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ELEVATION CERTIFICATE, page 2
<br />IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSuRANCE COMPANY USE
<br />Bu, Wg MOW AVress (Mends g Apn Unk, Sw moor By No i of r G Rome and Box No Policy Number
<br />Cis, H53:aceHl ZIP Code 9vw Company NAE Number
<br />SECTION 1) - SURVEYOR, ENTNEER. OR ARCHITECT CERTIFICATION (CONTINUED)
<br />E-c.Lsen sts-a
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<br />r; CZ -S; This ele atop is te _mom AW7 ning area for we w -Life. The uppe.�flnor I;vng area: i 77.8 feet
<br />qw CId EKwAn lE fir oxen car orf KA 23 square W "closed swinge rovi ash no fund aas,Lgs
<br />Or Qn. Alneo dyer and nawr heawr am wwo an boom tax %-g ana
<br />SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (W17ROUT BFE)
<br />FxZMWAOMa A mol out BFj,wwpwe itmoll'-E& K do CCmPlor-SACtio.-is A, 6
<br />C ;. Qws E, , we raws grace.'; We nswj,weilt und In PuE.:',c Kcfily, enterinakr:s
<br />pavae hvmmn wt0w01- 100 00�0 wz Ann Ye mwa es tc shvvy vzow he a%smr to a0we M cVcn the h1nev ajwwrl
<br />are, .t !0':'Vast ad;acenz' grar-e
<br />170* &bxw 50w:T1Udwg base m,T cvw*P7'-e 7' j NO D mWw', ��: nove orMe HAG
<br />c � Tc2� c- ;z;:,-, r �,: rm, tog baseme, � a," a.., once 0,enf,s,,., Dfeet E.rnetzex- '-1abo;eorL] loe�c'.,vtneLAG
<br />F2 =w BL40g Diagrams 6-9 0.0 pe, valew face 1penrgs powsi ri SevmnA 1terrs Paq�-�30 of AWNnUnn Mean Nperfkor
<br />Te bWW9 s feet D rlete!s C1 2X0.2 Gr Ej HAG
<br />E3 KwNec garage imp ofslab) k Wel Onvini Elanoveor []beAvMeHAG.
<br />F" -Cp C4 piv"'orr.) of mww"q a", equy"a" soww& the LOW M 11 to 13 memo Q alow or F7 nelay; We HAG
<br />EE ZweASGry
<br />cranuce? -,yes :, No rl Wwriow
<br />SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE, CERTIFICATION
<br />-'- sty cwrer or ,wer S a"Sn" "Pes"Ove Am mmwwn SeT ws A 6 wA E fu Zone A Whoit, a FDIA-rssoea rr comr-kin�1ty.,5sueo BFE;
<br />a Zwe AO mum &OWer, Toe irmternens ii Sams A, s, so L wo ad m oe wE "I, Evowledge.
<br />'�"'Op5ly 3'.ne a, O'.'ne. s �Utrior.zed Na r rev G Jac.-'-sc
<br />ZIP We 91078
<br />�:%'ass
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<br />ss., 6 20 L 14"wne W01005-
<br />sg -wr" - -
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<br />Check here if attachments
<br />SECTION G ~ COMMUNITY INFORMATION (OPTIONAL)
<br />Tw ywc Piet_ SwWonsh, 8 Cxrw sAG
<br />W"Is.wMck"w", w arts,rcynn Zrw
<br />G. ire I. Senor 0::.a5 *Her Qvn cza uonow w -i — naw been s1reo Pic simej by a fw.sw o""on engineer or archism wk�
<br />z au= .,,•,,._! by ow m cam! aln" wkwa" Ow*00 me m.n am UWT 4 Me "OOVw Cal w 1W (Am"ems area below)
<br />G.'_. ')'*,','t',:_;_C,7,-",!eled F Q a by An 0=41 w lain A ! Qw: a FEUXAs,ed or cwnmun4r *Sued BFE) or Zone AD
<br />Ir The T&ONQ is Prov da, f- f PW003es
<br />.7 Dawni
<br />0 ZEE or w ZwP AM d,K
<br />frac� meters (Dtun)
<br />Gil CX, mm y S dwq; 7=0 eavador,
<br />mate's LD:urn
<br />L=n Wows Nwy� -------
<br />&Fwori Date
<br />0
<br />Co3 - j'T''2')
<br />RepAces all previous edws.
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