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Home My Public Portal AboutEleventh Ter_6A ELEVATION CERTIFICATE J M 6 No 3067.0 Expires May 3 I r 99 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase reauirement. This torn Is used only to advise elevation Information necessary to ensure compliance with applicable community tloodplam management ordinances. to •etermtne the proper Insurance premium rate. andior to support a request tor a Letter of Map Amendment or Revision (LOMA or LOMR'. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION INSURANCE COMPANY USE EUILDING OWNER'S NAME l POLICY NUMBER STREET ADDRESS (including Apt. Un t. Suite anaor Bibb. Numoen OR PO. ROUTE AND BOX NUMBER { COMPANY NAIL NUMBER .THER DESCRIPTION (Lot aria Blocs Numbers. etc.) f � .� � r'� -'' t C ! .) I i -;TY STATE ZIP CODE SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION ?rovlae the following from thew proper FIRM (See Mstructtonsl: �MMUNIT + "LUMBER 2 PANEL NUMBER :UFFIX + DATE OF F;PM INDEX _ = RM ZCNE - iASE FLOOD ELEVATION j I n AO TAnef use ammo Indicate the elevation datum system used on me FIRM for Base Flood Elevauons (BFE): _ NGVD '29 _ Other (descnbe 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: . _ feet NGVD (or other FIRM datum -see Section B. Item 7), SECTION: C BUILDING ELEVATION INFORMATION 1. Using the Elevation Cer ticate Instructions, indicat the diagram number from the diagrams found on Pages 5 and 6 that best describes the subfect building's reference level - 2(a). FIRM Zones Al -A30. AE, AH. and A (with BFE). The top of the reference level floor from the selected diagram is elan elevation of 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- honzbntal structural member of the reference level from the selected diagram, is at an elevation of ._ 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 _ feet above or elow _ ;check one) the highest grade ad)acent to the building. d). FIRM Zone AO. The floorused as me reference level from the selected diagram is . _ feet above . or below (check one) the highest grade adjacent to the budding. If no flood depth number is available, is the building's lowest floor (reference even elevated in accordance with the community's tloodplain management ordinance'? Yes No _ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: _ NGVD '29 — Other (describe under Comments an Page 2). (NOTE: If the elevation datum used in measunng the elevations rs different than thawed on the FIRM (see Section B, Item 77, then cornreft the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) _ 4. Elevation reference mark used - appears on FIRM: _ Yes No (See Instructions on Page 4) 5. The reference level elevation is based on: . actual construction 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 construCtlon is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: feet NGVD (or other FIRM datum - see Section B. Item 7). SECTION D COMMUNITY INFORMATION 1. It the community official responsible for verifying building elevations speafiesthat the level indicated in Section C. Item 1 is not the 'lowest floor as defined in the community's ftoodplain management ordinance, the elevation of the building's 'lowest floor" as defined by the .. is: • ._-. feet NGVD (or other FIRM datum -see Section B, Item 7). 2. Date of the start of conslnuctortor subsume* 1.ment F EMA Form 81 -31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION - ' - s certification is to be Signed by a and surveyor, engineer, or architect wno is autnonzea by state or local law to certify etevatton -ormation when the eievanon information for Zones Al -A30. AE, AH. A (with BFE).V1 -V 30.VE. ano V (with BFE) is required. .:,ommunIty ottictals wno are author=ed by total law or ordinance to provide floodplain management information, may also sign the : ertification. In the case of Zones AO and A (without a FEMA or community issued BFE). a budding otficiai, a oroberty owner. or an :caner s representative may also sign the certification. = eference level diagrams 6. 7 and 8 - Distinguishing Features-if the certifier is unable to certify to breaKawavinon oreattaway wail. nciosure size. location of servicing equipment. area use. wa11 openings. or untinisned area Feature(s). then list the Features► not nciudea in the certification under Comments below. The diagram number. Sermon C. Item 1, must still be entered. ;:errrfv that the information in Sections B and C on this certrtfcate represents mV best efforts to Interpret the care available. ,;ncerstand thar any false statement may be punishable by tine or impnsonment unaer 18 U.S. Cope. Section 1001. j :ERTIFIER'S NAME _.CENSE NUMBER for Affix Sez, . - TLE COfv1PAN'i NAME ,... > . ,�.., � 1: ,r (r r. " ' , 6" m •f L C r /"..t) �.DORESS .J:TY . .a ` ATE ZIP � CN 'PE :ATE --ONE - Copies should be made of this Certificate tor: 1) community official..) Insurance agenvcompany, and 3) building owner. COMMENTS: ` "'Cf.. ON wm4 ON PILES, SLAM sasawarr MRS. OR COLuEaee 4 J 4 4 V NES :ONES 11" ZONES ZONES ZONES ,„i - I REFERENCE 'ft EvEL 1 FLOOD Il mm...— • LEAK 111 cLfVT ,,,�, i 1) t� .�J 7 lam+ ko„c 510 wT . . REF ERENCE ` I .I.1:00 .I.1:00 -._'. bw 5DE LEVEL I I ELEVATION EVEL , F . AAOE •. c' 4 OJIiCfJiff The aragrams 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. evanons for all V Zones should be measured at the bottom of the lowest honzontal structural member. Page 2