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Home My Public Portal AboutSECOND TER_1.pdfBUILDI el ( ##° - #9 - #i#.tkk or txplres July ;i1, zuu1 ELEVATION CERTIFICATE Read the instructions on paces 1 - 7. SECTION A - PROPERTY OWNER INFORMATION I For Insurance Company Use: 4' Suite, and/or Bldg. No.) OR P.O_ ROUTE AND BOX NO. area, Company MAIC " NAD 1927 LJ NAD 1983 LJ USGS Quad Map I I Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NPIP COM!M. NAME$ COMMi1N �N}8E B2. COUNTY NAME 63. STATE 24d 0 B4. AND P L 5. U X I IN B7. FIM PANEL B8. 0114?0 B9. BASE FLOOD ELEVATION(S) NUMB R ATE EFFE'; R ED DATE ZONE(S (Zone AO, use depth of flooding) �a% // r� i l E7 -4 B10. indicate the source of 11:13w6ase Flood Elevation (BFE) data orb se flood depth entered in 99. 1_1 FIS Profile I_I FIRM 1_1 Community Detjxmined J_j Other (Describe): B11. Indicate the elevation datum used far the BFE in B9: 1_ GVD 1929 1_1 NAVD 1988 j_J Other (Describe): 812. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (CPA)? ]_]Yes Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY RE=QUIRED) C1. Building elevations are based on: I_lConstruction Drawings* 1_18uilding Under Construction* I_--TFinished Construction *A new Elevation Certificate wi I be required when construction of the building is complete. C2_ Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and T. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations—Zones Al -A30, AE, AH, A (with SFE), VE, V1430, V (with BFE), AR, ARIA, ARIAE, ARIA] -A30, ARIAH, ARIAO Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculatin, Use essthe space provided orthe Comments area of Section D or Section G, as appropriate, to documentthe datum conversion_ Datum N611 z Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 1J Yes o ❑ a) Top of bottom floor (including basement or enclosure) ❑ b) Top of next higher floor , ft. (m) a ❑ c) Bottom of lowest horizontal structural member (V zones only) T �f ❑ d) Attached garage (top of slab) ❑ e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area_)Zd , _q_ ft. # No. 2a ❑ f) Lowestadjacent (finished) grade (LAG) &2 .JL- ft.(rrrT vU3y ¢ p ❑ g) Highest adjacent (finished) grade (HAG) _ _ // —ft. (rarl p 6UFiN ft ❑ h) No. of permanent openings (flood vents) within 1 . above adjacent grade 0 1 �HR�� A U iIrLEY) Total area of all permanent openings (flood vents) in C3_h sq_ in. (sq. cm) -+i 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. 1 certify that the information in Sections A, B, and C on this certificate represents my bestefforts to interpret the data available. Iunderstand that an fatn statement may be punishableb Ana orim risonmentunder18-U.S. Code, Section 1001. TITLE COMPANY ]NAME ADDRESSr CITY 5T ZIP COD SIG=?DA BONE 3� a =h LL Znrm 11 .11 [1. nn. Cf=G RGVr-pCI` C1rlr-Fr)R r-r)M-nM[ IA-nnKI PfZ01 Ar_rC' Gr I 1DPr- ()L r_C CnMt-)NV SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS CSe�-� = AG I -I Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El. through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building forwhich this certificate is being completed – see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is (_J_I ft.(m) I_.►_lin.(cm) 1_1 above or 1,1 below (check one) the highest adjacent grade. (Use natural grade, if available.) E3_ For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is i_LJ ft -(m) L„_Ijin.(cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. For Zane 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? 1-1 Yes J_j No I—J 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, C (Items C3.h and C3.1 only), 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, C, and Fare correct to the best of a knowied e. REPRESENTATIVE'S I_j 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. G1. IJ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. jJ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone A0. G3.1 I The following information (Items G4 -G9) is provided for community floodplain management purposes. 37_ This permit has been issued for: 1_1 New Construction 1_1 Substantial Improvement '38. Elevation of as -built lowest floor (Including basement) of the building is. _ft.(m)Datum: 39. BFE or. (in. Zone AO) depth of floodi ng at the building site is: _ft (m) D atu m: Lo 'AL OFFICIALS NRRE-- TITLE COMMUNITY NAME TELEPHONE SIGNATURE. DATE u Check here if attachments 'FMA Fnrm AL'A1 .ii it nn pi=pi Af'r=C At I pp;z mni i.q r=nrnnm.q .r,