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Home My Public Portal AboutBeachwood Ct_8 DALE JOHNSON 9122334474 P.02 O,M.ti, 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 fioodptain management ordinances, to ' determine the proper insurance premium rate, and /or to support a request for a Letter of Map' Amendment or Revision (LOMA or LOMP Instructions for completing this form can be 'found on the following pages. 4 SECTION A PROPERTY INFORMATION I FORi INSURANCE COMPANY US POLICY N MSER au ILO OWNER'S NAME U $TREET ADDRESS On fig Apt, Unit, sulte Andror Bldg. Num ; y r.) 9R { ,le €y . . ROUTE AND BOX NUMBER COMPANY NAIL NUMBER �J G?N Ft DESGRIATION fL t and bloc umbers, etc.? � � -dgN ' 0171' 4IV 1, :Iri# c SECTION 0 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION „Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANE. NUMBER • 3. SUFFIX' 4, GATE 0 FIRM IN Ex 6. FIRM ZONE , :. Q. BASE FLOOD ELEVATION' ',,, /35/64— + / (In AO Zqn *R use depths I, 7. Indicate the elevation datum system used on the FIRM,fof Base Flood Elevations (BFE): arrIGVD '29 0Other (describe ail lack) 6. 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 I H.(_ 1 feet NGVD (or other FIRM datum -see Section 8, item 7), , . SECTION C BUILDING ELEVATION INFORMATION 1, Using the Elevation Certificate Instructions, indicate/the diagram number f the diagrams found on Pages 5 and 6 that best describes the subject building's reference level / . 2(a). FIRM Zones Al -A30, AE, AN, and A (with BFE). The top of the reference level floor from the'selected diagram is at an elevation of 1 ' i VA.6feet NGVD (or other FIRM datum -see Section 0, Item 7). [i (b). FIRM Zones Vi -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference Level from the selected diagram, is at an elevation of 1 ' 1 I__'..__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._.-.' .`Li feet above ❑ or below ❑ (check one) the highest grade adjacent to the budding. , . '(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is 11J . LJ feet above D or below r (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 floodpiain management ordinance? ❑ Yes ❑ No ❑ unknown 3. Indicate the elevation datum system used in determining the above reference level elevations'. ❑ NGVD *2g ❑ Other (describe • A 3 easurin the elevations is different than that d under Comments on Page 2). (NQTE;, if the elevation datum used rrf rtt g hat � ,, the FiRM (see Section B item 7,, then convert the elevations to the d atum system used on the FIRM and show conversion equation under Comments on Page 2,) 4. Elevation reference mark used appears on FIRM: ❑ Yes L2 No (See Instructions on Page 4) 5. The reference level elevation is based on ' actual construction Q construction drawings, ' (NOTE: L!se of construction drawings is only valid if the building does not yet have the reference feve floor in place, In wh)oh 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.) j 6. The elevation of the lowest grade immediately adjacent to the building Is: j--L-l_1_1,1 feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNfTY INFORMATIQN 1 1 . If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, ttem 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 1 1 1 1 1 1.1.i feet NGVO (or'other FIRM datum -see Section B, Item 7), 2. Date of the start of construction or substantial Improvement V : EEMA Form 81.31, MAY 93 REPLACES Ali PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION ' DALE JOHNSON 91 22 ;4474 P . 03 SECTION E CERTIFICATION . This c&rtifiOrition 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, AN, A (with BFE),V1- V30,VE, and V (with FIFE) is required, , Community officials who are authorized by local law or ordinance to provide floodpfain management Information, may also Sign the certification, 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 certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway /non - breakaway wall, enciosure size, location of servicing equipment, area use, wail openings, or unfinished area Feature(s), then list the Feature(s) not included In the certification under Comments below. The diagram number, Se tion C, item 1, must still be entered. I certify that the information in Sections 8 and C an this certificate represents my bast efforts to interpret the data avalleble, 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ' P, CERTIFlE' 'S N , LICENSE NUMBER {or Affix Seal . TITLE 1 C OMPANY N AME • ADD ^S _ - -- CITY ,_._. - - -- &T ZIP s _ � • M( A) \1 g0 - _ V. _ J 0 SIGNATU r `1 RATE PHONE o pies sho d e o militate for 1) community official, 2) Insurance agent/company, and 3) bonding owner. COMMENTS: - �f - - - - - -- i ; j ON WITH ON PILES, SLAB BASEMENT PIERS, OR CQLU94146 A V A .; A V ZONES ZONES ZONES ZONgs ZONES r m , � REFERENCE r " l ' FF:fERENCE BASE LEVEL ,_, R{PcPcNGE LEVEL kt� FLOOD Ii yr. -. LEVEL III, 111 E! EVATO l ,' O t �. :il=..,4 % ; T i . - 1. B S$ BA6E ADJAGEAD , , . REFEREIrCE FLW. R OOD GRA LEVEL EI.F.YA �YOPI ELEVATION R FERENGE ADJACENT LEVEL GRACE .j. ? ::' - ,'Y AD,AGENT?. ' : : ., :a a.: :.k. ,. 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 bo rneesuled at the bony the toweiiit horizontal structural Inernber. Page 2