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• IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number City State ZIP Code Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED) ropy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments.. Ofl,../Cid l&,fie f? T® H ov,4 I2& 15 Gv a s r oi©U.s a eP v Pas r Signature e^ Date D � /e/r... D ❑ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRE )FOR ZONE AO AND ZONE A(WITHOUT BFE) 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. ..6.4 C. F''r itTrns�i_�I. ��ee n •.> _ ... - _. . _. .__.. _ _. _--'°-.._._.-a: , :.;-,y::,�,;,,,. -�..c......-w-... aub��.cr,[uac... .lrrucliu lGl)U UIIly.611CCf fCIeCBrS. EL__.__Pro_vide_eleeation.information_for_the.following.and check the appropriate boxes to show whether the elevation is above or below the highest adjacent dike(HAG)and i a lowest 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 . 0 feet 0 meters 0 above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood,openings provided in Sectio A Items 8 and/or 9(see age 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ._0 feet meters ❑above or LI below the HAG. E3. Attached garage(top of slab)is ❑feet❑meters ❑above or 0 below the HAG. E4.1 Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters ❑above or ci 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? 0 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 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 cress City State ZIP Code Signature Date Telephone Comments ' •LJ Check here if attachments SECTION G-COMMUNITY INFORMATJON(OPTIONAL) The 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), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. 01. ❑ 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.) G2. 0 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. 0 The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. pate Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for. ❑ New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: 0 feet 0 meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: 0 feet 0 meters(PR) Datum Local Official's Namejc Dapartmenf of pubes wow Title Community Name .epgineering Division hos revieVred Telephone Signature Date t..l rec mm-_ ds Comments f d -s no, recommend final a•prp atAmosia a ❑Check here"if attachrnenti =EMA Form 81-31,r rig - - •41. Replaces all previo. ns •