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Home My Public Portal AboutAnderson Ct_1 O.M.B. NO. 3067-0077 ELEVATION CERTIFICATE Expires May 31, 1996 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 used only to provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance prenliurn rate, and /or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMA). Instructions for completing this form can be founq on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDir OWNER'S NAME PO - -- !_ICy NUMBER 4 C � B - -AN -- - - S 11'iEET ADORE 'J �Z 'S / Apt ,Unit Stele rind. or Bldg Number) l IT OI1 r 0 RUE AND BOX NUMBER NUMBER R COMPANY NAIC NUMBER /�! (Including r Gd , -7- OTHER DESCRIPTION (Lot and Block Numbers, etc.) ... Lo7- / A(i74 /l VUJniY /0/-). Z - - - -- ... CITY 7 ' g `7G AID . . 3/:/2R 1 SECTIOtfB FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNI [Y NUMBEN 2 PANEL NUMBER 3. SUFFIX , I DATE OF FIRM INDEX 5. FIRM ZONE 6. BASE FLOOD ELEVATION -- 76 I / C- 1 �/ 7 g6_ I /4 5 (in AO Zones, use depth) 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevation (BFE): L _ 1 NGVD '29 rj 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: 1 1 1 1 1 1.1 I feet NGVD (or other FIRM datum - -see Section B, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level . _Y.. . 2(a). FIRM Zones Al -A30, AE, Atl, and A (wltn BFE). The top of the reference level floor from the selected diagram is at an elevation of I 1 1 1/ GI .6I feet NGVD (or other FIRM datum - -see Section B, 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 the selected diagrarn, is at an elevation of i 1 1. _1 1 1.1 . 1 feet NGVD (or other FIRM datum —see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is L.JJ.LI feet above 1 _1 or below I. .1 (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 I _ 1__I . L__1 feet above Li or below L:l (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 floodplain management ordinance? 1 1 Yes LJ No El Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: Li NGVD '29 LJ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM [see Section B, Item 7], then convert the elevations to the datum sy.stern used on the FIRM and ,show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: 1_1 Yes I _J No (See Instructions on Page 4) 5. The reference level elevation is based on: 1 ''factual construction 11 1 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 post - construction Elevation Certificate ' will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: L_ 1 _l 1.. -. 1 .14feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION 0 COMMUNITY INFORMATION 1. If 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 "lowest floor" as defined by the ordinance is: I 1 1 1 1 I.1 I feet NGVD (or other FIRM datum —see Section B, Item 7). 2. Date of the start of construction or substantial improvement . FEMA Form 81 - 31, MAY 93 REPLACES All. PREVIOUS ED1110N1S - SEE REVERSE SIDE FOR CONTINUATION C.• 11 L 1 .'1_11111 1u1111' -)I 1 his certilicniion is to be signed by a land surveyor, gnginoor, or arc who is authorized by slain or local law to certify elevR @nn information when the elevation information for Zones Al -A30, AE, AR, A (with B[E),V1-- V30,VE, and V (with BFE) Is required. Community officials Who are authorized by local law Or ordinance to provide floodplain !nanagoment information, may also sign the cel tifir.ation. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certificatiod. Reference level diagrams 6, 7 and 8 - Distinguishing Features —lf the certifier is unable to cer lily 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 hest efforts 10 interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CEOTIT'IER.. ME LICENSL NUMBER (or Altix Seal) 1111 COMPANY NAME AND TESS C7 /, r /((/ / I � � ti. STATE 71F A...) L r ( .1-S S1 GNAT // —.. / /{)A / PI �Z a� Copse oUld be lade of tfH Certificate for: 1) community official, 2) insurance agent /company, and 3) building owner. i . COMMENTS: -- ___ —._ -- -- .--- - -_ -_� - • ON Wnn ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A V A A v ZONES ZONES i ZCNES ZONES ZONES - -..'-- � NEI LACNC� '.11L VICE NCE — . p7 t1VEL }.\ - or F Nl C LEVEL 1 FLOOD — LEVEL r1CCF J k 1 /II f ELEVAIIptI J llrr —_-- -/ �� RASE — nxsr ADI /CCtlf l EMU/Cr 1 FI DOD FL(YJD GFADE / _ 1-1! LEVEI. 1 Et�_EVAIIO(J El IION REFERENCE ADJACENT LEVEL GRADE L ADJACEN ✓ GRADE Tm The diagrams above illustrate the points at which the elevations should be rneastlred in A Zones and V Zones. Elevations for all A Zone's should be pleasured ht the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2