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Home My Public Portal AboutBay St_1316B €3i1'JI��1R1ttik� t€`! 3i!ILYtNG r A PRC)PERTY BUILDING US NAIIUNAL 1-1_001) INSURANCE PROGRAM ELEVATION CERTIFICATE Im ortant: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION ti ludrn Apt, Unit, Suite, andior Bldg. Nc.i OR P,0, ROUTE AND BOX N0. r Expires July 31, 2002 For insurance Company Use. olity Number Company NAIC Nurnber C Par s unber, L .aI ■- cri non. - aal, +cn -re ;den is ..ition, . ssc , etc. se omments area, n>sary,) Lc�ITUDE'LONGITUIE (OPTIONAL) ( Thr - f1#1 - !#.?#" or 44.#e###°) H RIZ NTAL DATUM: SOURCE: E_J DPS (Type); NAD 1927 Le; NAD 1983 SECTION B FLOOD INSURANCE USGS Quad Map ;_,1 Other: TE MAP FIRM INFORMATION B iP MMUNFTY NAME & C.OMMUNITY NU BER B2. COUN 83,,S1-ATE Be. M!rat -�ANIL `A EL 85..,la i —G. FIR: D s I 88, FLOOD B9. EASE FLOOD ELE1,'ATIDN(S)7 NUNi3ER ATE EFFECTIVE/ VIS DATE Z NE S i (Zone AO, us depth of Flooding) 490,/ , c 67/7 67/7/06' ' 1 810. Indicate t'ne source of the B se Flood Elevation (BFE) data or base flood depth entered in 9. =!S Profile M i Community Dete ined ( _,I Other (Describe): 811 Indicate tie elevation datum used for the BFE in 89: i . NGVD 1929 11 NAVD 1986 1_1 Other (Describe): 812. is the building located in a Coasta 'Barrier Resources System (C8RS) area or Otherwise Protected Area (CPA)? 0esignatic,n Date: Li Yes SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C' . Building slevattons are based on I_..IConstructior Drawings' L„_ lBuildingg Under Construction* (`, inished Construetion 'A new Elevation Certificate will he reeuired when construction of the building is complete. 02. Building Diagram 'lumber p (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. f no diagram) accurately represents the building, provide a ek toh or photograph,) 03. E!e: ations - Zones A1 •A30 AE, AH, A (with BFE), VE, V1 -V30. V (with BFE), AR, ARIA, AR/AE, ARJA1 -A30, AR/AH, ARIA{ ;r p!ete items 03 a -i below according to the bui'cing diagram specified in item 02. State the datum used. lithe datum is different from the datum used for the BFE in Section 8, convert the datum to that used for the BFE. Show fseid measurements and datum conversion e,aoulation. Use the space provided or the Comments area of Section 0 or Section G, as appropriate, to document the datum conversion. "Dared) Conversion /Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 1I Yes I=Trio 2 a) Too of bottom floor (ir.ciuding basement or enclose re) . Z ft.{ ti • b) Top ofn9xtrignerfloor ,/7 ft.(04- O c) Bottom of lowest Iorizontai structural member (V zones aniy) a,�-' , ft.{+4} _irifec rt.(rn) t u _L ft, ( c� . ,.� ft. {►aid c ,n. �: t.,) Ho. of permanent openings (flood vents) within 1 ft. above adjacent grade e2 • Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm) d) Attached garage (too of slab) • e) Lowest elevation of machinery andior equipment sere sing the building (Describe in a Comments area) • f) Lowest adjacent (finished) grade (LAG) • g) Highest adjacent (`';Wished) grade (HAG) SECTION i1- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seaied by a and surveyor, engineer, or architect authorized by law to eertlfy elevation information, t cer,ify that the information in Sections A, B, and C an this certificate represents my best efforts to interpret the data available. understand that anv fa se statement may b nishabJe by fine °rift? risonment under 18 U. S, Code Section 1001. GER0F/E: ' ?T' 17, � -� —. L.ICEN