HomeMy Public PortalAboutBay St_1002 /1 3 )5' J FEDFRAL EMERGENCY MANAGEMENT AGE''-:Y 0 M.13, No 3067 - 0077
TIONAL FLOOD INSURANCE PROGRA Expires December 31, 2005
VV ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION `FottlnsOrar)ceMC9lItpanY ;::.:;. :.. I
BUILDING OWNER'S NAME Po)IcyNumber It:.�� _,;
BUILDING STREET A DDRESS (Including Apt., Unit, Suite, an /or Bldg. No. ) OR P O. ROUTE AND BOX NO. Company NAIC Nufnbet
Pty 2Gr =i I.
-
STATE ZIP CODE
E6 �sz,�
CITY ,,,, , x.313 2-
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
,Lc r7At
BUILDING USE (e.g , Residential, n- residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
LATITUDE /LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE:
( #ti - $1 • ## ##' or tt# #####O) II NAD 1927 I NAD 1983 Ii GPS (Type);
Il USGS Quad Map Ii Other
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3 STA
i ' /024,1d /35/~ l L G41tTti. &o 2Gi.9 J •
B4. MAP AND PANEL 85. SUFFIX 86. FIRM INDEX 87. FIRM PANEL 88. FLOOD B9. BASE FLOOD ELEVATION(S)
/3 � / ` /7/ DATE EFF TIVE /REVISED DATE ZON (Zone AO, use depth of flooding)
6
M./-fr. / 7 ,' CG. /0
B10. Indicate th ''source of the Base Flood Elevation (BFE) data or base flood depth entered in 89.
1 1 FIS Profile FIRM 1 — I Community Determined 1 - 1 Other (Describe):
B11 Indicate the elevation datum used for the BFE in B9:14 NGVD 1929 1 1 NAVD 1988 11 Other (Describe):
B12 Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? IX Yes 11 No
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
01 Building elevations are based on: ('Construction Drawings' 1!Building Under Construction* XFinished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2 Building Diagram Number 6 (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3 Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR /A, ARJAE, AR /A1 -A30, AR /AH, AR/AO
Complete items C3.a -i below according to the building diagram specified in Item 02. 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
calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion
Datum in z.. Conversion/CommeRts A/49-
Elevation reference mark used CAN iN ,J piip Does the elevation reference mark used appear on the FIRM? 1_1 Yes IX1 No
❑ a) Top of bottom floor (including basement or enclosure) 9 . 3 , ft.(m) - ,t; ..
❑ b) Top of next higher floor /9 . 5ft. � 0 RG /
❑ c) Bottom of lowest horizontal structural member (V zones only) A/ /R- . ft.(m) o sre
❑ d) Attached garage (top of slab) /�/on/ ft.(m) q - ° R ' o
❑ e) Lowest elevation of machinery and /or equipment w No „�, �°% - -
servicing the building (Describe in a Comments area.) /3 . ' ft.(m) �e r� `
❑ f) Lowest adjacent (finished) grade (LAG) 1 . Z ft.(m) z - 7 ( - 9 , 0
❑ g) Highest adjacent (finished) grade (HAG) P . 9G ft.(m) E !I:
% �O s up... , .
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 4- .6.'� E F p '(S
❑ i) Total area of all permanent openings (flood vents) in C3.h 82.b sq. in. (sq. cm)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a and surveyor, engineer, or architect authorized by law to certify elevation information
I certify that the information in Sections A, 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' NAME LICENSE NUMBER
W RRREPI 09 Ti+e> s /953
TITLE COMPANY NAME
/PEG. J-! D SUizUE 102 NAME,
PEG L(a tvi � U2 1 ./e - 1 /tV6_
ADDRESS CIT STAT ZIP CODE
9 9 /f Fly nn - E�s � p y vANiA C - ,305Z6
SIGNATURE DATE TELEPHONE
FEMA Form 81 - 31, January 2003 ' / See reverse side for continuation Replaces all previous editions