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Home My Public Portal AboutLullwater Rd_1DEC. -13' 99(;,10N) 14 ;00 J. WHITLEY REYNOLDS TEL 912 352 7787 P, 02 ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENPY ExiresJuly31, t999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTIOrt Use of this certificate does not provide a waiver of the flood insurance purchase rec(uiretTlent. This lona is used only to pro- vide elevation information necessary to ensure compliance with applicable conIMUNly floodplam management ordinances, to determine the proper insurance premium rate, and/or to support a request tor a Letter of Map Atttendtnent er Revisal (LOMA or LOMB). You are not required to respond to this collection of information unless d valid OMB control number le displayed In the upper right corner of tt115 torn. Inetntctione for completing this form can be found on the following gaigee. 0.M, B, No 3067-0077 SECTION A PROPERTY 1NFOnMAT)ON DUILIMO OWN 'SNAME 4 t ier!_....1. STREET � DRESSjocoudlrp AeL. Un Suite ender 8ld, Num OR A.0. OUTE AND ( o/ 4w FOR INSURANCE OQMPANYUSE PODGY NUMBER COMPANY NA1O NUttaER CITY OiHEA oESCR. I WIO DJptls Numb /•y7q��e,+�� /2 r /O iZ J� ,� C�j Cr SECTION H FLOOD INSURANCE RATE i4AP (FIRM) INFORMATION Provide the following from the proper FiRM (See InSUuctions), / 1. ! µC /+� 2 PANE / MBFA 9.c ar J g.6 / / 6, / Z dap' 7. Indicate the elevation datum system used on the FiRM for Base Flood Elevations (BFE): GAGVO '29 ❑ Other (describe an back) 8. For Zones A or V. where no BFE Is provided on the FIRM, and the community has established a l3FE for this building site, indicate bhe community's BFE: I I 1 I I I U feet NGVD (or other FiFtM datum -see Section B, item 7)• SECTION C BUILDING ELEVATION INFOFMMA'T1ON 1. Using the Elevation Certificate Instructions, indicateihe diagram number from the diagrams found on Pages S and 6 that best descries the subject building's reference level 2(a). FIRM Zones 1A1 -AA30, AE, AH, and A (with f3FE). The top of the reference level Door from the selected diagram is at an elevation otl,_1.1-.V12).l feel NGVD (Or othei- FIRM datum -see Section 13; Item 7). (b). FIRM Zones V1 -V30, VE, and V (with 8FE). The bottom of the lowest riorizottlal structural member of the reference level from the selected diagram, Is at an elevation of 1 .1 .) .1J .1 J feet NOVO (or other FIRM detwti -sae Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is w.Li feet abovell or below I (checK one) the highest grade adjacent to the 'wilding, td). FIRM Zone AO. The floor used as the reference level from the selected diagram is Lt-J.L 1 feet above 0 or below ❑ (check one) the highest grade adjacent to the building. 11 no flood depth number is available, ie the building's lowest floor (reference levet) etevgted in accordance with the community's Itoodplaln management ordinance! ❑ Yes ❑ Ijio n Urifsnown • 3. Indicate the elevation cistern system used in determining the above reference level etevations:0 NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: N rite elevation datum used In measuring ttt9 o(evations is different than that used on the FIRM (see Section H, 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 referenoe mark used appears on FIRM: ❑ Yes l 1 No (See Instructions on Page 4) 5. The reference level elevation is based on: [j actual construction ❑ construction drawings (NOTE_ Use of construction drawings is only valid if the building does nor yet have the reference levet floor in place, in which case this certificate will only be valid lot the builrlrng during the course of construction. A post-construction Elevation Certificate will be required once construction is oomplere,J 6. The elevation of the lowest grade immediately adjacent to the building is:I i 1 V' .LT-leet NGVD (or other FIRM datum•see Section B, Item 7). SECTION D COMMUNITY 1NFORMA11Qti 1. II the comrunity official responsible for verifying building elevation's s "pec lies that the reference ik let indicated In Section C. Item 1 is not the "lowest floor' as defined in the community's floodptain management ordinance, the elevation of the building's lowest llodr as defined by the ordinance Is: 1 1 1 1 I 1.1 1 feet NGVD for other FIRM datum -see Section 0, item 7). t. Date of the start of construction or substantial improvement ...__.. FEMA Fort 81 -31, MAR 97 REp)ACES AItPREVICUS EDiT1t7NS SEE REVERSE SIDE FOR CON1m Ar'toN DEC, -13' i)9 (MON) 14:01 J, A111TLEY REYNOLDS TEL :912 352 7787 P.03 SECTION E CERTIFICATION This rmrtIlicallon is to be signed by alaird surveyor, engineer, or architect who Is authorled by slate or local law to certify elevation information when the elevation information for Zones A1—A30, AE, Ali, A (with BFE),V1— V30,VE, and V (with BFE) Is required. Community officials who are authorized by local taw or ordnance to-provide floodplain management informalon „may also sign the certification. In the case of Zones AO and A (without a;FEMA arhtrriimuntty ttt ued EWE), a building official. a property owner, or an owner's representative may also sign the certification,' Reference level dagrams 6, 7 and 8 - Distinguishing Features-8 the certifier is unable m certHy to breakaway /non- breakaway wan, enclosure size, tocation of servicing equipment, area use, wan openings. or unfinished area Feature(s). then list the Feature(s) not included in the certification under Comments below, The diagram number, Section 0, Item 1, must still be entered. 1 cerrily that the information hi Sections Et and C on this certificate represents my trest efforts to interpret the data avallable. t understand that any false statement may be punishable by tine or imprisonment under re U.S. Code, Section 1001. CEATtFf LICENSE NUMEIEA Ahrg« TRL LOMPANY NAME A ZtP . PNDNE es a I! made of this Certificate tort 1) community official, 2) insu • : nee agent /company, and 3) building owner. ON SLAB A rages ZOrres The diagrams above inuatrate the points at which the elevations should be measured in A Zones and V Zones. Etevattoirs for all A Zones should be measured at the top of the reference Ievet floor. Elevalians for all V Zones should be measured at the bottom of the lowest horizontal structural member, Page 2