ENIIM:ER �-�- -- �� C C,11 A1J NAME 1 d L9LL Bsc 2IG sloTouPad EaI iulll C e82:80 c0 Ga Pew /'� iy'te'2: 3UILDING s EE'i ADDR SS (Includin NA I HUNAL 1-1_0O17 INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pa•es 1 - SECTION A - PROPERTY OWNER INFORMATION Apt, Unit, Suite; andior Bldg. No. ) OR P.O. R UTE AND BOX NO. Expires July 31, 2002 For Insurance Company Use: Policy Number Company NAIC Number PRCF'EFi•TY. ESGIR.ION (Lo .d Block Numbea Numb Tax P a . , bar, La al ell Vt.) BU EIING US k - ide trai, ion -re iden la . r ss tTlTUDE'LONGITU E (OPTIONAL) - ' - ##.4" or .#rAttli °) ition, n etc. se a omments area, if necessary.) Rf7_CiN-T-AL DATUM. I ^i NAD 1927 jI NAD 1983 SECTION B - FLOOD INSURANCE SOURCE: L_I ;BPS (Type): USGS Quad Map ,___.1 Other: RATE MAP (FIRM) 3NFQRMAT!ON , P1P COMMUNiT f NAME & COMMUNITY NUS B"R 132. COUN t'Z A E l B3. S :A LL . I `• 84. MAP AND PANEL NLIMRER 8 .67641 4 i E5. SuF IX C 1. FIRM IND,.:X t r 7. FIRM PANEL B8, FLOOD EFFECTIVE 'n 7 DATE 1 ZC�NEt� (Zone 89. BASE FLOOD ELEVATION(S) AO, us depth of �oodiru? R10. !ndkate the source of the se Flood Elevation (S FE) data or bass hood depth entered inB9. Ir; =IS Profile L_ RV i�;Community Dete ined 11 Other (Describe): 511. lndicato tie elevation datum used for the BFE in B9: I, NGVD 1929 I NAVD 1988 1_1 Other (Describe): 812. Is the building located in a Coasts' Barrier Resources System (CBRS) area er Otherwise Protected Area (OPA)? I_} Yes Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ' . elevations ars based on• 1_1Construction Drawings* I_IBuilding'Under Construction* L finished Construction *A new Elevation Certificate will be required when construction of the building is complete. 02. Building Disgrem NUM b5; 6- (Select the building diagram most similar to the building fervahich this certificate is being completed • see pages 6 and 7. :f no diagram accurately represents the building, provide a sketch or photograph.) 3. E`e \rations - Zones AE, AH, A (with BFE), VE, V1 -V30. V with BFE), AR, AR /A, AR/AE, ARJ'AI -A30, AR /AH, ARIAO 0cmp!°ete items 03 a -1 below according to the Pacing diagram specified in item C2. State the datum used, if the datum is different from the datum used for the BFE in Section B. convent the datum to that used for the BFE. Show field measurements and datum conversion caioulation. Use the space provided or the Comments area of Section D or Section 0, as appropriate, to document the datum conversion. Oac m �. conversion/Comments Eievat on reference mark used Does the elevation reference mark used appear on the FIRM? I_I Yes • a) Too of bottom floor (including basement or enclsu re) b) Top of net higher floor ft L: ci Bottom of lowest horizontal structural member (V zones only) . ft.( } O c) Attached carage (top of slab) yth.. t.(m) e) Lowest elevation of machinery and /or equipment e Servicing the 'ou:iidinq (Describe in a Comments area.` C� #i Lowest adjacent (Finished) grade (LAG) ft.(i • g) Highest adjacent (finished) grade (HAG) fS . ,• ft.(►ai•}- h.) No. of permanent openings (flood vents) within 1 ft. above adjacent grade ' �! I) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm) U SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seaied by a and surveyor, engineer, or architect authorized by law tc certify elevation information. 