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O.M.B. NO. 3067-0077
<br />ELEVATION CERTIFICATE ExpiresMc73t,t996..•,..
<br />FEDERAL EMERGENCY MANAGEMENT AGENCY
<br />NATIONAL FLOOD INSURANCE PROGRAM a
<br />ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form Is used only to4o,•'r'
<br />ide elevation information necessary to ensure compliance with applicable community floodplain management ordinerices, tq 1i
<br />imine the proper Insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMRIP
<br />Instructions for completing this form can be. found on the following pages. 't-
<br />SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
<br />BUILDING OWNER'S NAME POLICY NUMBER
<br />SutJS-Co�� LTy P�r�tt� R,S L-c_C-
<br />STREET ADDRESS (Including Apt., Unit, Suite and/or BldN umber) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIL NUMBER
<br />(r•Eo t� l_ -Pr U LSA S -T �2t-Z�'T . .. . _
<br />OTHER DESCRIPTION (Lot and Block Numbyyrs, etc.)
<br />CITY ��STATE' ZiP CODE
<br />SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />Provide the following from the proper FIRM (See Instructions); -
<br />i. COMMUNITY NUMBER
<br />2. PANEL NUMBER
<br />3. SUFFIX .,
<br />4. DATE,QF FIRM INDEX
<br />"!l
<br />5. FIRM ZONE
<br />6. BASE FLOOD ELEVATION
<br />lin AO Zones, use depth)
<br />© 990
<br />�f)C � t�,l��
<br />.4�
<br />7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): XNGVD'29 ❑Other (describe on back)'
<br />S. For Zones A or V, where no SFE is provided on the FIRM, and the community has established a BFE for this building site, indicate
<br />the community's BFE: 1 Li j.0 feet NGVD (or other FIRM datum—see Section B, Item 7),
<br />SECTION -C, BuiLDING ELEVATION. INFORMATION
<br />1. Using the Elevation Certificate Instructions, indicate.the diagram num4ef ft•om the`diagrams found on Pages 5 and 6 that best
<br />cribes the subject building's reference level �. .
<br />FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation.
<br />of L1�1.1S feet NGVD (or other FIRM datum—see Section B, -Item 7),
<br />(b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
<br />the selected diagram, is at an elevation of t i i l I.0 feet NGVD (or other,FIRM,datum—see Section B, Item 7):
<br />(c). FiRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I I LH feet above ❑ or
<br />below ❑ (check one) the highest grade adjacent to the building,
<br />(d). FiRM Zone AO. The floor used as the reference level from the selected diagram is L1J.0 feet above ❑ or below ❑ (check
<br />one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
<br />level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown,
<br />3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD'29 ❑ Other (describe.,..
<br />under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
<br />the FIRM [see Section B, Item 7], then convert the elevalions to the datum system used on the FIRM and show the conversion t
<br />equation under Comments on Page 2.)I
<br />1. Elevation reference mark used appears on FIRM: ElYes Uf No (See Instructions on Page 4) '
<br />The reference level elevation is'based on: V actual construction ❑ construction drawings
<br />(NOTE: Use of construction drawings is only valid it the building does not yet have the reference level floor in place, In which
<br />case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate i
<br />will be required once construction is complete,) ����,,,,��rr
<br />The elevation of the lowest grade immediately adjacent to the building is: U).0 feet NGVD (or other FIRM datum -see
<br />Section B, item 7).
<br />SECTION D COMMUNITY. INFORMATION `i
<br />community official responsible for verifying building elevations specifies that the reference level indicated in Section C, item 1 t..'
<br />t the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
<br />floor" as defined by the ordinance is: 1111 l l IJ feet NGVD (or other FiRM datum -see Section B, Item 7).
<br />:)ate of the start of construction or substantial improvement
<br />EMA Form 81 .31, MAY 93 REPLACES AU. PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUAMON
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