HomeMy WebLinkAbout7-5-005:012FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
FLOODPROOFING CERTIFICATE
FOR NON-RESIDENTIAL STRUCTURES
O.M.B. NO. 3067-0077
Expires July 31, 2002
The floodproofing ofnan residential bur7dings maybe permrited as an aRemative to elevating to orabove the Base Flood Elevatron; however, a
floodpr0ofing design certificetan Is required This form is to be used for that certification. F/oodproofing of a residential budding does not alter a
commundy s floodplain management elevation requirements or affect the insurance rating unless the community has been Issued an exception by
FEMA to allow floodproofed residential basements The permitting of a floodproofed n:sidential basement requires a separate certification specifying
that the design complies write the local floodplain management oriinance.
I / FOR INSURANCE COMPANY USE
M • r POLICY NUMBER
Ss ?Z /Cyak/ni gtwy-
RESS (Incl Unit Suite, and/or Bldg. NumberpR PP..O. 1 UTE A BOX NUMBER
,r . Z COMPANY NAIC NUMBER
RIPTIONand Numbers. etc) •
v - 4i ova, �,4 VA 96 7
-7 �C `00 S 1 b � STATE ZIP CODE
U SECTION I FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM:
COMMUNITY NUMBER
PANEL NUMBER
D / . /
SUFFIX
DATE OF FIRM INOEX
/ i /
FIRM ZONE
J 4 i5
BASE FLOOD ELEVATION
(In AO ones )
' 1
SECTION 11 FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect)
Floodproofing Design Elevation Information:
Building is floodproofed to an elevation of .....o. •:.. ............ feet NGVD. (Elevation datum used must be the same as that on the FIRM.)
Height of floodproofing on the building above the lowest adjacent grade Is ........-7.:..-S .............. feet
(NOTE for insurance rating p urposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to
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
Premium.)
SECTION III CERTIFICATION (By Registered Professional Engineer or Architect)
Non -Residential Floodproofed Construction Certification:
l certify that based upon development and(orreview of structural design, specifications, and plans for construction, the design and methods of
construction are in accordance IMM accepted standards of practice for meeting the folloWng, provisions:
The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with
walls that are substantially impermeable to the passage of water.
All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and
anticipated debris impact forces.
I certity that the information on this certificate represents my best efforts to Interpret the data available. I understand that any false statement
maybe punishable by fine orirriprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER (Or Anbc seal)
KRIS To r-1,ysoA/ //0/67-5
ITLE COMPANY NAME
,VX1AJG/PAC. 6,=DS E•ylr�iyEEieS
AGGRESS CITY STATE ZIP CODE
(05 -/Z9/ p 57-1 203 94rrOW44 y/ (7�If 3
SIGNATURE DATE PHONE
08-2.q-01 $O$ - 8(7-6 ZSO
Copies should be made of this Certificate for. 1) community official, 2) Insurance agentloompany, and 3) building owner.
FEMA Form 81-65, AUG 99 Replaces all previous editions F-056 (8/99)