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Home My Public Portal AboutJones Av_708ELEVATION CF TIFICATF FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL. ROOD INSUj ANCg PRRGfiAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and /or to support a request for a f-etter of Map Amendment or Revision (LOMA or LOMB). Instructions for completing this form can pe fpun 1 . r) jflg 19. Owi ng pages. O.M.B. NO. 3067 -0077 Expires May 31, 1996 SECTION A PROPERTY INFORMATION 81111 D 2 pii ell• STREET ADDRESS (Including pt., Unit, Suite and /or Bldg. Number) OR P.O. ROUTE AND BOX NUMBPR log �� ici- OTIIER ESCRIPTION of and Bloc tubers, Ic.) Z-0-7— 6 gg- 412-o_ -Tic.g65 CITY — 4L4) F SECTION 1H FLOOD INSURANCE RATF MAP (FfRM) INF °RMATION FOR INSURANCE COMPANY USE POLICY NUMBER COMPANY NAIC NUMBER 65*1 1/4 11T2',EN Provide the following from the proper FIRM (See Instructions): 1 COMMUNITY NUMBER / 2 PANEL NUMBER / 3. SUFFIX C 4 DATE OF FIRM `� IN EX 6 h l (p _ 5. F M ?ONE 8 6. BASE FLOOD ELEVATION (In AO Zone'sJuse depth) 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFF): 1�NGyp'29 ❑Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a pFE for this Wilding site, indicate the community's BFE:1 1 .1 1 1 .1.1.1 feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicatq the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level __. ._. . 2(a). FIRM Zoneis /A1 -A30, AE, Ali, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I 1 _ 1 .1/ 1L 1. Cleet NGVD (or other FIRM datum -see Section B, 'tern 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 1 1 1 1 1.1 1 feet NGVD (or other FIRM daturn -see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is L. 1 _J.L1 feet above L_1 or below 1__.1 (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 LLJ.LJ feet above ❑ or below [.1 (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 ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: ❑ NGVD 29 Ll 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 7J, 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 FIRM: 1_1 Yes L-1 No (See Instructions on Page 4) 5. The reference level elevation is based on: ------a--c"tual construction 1 ] construction drawings (NOTE: Use of construction drawings is only valid if 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. I Post- construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is • L 1 Li 171 Section B, Item 7). feet NGVD (or other FIRM datum see 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: l _1 1__1 _ 1..1.1 1 feet NGVD (or other FIRM datum -see Section 13, Item 7). 2. Date of the start of construction or substantial improvement LMA Form 81 -31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevatiu, . information when the elevation information for Zones A1—A30, AE, AN, A (with BFE),V1— V30,VE, and V (with 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 Comrnents below. The diagram number, Section C, Item 1, must still be entered. 1 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. CERT FIEn' E TW LICENSE NUMBED �r2ilix e TITLE COMPANY NAME L� Aftwu!t1 fia /q4- 411ls-£'erf ate for: 1) community official, 2) Insurance agent /company, and 3) building owner. ON SLAB A ZONES V ZONES BASE FLOOD ELEVATION ADJACENT GRADE WITH BASEMENT A ZONES BASE FLOOD ELEVATION ADJACENT GRADE REFERENCE LEVEL IREFERENCE LEVEL ON PILES, PIERS, OR COLUMNS A V ZONES ZONES BASE FLOOD ELEVATION ADJACENT: 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 lop of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2