1 cerify that The information in Sections A, B, and G on this certificate represents my best efforts to interpret the data available. understand that any false statement may b ' nisAhable by fine or imprisonment under 1i3 U. S. Code Section 1001. :cR it1 '?a lA M/L� - 44e, n,•� LICENSEN rDLE COM ANY NAME d L9Lc. zsc 2T6 RFDI Ar`FR M 1 PPXVIni IS Fr1ITICINIC sP T ouRaI Par4TLin C esa : BO c0 6a PEN nrvin A PA I* 1 IA I 1.7 7.7..D(NG STREE i riduding A 144 Su' No.)C-7777*AND BOX NO. DE ...smarty tiiAic, Number SECTION - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTevUED) ciy both sides: f this Elevallon Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Policy Number , Check here if attachments SECTi(N E 'autL.Dow, ELEYATiON INFORMATION NFORMAflON SURVEY NOT REQUIP,F.,D) FOR ZONE AO AND ZONE A fwirpiouT BFE) or 2-no AO a nrd ;Zone ii",(vvithout SFR), ccfrjte items El. through E4. if the Elevation Certificate is intended f Or use aa supporting m': or a LomA or LOMR-F, Section C must be completed. Ruling Diagram Number 'Seleict the bufiding diagram most similar to the building for which :his certificate is being completed - see pages 6 and 7 If no 'diagram accurately represents the buildina, provide a sketch or photograph ) Tho top of the bottom floor (including basement or enclosure) of the building is j ft (m) 11 above or below (criecit one) the highest adjacent grade. (Use natural grade, if available.) 3. Fp, Buliding Diagrams $--8 with openings (see page 7), the next higher floor or eievated floor (e/evatior of thit:.; btiIdn g s fti tm) il_linjcrn) above Me highest adjacent grade. Complete !terns C3.h and C3.1 on front of lomi. 'For 2one AO poly: if no flood depth number is available, is the top of the bottom floor elevated in accordance with• the community's _floadsiain ftl na ernent ii.)rdinance? ' Yes N..12 The local official roust mrlikthls information in Section G. SECTION F PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION ..:.roperty owner or owner's authorizes -representative who completes Sections A, 8, (Items 03.11 and 03.) onW, and E for Zone A (without a FEitiik-issued or community-issued BFE) or Zone AO ratist sign here. The statements in Sections A, 8, C, and are correct id the best ofIrypiiowledge, .17..r5M77-.7.1,in7r 5 I a; S NAME A515717.is-g ■ITY SInrfriff.P.- 7.77,...MTE,Nfrif; TEEEPFZNE SECTION C3 - COMMUNITY ifORMATIC5N (OPTIONAL) ■■■■••••■■■.•(*MO• rlte lout; official who is authenzaa by law or ordinance to administer the community's floodplairs management ordinance can complete S-ons A, 9, 0 (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. The information in Section 0 was tal<en from other documentation that has been signed and embossed by a licensed surveyor, engineef, or architect who is authorized by state or local law to certify elevation information, (indicate the source and date of the etevation data M the Comments area below.) C2. A COCTIMUrtfty official competed Section E for a building lucatedin Zone A (without a F'EMAssued or corn trunity-iSV.Ied BEE) or one AO. 1_,.1 The following information (Items G4-3.9) is provided for community floodplain management purposes, PERM-1TMM- Ge. ITE 0171TIFICATE -COMPLiANCLIT=015; ISSUED 07. This permit has been issued for New Construction 1_1 Substantial improvement GS. Elevation of -as-bullt lowest floor (including basement) cif the building is; BE or tin Zone AO) depth of flooding at, the bt,ilding site is: I Check her if attachments ri COAANVit41" SK3NAITTFIF (ZWVEN17) T TELEPHONE DATE ft,(m)Daturn: ft.fm)Oatuirs _I...Shed( here if attachments Mil e,rrn P1j u ilt1 LOL6 asc 216 PPP! Ar.P5 7, + DP Plitr.1 Lt; cr11/'\J apTouRad c el32:80 CO 62 PRl14