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This certification is to be signed by a; land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
Information when the elevation information for Zones Al -A30, AE, AH, A (with BFE),Vl-V30,VE, and V (with BFE) is required,
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. in the case of Zones AO and A (without a FEMA or community issued FE), a building official, a property owner, or an
owner's representative may also sign the certification,
Reference level diagrams 6, 7 and 8;,. Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall',
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification 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.
CERTIFIER'S NAME c` f' j LICENSE NUMBER (or Affix Seal) / (y
, 4 a 5 , . 9-"
. 7-J ice- . � U;9.6�,/� � 9 '� t A {a°
TITLE COMPANYNAME '
V A IV ALI 4 i C--,L-
ADDRESS CITY ` STATE ZIP
r
SIGNATURE ' DATE PHONE
Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building' owner.
COMMENTS: / `r`` ";' ® t + L,,D ` PeR-m., I- _ ` - 0 /
` 0k' c er H' aft
ON WITH ON PILES,
SLAB BASEMENT PIERS, OR COLUMNS
A V A A v
ZONES ZONES ZONES ZONES ZONES
REFERENCE:
LEVEL REPERENCE
nEILEVELCC FOOD LEV£L
ELEVATION
t
T11
nx
X f
.z
BASE
EAS£`. ADJACENT .. REFERENCE FLOOD
FLOODGRADE :LEVEL ELEVATION -..
ELEVATION REFERENCE. ADJACENT
LEVEL GRADE...
P
i xr ADJACENT
GRADE
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:
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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