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Home My Public Portal AboutLovell Av_1505SER (WED) ()8.17 1tiH1.TLEY REYNOLDS TEL:912 352 7787 ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is Ltsed only to pi vide elevation information necessary to ensure compliance with applicable community Iloadplain management ordinances, to determine the proper insurance premium rate, andtor to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). Yt.0 are n required to respond to this collection of information unless a valid OMB control number is displayed in the upper right coiner of tl,ie Instructions for completing this form can be found on the following pages. P. ;11 Ne.:106. /.uu / Expires }4Iy 31, 19'9 SECTION A PROPERTY INFORMATION Utit UMBER FOR INSURANCE C .6 feet NGVD (or other FIRM datum -see COMPANY EUILDIN OWNER'S NAME so • .0 STREET ESS ndudini t:. Unit, Suityn r ek. umber) QA P.O. ROUTE AND BOX NUMBER CTNER,pESCF}IPT1 (Lot r,tl B1b Num� s `t4 J� r�d�-44 (( / /G,r�} J]' r— STATE CITY �%�'� POLICY NUMaR COMPANY NAtC N SECTION t3 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FiRM (Sets Instructions)' L 1. COMMUNITY NUMBER / r / r ` 2. PANEL NUMBER 3. SufFIX 4. CATO FF F: INDD X 67 I r ! �7 _,..__..W.. E. Fifl ON E. MSS FLOoO eLEvAr,aN --, !{n A� TAgsa. uja dvvm'� /) ..'•�? 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): GVD'29 Le! Other (describe on backi S. For Zones A or V, where no BFE is provided on the FIRM, end the community has established a BFE for this building site, indicate the community's 13FE: L) ` i ! i L.,1 feet NGVD (or other FIRM datum -see Section d, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using ine Elevation Certificate Instructions, indicaf)he diagram number from the diagrarns found on Pages 5 a.nd 6 that best describes the subject building's reference level _ 2(a). FIRM Zone ' At -A30, AE, All, and A (with f3FE). The top of the reference level floor from the selected diagram is at an etevatio,•� 011 j 102.0 feet NGVD (or other FIRM datum -see Section 8, Item 7). • (b). FIRM Zones Vi-V30, VE, and V (with SFE). The bottom of the lowest ho:teorttal °structt.ral member of the reference level from the selected diagram, is at an elevation of L! ; J ,LI teat NGVD (or other FIRM daturn --see Section B, item 7). (c). FtRtel Zone A (without liFE). The floor used as the reference (eve; from the selected diagram is Lt.! .L _1 feet agave I or below E (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 L_;...J . L. feet above LL or below ., (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 floodplein management erdinanca? i Yes 0 No 71 Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: J NGVD `29 r !! Other (describe under Comments on Page 2). ;NOTE: If the elevation datum used in measuring the elevations is different than that used an The FIRM (see Section 8, Item 7f, 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: J Yes l=1 tvo (See Instructions on Page. 4) 5, The reference level elevation is based on: Lctual construction . Lj construction drawings (NOTE: Use of construction drawings is only valid If the building does not yet have the reference level fluor in place, in which case this certificate will only bo valid for the building during the Course of construction. A post - construction Elevation Certificate will bra required Once construction Is complete.) 6. The elevation of the lowest grade immediately adjacent to Ina bu;Ic ing is: Section B, Item 7), SECTION D COMMUNITY INFORMATION 1. It 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 "iowes; floor" as defined by the ordinance is: 12 . i _ J feet NGVD (or other FIRM datum-eta Section B. Item 7 r. 1 P. -17 97i \\ED) 08:08 J. 11'HITLEY REYNOLDS TEL:912 352 7787 P. 02 SEOT1ON E CERTIFICATION tl ■Pa corhflcation i$ to be signed by a land surveyor, engineer, or•architect who is authorized by state or local law to certify elevation lilt rnhtJu n when the elevation Information for Zones A1-A33, AE, AH, A (with BFE),V1- V30,VE and V (with E>=E) is required. h..ornununity officials who,are authorized by focal law or ordinance to provide floodplain management information, may 'also sign the r•fitiration, In the case of Zones AO and A (without a FEMA or community issued BFE), a building officio?, a property owner, or en * representative may also sign the certification, lzDlarpnce level diagrams e, 7 and 9 • Distinguishing Features -If the certifier is unable la certify to breakawayrnon- breakaway wall, mclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then it the Feature(s) not ir.c uded in the certification under Comments below. The diagram number, Section 0, Item 1, must still be entered. / c.:ertiry that the information in Sections 6 and C on this certificate represents my best efforts to interpret the data available. unrlvr $And that any false statement may be punishable by fine or imprisonment under 18 U.S, Code, Section 1001, LICENSE NUMBER (or; MENTS: CITY e'• TE zlr Are PH Is Certificate for:1) community official, 2) insurance agent/company, and 3) building owner. ON SEAS A zoNeS ZONES WITH 64SEMENT ZONE 3 A AWAGICIT RAGV• HF�FRfhn, LEVE! • ON PILES, PICAS, Ori i`OLUMNS 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, i.'v:I;'o,,s for ill V Zones should be measured at the bottom of the lowest horizontal structural member.