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Home My Public Portal AboutBrewer's Ld_919A ' DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE I OMB No. 1880-0008 FederaLFrnerxgencj Management Again? EXt)ires February 28, 20 National Flood Insurance Program Important: Rte the instructions on pages 1 -8. . Al. Building Owner's Narne SECTION A - pROPERTY INFORMATION i For Insurance Company Use: f G AA) -De..v Lnf' EAEiv r lNc _ .. i Polley Number A2. Building Street rasa nctudi ll Suite an or eq.) r P. Ro and o. Company NAIC Number � 9! 9 1 ,Qz & 3' 4Ad A / D7 ., ( 01.0 , , ge) I _ rz e / 1 Oa: r, Stale 6 ZIP Code A3�pe rtY � � Dc�t� d G e3�r ' Taut P roeNurtKisr1 Description, etc.) A4. Building Use (e.g., Residential, N� Residential, Addition, Accessory, etc.) L? ES f b �" .4 / / A __ A5. LatzludelLongtude: Let. Long. Horizontal Datum: U NAD 1927 0 NAD A6. Attach at least 2 photographs of the building it the Certificate is being used to obtain flood insurance. A7, Budding Diagram Number 7 AB. Fore building with a crawl space or enciosure(s), provide: / 3 A9. For a building with an attached garage, provide: a) Square footage of craws apace or encloaur (a} se ft a) Square footage of attached garage // t,5 � sq f b) No_ of permanent flood openings to the crawl space or b) No of permanent flood openings in the attached Arage enclosure(s) walls within 1.0 fool above adja grade 5 walls week 1.0 foot above adjacent grade 4 - c) Total net area of timid openings in A8.b _Q Win c) Total net area of flood openings in A9.b sq SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION I 7 - T i61--"E Name & g eminently Ntxnber 02. County Name / s n � t State >31. i�IFIP - unttY ( e7 L A f ,- ;/e d. C L74 /"l 4 84. Map/Panel Plumber i Be. Suffix I Be FIRM Index I 87. FIRM Panel 88. Flood j 89 Base Flood Elevation(s) (2 II i3 /.6' odd f � CI Date 1 evised Ela I Z s I AO, use base flood depth) � C — ! � -ff � � -� � I - _ , 1 �z ¢ o 1310. Indicate tte source of the Base Flood Elevation (BFE) data or base flood depth entered in ftem B9. FIS Profile ERIIRM [j Community Determ ned Q Other (Describe) . - -- _ i 811. Indicate elevation datum used for 8FE in ftern B9: ZNGVD 1929 0 NAVD 1988 Q Other (Describe) B12. la the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (CPA)? 0 Yes E410 Designation Dale D CBRS 0 APA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl Building elevations` are based on: ❑ Construction Drawings' 0 Building Linder Construction° Er Construction, *A new Elevation Certificate will be required when txmaSruclion of the building e complete. C2. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V 1 - V3G, V (with BFE), AR, AR/A, AR/AE, AR/A1 -Ale, AWAIT, AR/AO. Complete Items C2.a -g below according to the buiidin °�grarn specified in Item A7. i / Benchmark Utilized /Z� 6 Vertical Datum (� + / /� 7 C Conversion/Comments Check the measurement used, f '_ a) Top of bottom floor (including basement, crawl space, or enclosure floor) t �feet 0 meters (Puerto Rico only) b) Top of the next higher Ikrar ----L� --�--. & bleat 0 meters (Puerto Rico on y) c) Bottom of the lowest horizontat structeral number (V Zones only) <v . _ Q feet 0 meters (Puerto Rico only) d) Attached garage (top of slab) 11, [J meters (Puerto Rico only) e) Lowest elevation of machinery or ecfvi ernent servicing the bulding . /4_ . _ _ -[J t [l meters (Puerto Rico only) (Deisrxtbe type of equipment in Comn*rKs) 1) Lowest adjacent (ffnhrtted) grads (LAG) 8 . _[d et [0 meters (Puerto Rico ony) g) He etest adjacent (finished) grade MAGI- , . C- I n areet 0 meters (Puerto Rico only) SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION • This certification is to be signed and meted by a land surveyor, engineer, or architect atrthortzed by Mw to certify elevation atomwrtian. 1 oertit*y (fret the ktfternafen on this Cerbifoate represents my best efforts b interpret the data evadable. I understand that any false statement may be punishable by brie or imprisonment trader 18 U.S. Code, Section 1001 Q Check here rf comments are provided on beak of form. 1 Conyers Name ye No. 1562 .. ti ar3 Ali'4 `.tom,.°"ik nt,°r /58Z L5 _ * f - "i- r ride /- S - /s TER D L Al • LJRt!Er'c'1 RC.4CI r I G� �� 5 .t Q Address t3a 7 ?6 � C"y 7;.136--- .. e. slat q ZIP 3/3 `. 