The URL can be used to link to this page

Home My WebLink About2-1-018:005 & 036 O.m B NO. 3067.0077 ELEVATION CERTIFICAI E Epiresmay 31, 1996 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This;torm is used only to provide elevation information necessary to ensure compliance with applicable.community floodplain management ordinances,to ,ermine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER GL.kLi V 1 A. CZb1-1 re, 5ca11- „44,3171ZwW5 STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 4 4:4J,✓ STKfr e_r 14 Leo , 141 76 7 2.0 OTHER DESCRIPTION(Lot and Block Numbers,etc.) 1<- '1 P 2. 1 -0 1 f5 : 5 Te 'G LtYr 3d"—A t HlA FRRaC. Resro>;IJCt LoTS SOUTi-1 NICO) I.144 011 CITY STATE ` ZIP CODE �(,7ZQ Ejt(.d • SECTION B FLOOD INSURANCE RATE MAP(FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4,DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION 1 S S l G G o e a S . e• 3//‘ /a 7 »� fin AO Zones.use depth) 1�j 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): NGVD'29 Li Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: I I I I.LJ feet NGVD(or other FIRM datum—see Section B, Item 7)• SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level_r`. a). 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 of I I I I 114.1.'G1 feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1-V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from • the selected diagram, is at an elevation of I I I I I I.LJ feet NGVD (or other FIRM datum see Section B, Item 7). (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is I I I.LI feet above Eli or below❑ (check one) the highest grade adjacent to the building. • (d).FIRM Zone AO. The floor used as the reference level from the selected diagram is LU .0 feet above❑ or below❑(check one)the highest grade adjacent to the building. If no flood depth number is available,is the building's lowest floor(reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ( i Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations:2I NGVD'29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM [see Section B, Item 7), then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) �-,( 4.Elevation reference mark used appears on FIM: ❑ Yes U No (See Instructions on Page 4) •• 5.The reference level elevation is based on: LJ actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid it the building does not yet have the reference level floor in place, in which • case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate• • will be required once construction is complete.) 6.The elevation of the lowest grade immediately adjacent to the building is:I I I : 01.0 feet NGVD (or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: I I I I I I.0 feet NGVD(or other FIRM datum—see Section B, Item 7). 2.Date of the start of construction or substantial improvement FEMA Form 81.31,MAY 93 REPLACES All PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION • SECTION E CERTIFICATION Tt 2- 1 -a 1 I ; Obs 'o3b v This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones A1-A30,AE,AH,A(with BFE),V1-V30,VE, and V(wit .BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a building official, a property owner,or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8- Distinguishing Features-If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) ' 'PAuL. H. 1,.1u)zxt-A/ VS - 15 .229 TITLE COMPANY NAME 1ZEGI 5TH'-GU SU1Z11volZ 1.45g...7.-AY( 51.1714 lz A5SOGisvci ), t,-Tp ADDRESS 63 CITY 14)Lc STATE x` ZIP ?.D. 130 SIGNATURE a e.4„ .',...Y,, DATE. 'r" C7/ /O -p p PHONE 9.35- q 7 15- Copies 5+Copies should be made of this Certificate for: 1)community official,2) insurance agent/company,and 3) building owner. Tho Dopartmcnt of Peblk Works COMMENTS: Engineering Division has reviewed the levation Certificate and recommends 0 does not recommend - final approval By_______ Date VP/it*6. ' - '''. ---- 4.;:il ON WITH ON PILES, SLAB BASEMENT PIERS,OR COLUMNS A V A ZONES ZONES II1 ZONES ZONES ZONES LT REFERENCE "/1' .-. 11,. 1 LEVEL I� M REFERENCE Ill BASE LEVEL REFERENCE • LEVEL I'1 'II FLOOD ►�I ELEVATON BASE BASE ... REFERENCE FLOOD FLOOD ADJACENT : LEVEL 1 ELEVATION GRADE ELEVATION REFERENCE ADJACENT LEVEL GRADE ti 1, Q • ::i�i> m 11 GRADE The diagrams above illustrate-the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. • Page 2