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Home My Public Portal AboutPULASKI ST_14.pdfSECTION A PROPERTY INFORMATION BUILDING OWNER'S NAME C A STREET ADDRESS (Inclu&V Apt_ Unit, SWI* &"or eldp Number) On P.O. ROUTE AND BOX NUMBER 14:� f:1 L- A 5 K OTHER DESCRIPTION (Loi and Block Numbers etc.) E-A-srur-K) FluaT) ow OF La !J_,_ t3 c_oc W- 34�PVP-T- 5c n. E_vE_ 'N LOA_a L) - CITY STATE ZIP CODE T - Y o iY E I S c A N A+ Gd, SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION FOR INSURANCE COMPANY USE POLICY NUMBER COMPANY NAIL NUM3EA Provide the following from ilia proper FIRM (See Instructions): t. COMMUNITY NUMBER 13J -1C 4 2. PANEL NUMBER 0) 3. SUFFIX C 4 DATE OF FIRM INDEX P -2) S>4 5. FIRM ZONE AF 6. BASE Wy)n ELEVATIpN lin AO ) �usadep[hJ 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): iKNGVD'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 BFE for this building site, indicate the community's BFE:.I III I LJ feet NGVD (or other FIRM datum -see Section 8, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, Indicalf the 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 floor from the selected diagram is at an elevation of LLLJ j1Bj.0 feet NGVD (or other FIRM datum -see Section 8, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from ilia selected diagram, is at an elevation of IJP.-❑_ JJ J feet NGVD (or other FIRM daturn-see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as ilia reference level from the selected diagram Is LLL.❑ feet above l or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from ilia selected diagram is ❑J.❑ feel above !A or below I. _] (check one) ilia highest grade adjacent to the building. It no flood depth number Is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? U Yes ❑ No L] Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: X NGVD'29 ❑ Other (describe under Comments on Page 2). (NOTE: It the elevation datum used in measuring the elevations is different than that used on the FIRM [see Section B, Item 71, then convert the elevations to the datum system used on the FIRM and show fire conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: LJ Yes A No (See Instructions on Page 4) 5. The reference level elevation is based on: Ix actual construction I I construction drawings (NOTE: Use of construction drawings is only valid if 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 past -construction Elevation Certificate will be required once construction is complefe..) 6. The elevation of the lowest grade Immediately adjacent to Ilia building is: i_ I _).-1117J.1t .feet NGVD (or other FiRM datum -see Section 8, 1181117). SECTION D COMMUNITY INFORMATION 1. if the community official responsible for verifying building elevations specifies that the reference level Indicated in Section C, Vern 1 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: L_l_❑_ ILJ feet NGVD (or other FIRM datum -see Section B, Item 7). 2. Date of the slart of conelruction or subetantial improvement FEMA Form 81 -31 , MAY 93 REPLACES All PREVIOUS EDITIOt4S SEE REVERSE SIDE FOR C(Arn14UATI0N Reference level diagrams 8. 7 and 8 - Distinguishing Features --If the certifier is unable to cenity to breakaway/non-breakaway waq, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the cenification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. 8 �-]r � . Ba x� rr Srz_ 1 )a- . 41' Z 39 CERTIFIERS NAME LICENSE NUMBER (or Affix Seal) G. 5. 3 ,4 g -R -E. rT LAAry qua -y F Y 1 N (a , I N r TITLE COMPANY NAME ,A -L/ A AJ N A ADORES S CITY /^ STATE ZIP 67 or't Io -Z Al jYI�--��-b o SIGNATURE DA E �� PHONE Copley should be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner. COMMENTS: _ ON SLAB A V ZONES ZONES nEFERENC( iEvEi BASE Hoon E1 EVAiK)H REFERENCE AO IACENT IEVEI GRADE GRACE WITH BASEMENT A tr ZONES BASE fiOgl Vn l'.4C.1 PIERS, OR COLUMNS A v ZONES ZONES 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 levet floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.