <br />COMMUNITY NUMBER <br />PANEL NUMBER <br />D / . / <br />SUFFIX <br />DATE OF FIRM INOEX <br />/ i / <br />FIRM ZONE <br />J 4 i5 <br />BASE FLOOD ELEVATION <br />(In AO ones ) <br />' 1 <br />SECTION 11 FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) <br />Floodproofing Design Elevation Information: <br />Building is floodproofed to an elevation of .....o. •:.. ............ feet NGVD. (Elevation datum used must be the same as that on the FIRM.) <br />Height of floodproofing on the building above the lowest adjacent grade Is ........-7.:..-S .............. feet <br />(NOTE for insurance rating p urposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to <br />reoei(e rating credit ff the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result in a higher <br />Premium.) <br />SECTION III CERTIFICATION (By Registered Professional Engineer or Architect) <br />Non -Residential Floodproofed Construction Certification: <br />l certify that based upon development and(orreview of structural design, specifications, and plans for construction, the design and methods of <br />construction are in accordance IMM accepted standards of practice for meeting the folloWng, provisions: <br />The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with <br />walls that are substantially impermeable to the passage of water. <br />All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and <br />anticipated debris impact forces. <br />I certity that the information on this certificate represents my best efforts to Interpret the data available. I understand that any false statement <br />maybe punishable by fine orirriprisonment under 18 U.S. Code, Section 1001. <br />CERTIFIER'S NAME LICENSE NUMBER (Or Anbc seal) <br />KRIS To r-1,ysoA/ //0/67-5 <br />ITLE COMPANY NAME <br />,VX1AJG/PAC. 6,=DS E•ylr�iyEEieS <br />AGGRESS CITY STATE ZIP CODE <br />(05 -/Z9/ p 57-1 203 94rrOW44 y/ (7�If 3 <br />SIGNATURE DATE PHONE <br />08-2.q-01 $O$ - 8(7-6 ZSO <br />Copies should be made of this Certificate for. 1) community official, 2) Insurance agentloompany, and 3) building owner. <br />FEMA Form 81-65, AUG 99 Replaces all previous editions F-056 (8/99) <br />