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. 2003 08:39 8089697842 BRILHANTE HI PAGE 02
<br /> • r -2ee3 01 :40 PM PAUL-IH4MURRAY 8089590355 P. 02
<br /> J FEDERAL EMERGENCY MANAGEMENT AGENCY
<br /> NATIONAL FLOOD INSURANCE PROGRAM 0.M•B• No, 3067-0077
<br /> ELEVATION CERTIFICATE Expires July 31,2002
<br /> Im ortant: Read the instructions on a
<br /> SECTION A•PROPERTY OWNER INFORMATION For Inauranae ber y
<br /> btAlLAll�I�i o R'S NAME Compsn Use:
<br /> ----- �. --.-SAM,.. t ti L}`�JAar1Tq» Policy NUm
<br /> aoLD!NG STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg•No,)OR P,O.ROUTE AND BOX N0.
<br /> CITY a 1 .4 A,I C:;), M""LAGt.' nY NAIC Number •
<br /> Lp STATE ZIP CODE
<br /> FR07 RTV DESCRIPTION(Lot and Stock Numbers,Tax Parcel Number,Legal Description etc.) A��1 l
<br /> `_° cS - -1 b si 1 2 ' ' _C-79 015
<br /> BUILDING - RA,.Residential, `on-residenbat, •.t on,Accessory,etc. Coffman 3 section it necessary.)
<br /> zg:- s t Oli 'T-litf._ -- N V4•1_ p ,)E.L.I.-.
<br /> iATi i UDE/LONG(TUDE 1OP11 NAL) HORIZO AL DATUM: SOURCE: 1 GPS(Type)
<br /> ( ••efr-NN,w Or 1/6.N altW) U NAD 1927 U HAD 1083 LI USGS Quad Map --1_71----7---
<br /> ....,.
<br /> SECTION Et•FLOOD INSURANCE RATE MAPFIRM INFORMATION
<br /> , El. COMMUNITY NAME I COMittUNfTY NUMBER 82.COUNTY NAME B3.STATE _
<br /> 64:MAP AND PANCL B6, U FIX Be.FIRM INDEX 97,FIRM PANEL ,FLOOD BB, FLOOD AI N(S)
<br /> ! 6� • TE EFFECTI R.VISED DATE ZONE(S) (Zone AO,use depth of flooding)
<br /> G 02 9g q ib t8 4. I
<br /> ", ; .icate the source of they Base Flood Elevation(BFE)data or base flood depth entered 1n H6,
<br /> L_1 F15 Profile I•'r FIRM 11 Community Dglermined 11 Other(Describe):
<br /> 811, Indicate the elevation datum used for the BEE In 89:[fNQVD 1929 11 NAVD 1986 II Other(Describe):
<br /> 2. is the building located In apoestal Barrier Resources System(CBRS)area or Otherwise Protected Ares(OPA)7 1J Yes Lid No
<br /> Designation Date: kVA
<br /> SECTION C•BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
<br /> C'.Building elevations are based on: L--IConatruclion Drawings* LIBulIding Under Conetructian• Finished Construction
<br /> 'A new Elevation Certificate will be required when construction of the building Is complete,
<br /> C;2.evllding Diagram Number 5 (Select the building diagram most similar to the building for which this certificate is being completed-see
<br /> pages S find 7. if no diagram accurately represents the building,provide a sketch or photograph.) •
<br /> C3.Elevations-Zones Al A30,AE,AH.A(with SFE), VE,V1•V13O, V(with BFE),AR,AR/A,ARAE,ARIAM-A30,AR/AH,AR/AO
<br /> Co-epiete Items 03e-I below according to the building diagram specified In Item C2.State the datum used,If the datum Is different from
<br /> ,:-,?..c,-,;1..;,7.-.. used for the BFE in Section 8,convert the Boum to that used for the BFE.Show field measurements and datum conversion
<br /> calculation. Use the space provided or the Comments area of Section 0 or Section 0,as appropriate,to document the datum conversion.
<br /> Datum___-•___-,- Conversion/Comments
<br /> Elevation reference mark used 1re'. I. M014 �...._Does the elevation reference mark used appear on the FIRM? LI Yes 1 j No
<br /> 1? s)Top of bottom floor(Including basement or enclosure) '9•.941 .L.ft(m) 7f
<br /> Top of next higher floor _._ft(m) h `)� H. A4/./A,R 1?.0743
<br /> : 7-; Sot=of lowest horizontal structural member(V zones only) _11(m) 1 qP q
<br /> At.
<br /> Attached*age(top of slab) .�-ff'(m') .1LICENSED
<br /> • PROFESSIONAL �
<br /> e) Lowest elevation of machinery and/or equipment 8 * LAND SURVEYOR #I
<br /> servicing the building en(m) f
<br /> 17.1 `},Lowest adjacent grade(LAG) ' '—� .1......11(m) No.LS-7589
<br /> ilii
<br /> 3, Highest adjacent grade(HAG) 11-.$q 4.ff,(m) r
<br /> ^_ '-," Rb.of permanent openings (flood vents)within 1 n,above adj amt grade,1,j'l.A, 441144 N tJ 5' p
<br /> O �)Total area of all permanent openings(flood vents)in C3h I4sq.In,(sq.cm) G ,c-----.6
<br /> SECTION 0•SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
<br /> This certification is to be signed and sealed by a lend surveyor,engineer, or architect authorized by law to certify elevation information.
<br /> I cnrllfy that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the date available.
<br /> jrce .'and that an false statement me be •unl hable b fine orirn•risonmenf under 18 U.S.Code Section 1001,
<br /> `° !BR'S NAME .r-
<br /> ' ' ANY NAMF
<br /> L-LC.1, pjt rIZS3tok1�L, L-41D dUrtVrsyoK, , -avL 6 . iIrzpAlf' IP. Assala-its , LL...C,,,
<br /> AMR-SS 1%e
<br /> ibezncCITY ILO) tl
<br /> STATE .� ) 31P COPE Cl�^f 1,118.1
<br /> '� �� r �"�r-«--^ -
<br /> ., DATE -o,7 142176
<br /> YELEPHO - act 959•g.99 5 ..
<br /> :. -1= A!Ir.PO -CFF RF'lfF cF Rir1F Fr1f7 r:r1NTINi IATIr1N PDI AC. AI I PP Vlrll Is Rr1ITIr1NF
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