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Home My Public Portal AboutEagles Nest Ln_202EP, -04' 981FRI1 10:24 3, WHITLEY REYNOLDS TEL:912 352 "8" P. 01 ELEVATION CERTIFICATE FEDERAL. EMERGENCY MANAGEMENT AGENCY Expires July 31, 19'. NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to prr vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, andlor to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are! required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this forrr Instructions for completing this form can be found on the following pages, O,M,B. No 3067.Ot SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE EUILDING ER'S NAME POLICY NUMBER STREET DDRE$ (Inching ApL. Unit, Sues and/or E. Number) OP P 0 ROUTE AND 80X NUMBER OTHE DESCRIPTION (Lot and Block Numbers, eIC.) 1� f3 7- J r'rf. ri r SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION COMPANY NAIC NUMBER Provide the following from the proper FIRM (See Instructions): 1 COMMUNITY NUMBER / 5.f1 �- 2, PANEL NUMBER / 3, SUFFIX 4. DATE OF FIRM 1 DEX it /7 6 5, FI�tM ZONE /l�1 6, BASE FLOOD ELEVATION (I^ AO Zones, use depth) Z 7. Indicate the elevation datum system used on the F1RM for B ise Flood Elevations (BFE): EVD '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 8FE for this building site, indicate the community's BFE: 1 L' feet NGVD (or other FIRM datum —see Section B, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate, e diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level " 2(a). FIRM Zones Al •A30, AE, AH, and A (with BFE). The top of the reference level tloor from the selected diagram is at an elevation oft 1 1 III. L Bet NGVD (or other FIRM datum —see Section,, 8, item 7). (b). FIRM Zones Vi -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 L feet NGVD (or other FIRM datum —see Section B, Item 7). (c). FIRM Zone A (without 8FE). The floor used as the reference level from the selected diagram is 1 1 I . U feet above or below ❑ (cheek one) the highest grade adjacent to the building, (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is ( 1 1.LI feet above or below L2 (check one) the highest grade adjacent to the building. if no flood depth number Is available, Is the building's lowest floor (reterence level) elevated in accordance with the community's floodplain management ordinance? E Yes E No 7 i Unknown 3. Indicate the elevation datum system used in determining the above reterence level elevations: E NGVD '29 H, 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 77, 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: rl Yes No (See Instructions on Page 4) 5. The reference level elevation is based on: [a actual construction [11 construction drawings (NOTE: Use of construction drawings is only valid N 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 win be required once construction Is complete_) 6. The elevation of the lowest grade immediately adjacent to the building is:1 1 lL� feet NGVD (or other FIRM datum see Section 8, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Sectron C, Item 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: t 1 1 1 1 1 L feet NGVD fur other FIRM datum —see Section B, Item 7). CEP, 0� 981FRI1 10.25 J. 'TLEY REYNOLDS TEL: 1 552 - 787 F. 02 SECTION E CEA1IFICATION 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 tor Zones A1—A30, AE, AH, A (with BFE),V1— V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodptain management information, may also sign the certification. in the case o1 Zones AO and A (without a FEMA or community issued BFE); a building official, a property owner, or ar owner's representative may also sign the certification, Reference level diagrams 6, 7 and 8 • Distinguishing Features —it 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. 1 certify that the information in Sections 8 and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by tine or imprisonment under 18 U.S. Code, Section 1001, CERTIFIE 'S N I, TITLE AODR S SIGNATUP LICENSE NUMBER (or ABlx Seal ez COMPANY NAME AUE :iC17YL'U /Z C 4 Y .41tIT ' ?4 SAT PHONE P5 j OMMENTS• _ Certificate for: 1) community official, 2) Insurance agent /company, and 3) building owner. ON SLAB A ZONES ZONES WITH LASEMENT raEFEFENC[ U; VEL ON PILES, PIERS, OR COLUMNS A V ZONES ZONES hfJ EPEr.0 LE V' L BASE FLOOD LLEVA7ION 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 ADJACENT CFUDE