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HomeMy Public PortalAboutButler Av_1101 u4 /nr at7 viu_v 1u:ur rftt 014,7L1lOYV .,,•,,,,,, - - O.M.B. NO 3067.O077 ELEVATION CERTIFICATE Exptr•f May 31,1P46 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE Pfbt fAM ATTENT1O tt Use of this certificate does not provide a waiver Of the flood Insurance putchase regUtrement, This loin is used only to provide elevation information necessary lc ensure compliance with applicable community tioodpleirt management ordinances, to determine the proper Insurance premium tale, and /or to support A request for a l.sltet of Map Amendment or' Revision (LOMA or LOA4t1). InstrUctIone for completing this loin Cell be foUnd on the tollowing pages. SECTION A PROPERTY INFORMATION I roe INSURANCE COf iPAN`J USE Bt}1L 1Nr3 OWNERS NAME { POItCY NUMBER ,JAc c C,-LIST2"Cnon► Co. 1 sreeeT ADDRESS (Including Apt., Unit, Suite and'or 8Idp. Number) OR P.O. ROUTE AND BOX NUfdeER I COMPANY NAIL NUMBER /J a/ 1 3 0 r L E tL kVENUL 1 OTHER DESCflPTIoN7!i R . and 419 CITY . • , MATE , ZIP CODE. r Yor 4 I ,v© 6 ,4, i'Z8 SECTION'B FLOOD INSURANCE SATE MAP (FiliM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNI ?Y NUMBER 2. PANEL_ NUMBER 3, SUFFIX 4. OATS OF Fin] INDEX 9. r'nM ZONE 8, EASE 9.000 ELEVATION / 3 6 0 4 i :ace, 2— (In AO 7. 9. US8 dep(M 7. indicate the elevation datum system used on the FIRM tor Base Flood Elevations (8q): KNGVD ❑ Other (describe on back) B. For Zones A or V, where no EWE is provided on the FIRM, and the coreenUnity has established a BFE to this Wilding site, Indicate the community's BFE',1 1 f I 1 l ,U feet NGVD (or other FIF1M da(UM -'see Section 9 Item 7), SECTION C BOLDING ELEVATIC)N t 4FofMATION 1. Using the Elevation Certificate Instructions, Indicite the diagram number from the diagrams found on Paget 5 and 6 that best describes the subject building's reference tweet _ 2(a). FIRM Zones A1-A30, AE, AH, and A (with EWE). The top of the reterence level floor from the selected diagram Is at an elevation of I 1 I i i !'!,4-I feet NGVU (or other FIRM datum -see Section 13, Item 7). (b). FiFtM Zones V1 -V30, VE, and V (with BFE). The bottom vi the lowest horizontal structural member of the reference level from the selected diagram, Is at an elevation of I 1 I 1 1 ',Li feet NOVO (or other FIRM datum -see Section g, item 7). (c). FIRM Zone A (without BFE). The floor Used as the reference level from the selected diagram Is 1 1 I.0 lee"( above ❑ or below ❑ (check one) the highest gtade adjacent to the building. (d). FIRM Zone AO, The floor used as the reference level from the selected diagram le 1 1 I,L feet above 0 or below ❑ (check ono) the highest grade adjacent to the building. If no flood depth number is available, Is the building's lowest !loot (reference level) elevated in accordance with the community's lioodplafn Management ordinance? ❑ Yes ❑ No 1l Unkna>Nn 3, Indicate the elevation datum system used In determining the above 'reference revel elevations: ntlGVD 'Sa ❑ Other (describe under Comments on Page 2), (NOTE; If the elevation datum used in measuring the elevations re different than that-Used on . the FIRM fsee Section S, item 7), then convert the elevations to the datum system used on the FIRM and show the Conversion equation under Comments on Pape 2.) 4. Efevattan reference mark used appears on FIRM: L7 Yes ZNa (See Instructions an Page 4) 5. The reference level elevation is based on: FNacitial consiructiort 0 construction drawinge . (NOTE. Use of construction drawings Is only valid II the building does Mot yell 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 posf-conshtibtion Elevation Certificate WI be required once construction Is . complete.) 6. The elevation of the lowest grade immediately ad }scent lo the building Is:1 1 1 1 191au .leer NOVO (or other FIRM datum -see . Section 9, Item 7). SECTION U coMMUNiTY iNRotaMATION 1.11 the community otllcial responsible for Verifying bullding tateVeltohtt Chenille§ that the reference level indicated In Sec(lon C, Item i . Is not the "lowest floor" as defined In the community's tfoodplatn management ordinance, the elevation of the building's "lowest floor" as teethed by the ordnance lc 1 l L_U .0 teat N 3V'D (or other FIRM datum —see Section B, Item 71. 2. Cate of the stern of construction or substantial Improvement . FEMA Form 9 i -3 i', MAY P3 REPtACES Ali PREV14U5 ttATICNS SEE REVERSE SIDE FOR CONTTN'UAr1CN