6 = , R ° T ee Signature 67( (...\ 1] ° 2z. �' e ' / ` z �F 80 • I, �! . . , FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editi . - ----. • - . - • _- - IMPORTANT; in the spaces, copy the corresponding hlorrnation from Section A. • Far Insurance company Use: Buildin g„St ress8cigziZ, j/DIL,Sgfie, anr..ksle.) er P,D. Roott_and Spx No. a ....., ) : Pettey Number • .., Y G2cie'. City . State A .. ./, , E . apiii - ' I Company NAIC Number - 7 - pe&- --- 1.6'. SECTION 0- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONT)NUED) .. , Copy both sides of this Elevetion Certificate for (1) communey °MOO, (2) insurance agenticompany, and (3) building owner. ...... . _ . Comments . „.. ... . ■, • — , a ' Signa 114W ture e tle ‘ ), ‘ . Data - - 03 r 1 1 / N 11111, A... .1— • 2 here if attachment SECTION E = BUILDIN ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) ' \ • For Zones AO and A (withoot BFE), complete hems E1-E5. tf the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For films E1-E4, use natural guide, tf aveReble. Check the meas urement used In Puerto Rico only. enter meters. El . F'rovicte elevation inforMatien for the following sine check the appropriate. boxes to shoot whether the elevetion is (above or below the highest adjacent grade (HAG) and the lowest octet:ere grade (LAG). a) Top of bottom floor (inc)uding basement, crawl Space, or enclosure) is . Li feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including besernent, crawl specs, or enclosure) is .— CI feet [1 meters D above or 0 below the LAG Ea Ear Evading Dams 6.8 with permanent food openings provided in Societe. ttealls 8 n vo, 9 (see uze 8 of instructions), the next higher floor (elevation O2.e in the diagrams) of lee building is 0 feet meters above or Li below the HAG._ El Attathed garage (toe of slat) is 0 feet 0 meters 0 above or Li below the HAG. E4. Top of platform ce machinery and/or aquiver-ere seivicing Wet building ts . 0 feet ril meters 0 above or ril below the HAG E5 Zone AO oniy, if no hood dept runiber is avatable, is the top of the bottom floor elevated in encordence with tr,a e)mmunityseeer.epeen managemen ordinance? [J Yes D No ID Unketeem. The locei official treat uelNy this ieformation in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representeve who completes Sector* A, B, and E for Zone A (without a FEMA-lasued or eArnmunity-ls*ueci BFE) or Zone AO must sign here. The steternena in Sections A. 13, end E are convict to the best of try iv:owlet: . Property Ones or Owner's Authoezed Representative's Name __ - - ' - ----- Address Cite State ±5 ---- -^ Signature Date Telephone _ Comment SECTION G - cosaveutin INFORIIIIATION (OPTIONAL) The local offic io! woo is authorized by taw or ordinance !o adrniniater the communlys floodplain management ordinance can comp/We Sections A, 6, C (or 6), end G of this Elevation Certificate Complete the lapplicabie items) arcs sign eelow, Chet the neassuremere eeed in items GB. and G9. 6' , n The inforrteeion in ection C was taken from other documentation that has been s!gried end seeded by a licensed surveyoy, engineer, or architect wht -- is authorized by low to witty elevation intormon tiodttate the source mod date of the elevation data in the Comments area below) G2. Li A cxxorrtunity official compiete.c, i Sector, 6 for a Puking located in Zone A (Without a FEMA-issuee or cornmatity-is.sued BE or Zone AO 0 The following intomietion (Items 64 -Ge ) is provided for vommurilty floodpiaM rnansigement purposos. T_ -- GE — Date Perm--Issued . --- 1G8. 15ate Certificate Of Corripiecer0ocupancry Issueo 1 G4 Permit Number i . it t G7. TTS* permit has been issued for D. New cAxistrues-km 0 Sul:laterals! Improvement 68. Eisvation 01 as-b4 test floor (including basement; et tree bueding: _ ri feet 0 meters (Pfe) Datum__ 69. BFE of (iil Zone AO) depth of flooding et the building sew 0 feet. L i meters (PR) DattNTI____ - _ Loci ofric4rs Name --------- Tale . — Community fgaine .._... Signature t4e comments ______ ______ _ _____---- • - _______ _._ 0 Check haltil attaohneei FEMA Form 81-31, February 2006 ' . . fiep‘aras all previous aditiCe •