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Home My Public Portal AboutSolomon Av_1405_20110119U.S. DEPARTMENT OF HOMELAND SECURIT Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE important: Read the instructions on pages 1-9. OMB No. 1660 -0008 Expires March 31, 2012 -SECTION A - PROPERTY INFORMATION Al. Buil ng Owner's Name A2. Building Street Addres (including Apt, Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. /4-0-5 ot,dax> ,4�iw� City _ c( (-4114)P° 4 (-4114)P° A3. Property De cription (Lot an Block Numbers Tax Parcel Number Legal Description, etc State Lo-r- i� S4-Nc7rof 427, ��4 56 A4. Building Use (e.g., Residential, Non - Residential, Addifio Accessory, etc.) (�gS /,ai c4' //¢_ • C! 1' -3(0 . U " Horizontal Datum: NAD 1927 [D 1983 to obtain flood insurance. For.lnsyrance Company Use: Policy Number.` Cotnpany :NAiC:Nutimber ZIP Code 3/ 32,8' A5. Latitude /Longitude: Lat. 4. 1 r /'3. L " Long. G )O 1 A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number (O A8. For a building with a crawlspace or enclosure(s): Square footage of crawlspace or enclosure(s) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade Total net area of flood openings in A8.b Engineered flood openings? fl Yes [lo a) b) c) d) • '3 3CCsgft O sq in A9. For a building with an attached garage: a) Square footage of attached garage ,o4 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade Ant c) Total net area of flood openings in A9.b i.J4 sq in d) Engineered flood openings? [] Yes E 1-11 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number - i'ty - Tct »6 / Sc.,a 134"1 cv4-- 82. County Name �4- r7fa4fn 83. Stake / -7t•i, B4. M p/Panel Number 1136q/ Go 2 t 3 B5_ Suffix P 86. FIRM Index Date • q-210-.08 87. FiRM Panel Effective/Revised Date q -sca_o s B8. Flood Zone(s) !/� B9. Base Flood Elevation(s) (Zone AO, use base flood depth) /3 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile IRM f Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in item B9: ❑ NGVD 1929 iRicrAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? D Yes Designation Date 0 CBRS Q OPA [1710 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction* Ijiiinished Construction *A new Elevation Certificate will be required when construction of the building is complete_, 02. Elevations - Zones Ai -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a -h below according to the building diagram specified in Item A7. Use the same datum as the BFE_ Benchmark Utilized 4.. vs 4,�.7 -t eld,L!e- Vertical Datum NOD eS Conversion /Comments a) Top of boftom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor C) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support /�C-EFT the measurement used. 8 _ 4 rE. i t El meters (Puerto Rico only) 7 .`if l�Tfeet Ei meters (Puerto Rico only) 1 iG .4 eel ❑ meters (Puerto Rico only) A!%40 feet 0 meters (Puerto Rico only) / 1 t ❑ meters (Puerto Rico only) . i0 nfeet ❑ meters (Puerto Rico only) meters (Puerto Rico only) ID meters (Puerto Rico only) _ eel es ._L eel SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information 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. neck here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? []' fes ❑ No Certifier's Na e Gies .1.t Tir. tim Addrepo` P3 ce2 Signa ure Licens Number //4 /Svc. -,01,44410 L. £4-i1? 4t. 23q7 Company Name ate D /- 74-/r state ZIP // 324 - Telephone 912 -7 - (c. FEMA Fora(81 -31, Mar 09 See reverse side for continuation. Replaces all previous editions - IMPORTANT: in these spaces, copy the t esponding information from Section A. Building Street Address (including Apt, Unit, Suite, and /or Bldg_ No.) or P.O_ Route and Box No %4-0 S S0(.00 "OA) AniestA4E. - For Insurance Company Use: Policy Number City State ZIP Code Company NAtC Number `f36e- 15c./ 3/329. = SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community-official, (2) insurance agenticompany,.and (3) building owner. Comment's a) C- C 2. r D "s o r 44✓c✓? DL/-4.7" . Gt >dK/L scJ4c 0S /4.4'. £ p174 1e TV e44ic.41'� C,4" uS . d'11-11 —re> 6AuL w5 .6 Signature _ i Da lam? l r eck here if attachments SECTION - UILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. tithe Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. in Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is . ❑feet Eli meters ❑above or ❑below the HAG_ b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section 4 Items 8 and/or 9 (see pages 8 -9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet LJ meters ❑ above or Lt below the HAG. E3. Attached garage (top of slab) is . D feet ❑ meters [ above or 0 below the HAG. E4_ Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters E] above or ❑ hetoin( the HAG.' E5. Zone AO only: if no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct- to the best of my knowledge. - Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below, Check the measurement used in Items G8 and G9- G 1. C The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below_) G2- ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community- issued BFE) or Zone AO_ G3. ❑ The following information (items G4-G9) is provided for community floodplain management purposes. G4- Permit Number G5, Date Permit Issued G6_ Date Certificate Of Compliance/Occupancy Issued 67. This permit has been issued for ❑ New Construction ❑.Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site ❑ feet ❑ meters (PR) Datum 610. Community's design flood elevation - ❑ feet ❑ meters (PR) Datum Local Official's Name • Title Community Name Telephone Signature Date Comments ❑ Check here if attachments FEMA Form 81 -31, Mar 09 Replaces all previous editions