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Home My Public Portal AboutTwelfth St_8-ADEC., -24' C6 (TUE) I0:47 J. Will? REYNOLDS TEL:912 7787 ELEVATION CERTIFICATE FEDERAL EMERGENCY MA- NATIONAL FLOOD INSUF ATTENTION: Use of this certificate does not provide a waiver of the flood vide elevation information necessary to ensure compliance with applicable the proper insurance premium rate, and/or to support a request far a Latta required to respond to this collection of information unless a valid OMB co Inetnutions for completing this form can SECTION A PROPERTY INFORMATION BUIL NG OWNER'S NAME P. 01 O.M.B. No, 3067 -0077 .� _. F. nit',es..}u.(.0 l 1999 _ Posit- -]it• Fax Note 7671 Date1 / 4 puos�, 3 �'T/ To chi J chi From i �% " w �� olDemil Co. Phone # Phone E Fax tI Fax 0 STREET A )DRESS (Including Apt., Unit, Suite dfor Bldg. Number) OR RO. ROUTE AND BOX NUMBER F-,4 7il 'T OTH DESCRIPTION (Lot and BIG . Numbers, etc.) CITY 1 COMPANY NAIL NUMBER STATE sj,g25, SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER /35763 2. PANEL NUMBER 2 9. SUFFIX c 4, DATE OF FIRM INDEX 6//7 , S. FIRM ZONE A 6. BASE FLOOD ELEVATION (In AO nes use depth) 7. Indicate he elevation datum system used on the FIRM for Base Flood Elevations (BFE): ❑NGVD '29 ❑ Other (describe on back) 6. For ton : s A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the com unity's BFE: 1 I 1 f 1 I LJ feet NGVD (or other FIRM datum —see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1, Using th Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describe the subject building's reference level 2(a). FIRM ' ones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of l I I [1341 feet NGVD (or other FIRM datum —see Section 8, Item 7). (b). FIRM ' ones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the se acted diagram, is at an elevation of 11 I I 1 I LJ feet NGVD (or other FIRM datum —see Section 8, Item 7). (c), FIRM ' one A (without BFE). The floor used as the reference level from the selected diagram Is J f I L feet above ❑ or below ■ (check one) the highest grade adjacent to the building. (d). FIRM . one AO. The floor used as the reference level from the selected diagram is L 1 1 LL feet above ❑ or below ❑ (check one) th = highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) _ evated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate t e elevation datum system used In determining the above reference level elevations: ❑ NGVD '29 ❑ Other (describe under Co ments on Page 2). (NOTE: if the elevation datum used In measuring the elevations is different than that used on the FIR [see Section 6, Item 71, then convert the elevations to the datum system used on the FIRM and show the conversion equation nder Comments on Page 2.) 4. Elevation eference mark used appears an FIRM: [] Yes JNo (See Instructions on Page 4) 5. The refer (NOTE: case this c will be req ce level elevation is based on: U actual construction ❑ construction drawings e of construction drawings is only valid If the building does not yet have the reference level floor in place, in which rtiticate will only be valid for the building during the course of construction. A post- construction Elevation Certificate red once construction is complete.) 6. The elevat •n of the lowest grade immediately adjacent to the building is: L ( I Section 9, tem 7). LLJ feet NGVD (or other FIRM datum -see SECTION D COMMUNITY INFORMATION 1. If the com unity official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "I west floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as de ined by the ordinance is: 1 1 1 1 1 1 U feet NGVD (or other FIRM datum —see Section 8, Item 7). 2. Date of the tart of construction or substantial improvement FEMA Form 1-31, AUG 96 REPLACES ALL PREVIOUS EDMCNS SEE REVERSE SIDE FOR CONIINUAT)ON DEC .'d '9; iGt:r; DES :, -24' 6(TUE) 10:48 J. WHIT REYNOLDS TEL:912 3 7787 SECTION E CERTIFICATION P. 02 This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation info =tion when the elevation information for Zones A1—A30, AE, AH. A (with BFE),V1— V30,VE, and V (with BFE) is required. Com unity officials who are authorized by local law or ordinance to provide floodptain management information, may also sign the certtft•atton. to 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. Refer -nce level diagrams 6. 7 and 8 - Distinguishing Features --If the certifier is unable to certify to breakaway /non - breakaway wall, enclo re 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 ecru/ that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I unde .-rand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIfTI R'S TITLE ADD • LICENSE Num (or A4Zt S I) COMPANY NAME 1417411 SIGNAT opies 5 PHONLE Via" Z e of t s Certificate for: 1) community official, Z) insurance agent/company, and 3) building owner. COMM NTS:.. ON WRH SLAB BASEMENT A Y A ZONES ZONES 1111 ZONES I, FL..p ELEV TION REfEAtNCE LEVEL AOJACENI GARDE ON PILES, PIERS. OR COLUMNS A ZONES ZONES Is4 e FLOOD ELCVA'ION =ADJACENT:; CNAOE The dagrams 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. Eleve ions for all V Zones should be measured at the bottom of the lowest horizontal structural member, rlFr. d ' SIR Page 2