HomeMy WebLinkAbout6-9-005:002 Main BldgU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-8.
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Building Street Address (Including Apt, Unit, Suite, angg�or Bldg. No.) or P.O. Rot
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9743
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A4. Building Use (e.g.. Residential Non -Residential, Addition, Accessory, etc.) R�n S / P 6N riA.[.
AS. LatitudeCongitu le: Let - / P '02-71'W tong. -1Su�" ' DD• ' -- H
Attach at least 2 r °�+tel'oae„t.;:, :-. uen:lo�-un �o
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A8. A
photographs of the bullding h the CertlHeate Is being used to obtain flood Insurance. — pr _� ._�
AT. Building Diagram Number -.g
A8. For a building with a Cf VM apace orondoeure(e), provide: Fara aiaiki g wiot an attached garage, provide:
' a) Square footage of craM space r encloeure(a) -— aq N garage so 3
a)._ Square footage o! electees
---.27!_-Ng.pt.pumanentfrood openings in the aawi space or b) No. of permanent ROW openings In the attached garage
-,:- •--erxbatue(e)-we9s wllhlrt-1.0 root above adjacent grade wags within 1.0 toot above adjaoart grade
c) Total net Brea of flood openings In AS.b sq In C) Tote) not area of flood openings In'A9.b eq in
G_ _TJ.1j
I /S6'/66 -0276 G N. 14G V WIN] ISN,, O®1e
B4. MaWanel Number
�.�i /ice 021
W. Sufl k
1)v Olt
N. FIRM Index
DebEBxtivelRevbed
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ST. FIRM Panel
Data
-/40-90
88. Fbod
Zone( e
V�L
88. Base Flood ElevWlmX*) (Zone
AO. sae base flood depth)
R.p 0=00r
0511). Inmate ate source or the ease Flood Elevation (BFE) data or base food depth entered In Rem B9.
❑ FIS Profile FIRM ❑ Community Dotemdned ❑ Other (Desame)
B11. IndMate elevation datum used for BFE in Item B9: Of NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
612. b ane betiding located in a Coastal Baxter Resources System (CSRS) area Date ❑ or arise Protected Area (OPA)7 [3 Yes No
Designation DaCBRS A .
SECTION C - BUILDING ELEVATION INFORMATION SURVEY REQUIRED
C1. Building elevations we based on: ❑ConsWctionDrawings- ❑BuldlgUnder ConstruedW FinisheclConsWction
-A new Elevation Certificate will be required when construction of the building Is complete. .
C2. EwvaBone - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30. V (whh BFE). AR, ARIA. ARAE. AR/AI-M ARIAH, ARIAO. Complete hems Clay
below according to the buk-2v diagramsoed�e in Item A7./�e
Benchmark utilized RAI —.day FI
�m NiVP— BM Yorke!Daluri MS V
carwwsw vcomments
Check the measixemem used.
a) Top of bottom Noor (Including basement, crawl space. or enckisnae Boor) �' Mot 13motors(Puerto Rkw only)
b) Top of the next higher floor ON 0 5 "A.V Ba Oda. ,_❑ fast ❑ meters (Puerto Rico only)
c) Bottom of the knreot hodaoMal structural member (V Zones only) t' feet ❑ meters (Puerto Rico only)
d) Attached garage (top of slab) Alp A/ d ❑ ❑ meters (Puerto Rico only)
e) Lowest etevsticrn cf mad*mryor egtdp..km servicing the bunding > ❑ meteira (Puerto Rlco only)
(Describe type of equipment in Comments) ... .
0 Lowest adjacent (Qrdahed) glade (LAG) ---- 7. add uretero (Puerto Rico only)
9) Hiptieot adjeceru (finished) grade (HAG) - _Z,. ...feel 8 meters (Puerto Rim only)
D- SURVEYOR, ENGINEER. OR
-yww m,a seauto Dy a ram surveyor, engineer, or arcrdtaa authoemed by law to Certify elevation
Information. I crani* that me Informadon on IN$ CorWcate represents my best efforts to hit” I ie dare available
II understand that any Ia/se statement maybe punklimble by One or hnpdsonment under 181L3 Code, Secflorr 1001.
LTJ Check here if comments are Provided on back of form.
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Signaler
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FEMA Form 81-31, February 2006
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9 5arev6y
AIA State
See reverse side
.. r..:... ....
4968
all previous editions
In
City
or
MW
Insurance Company Use:
ac�I Ivn U • AUKVt:yOR ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Ropy both sides of this Elevation Certificate for (1) community official, (2) Insurance egenVcompany, and (3) building owner.
Comments.. RL'FR 14 ' h rB,* 70 R .
&HAA -eh 04aG 1.5 ,q Gy15sr,Uovsao.v /--P s Plotz.
Signature05 _ Date D
.. .__._ .. .. ._ _._ .. _.. ..
1.
❑ check here If attachments
SECTION E BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRE FOR ZONE AO AND ZONE A (WITHOUT BFEI
Fer Zones AO and A (without BFE), complete Items E1 -E6. If the CerBflcate Is Intended to Support a LOMA or LOMR-F request, complete Sections A, 8,
un.1 r. Fnr aero• Ft.Ft „•• w•....eh•.-. :r _..:,_>:,, .-i__r. • _ �;r�wnuiciw uiuy: nuinr mnlnra.
EI_.P.wAda_elevation.(nfomtatlonixthe.following.and..check the appropriate boxes to -show whether the elevation Is above or below the highest adjacent
grade (HAG) a owesi 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 _. _ feet ❑ meters ❑ above or below the LAG.
E2. For Building Diagrams e-9 with permanent flood,openings provided Irt SeCtIMA Items 8@�Mr 9 (see ggga 8 of Instructions), the next higher floor
(elevation C2.b In the diagrams) of ft building Is 0 toot U meters („J above or LJ below the HAG.
E3. Attached garage (top of slab) Is . _ ❑ feel ❑ metes ❑ above or ❑ below the HAG.
E4.: •Top of platform of machinery and/or equipment servicing the building IS _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E8. 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? ❑ Yea ❑ No ❑ Unknown. The local official must certify this Information In Section G.
-PROPERTY
The property owner or owner's authorized representative who completes Sections A. B, and E for Zone A (wllhout a FEMA -Issued or community -issued BFE)
Or Zone AO must sign here. The statements /n Sedffoas A, A and E are correct to Ne beef of my browbdge.
al
and G of tics Elevation Cer9ficate. Com ate tire -..-- •- ......_..a•y
pl applicable--.fiem(sw).anti..- dgna:,belo,,w,w.
used In fMms G8. and
G1. ❑ The Information in SeWon C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
Is authorized bylaw to oeNfy elevation Information. (Indicate the source and data of the etevatlon dab In the Comments area below.)
G2. ❑ A community official completed Section E for a building located In Zone A (withoida FEM44Nwed or community -Issued BFE) or Zone AO.
G3. ❑ The following Information (Items G4.49.) Is provided for community floodpill fleanapNtront pteptsm.
G4. Permfi Number GS. Data Permit Issued Gil. Dab Certificate Of Complianpe/Ocaupancy Issued
G7. This permit has been Issued for. ❑ New Construction ❑ Substantial Improvemerd
G8. Elevation of as -bush lowest floor pnduding basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building she: ❑ bet ❑ meters (PR) Datum
Local Umdel a Namef" gi*crh"W Of wofft Title
Community Ndme • �rvttg Ota di PS W@ Telephone
vale
Replaces all previosr�;