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Home My Public Portal AboutGen George Marshall Blvd_111 . �DERAL atERGENCY MANAGEMENT . _ENCY O_ tl.i3. Flo, 3067 -0077 i NATIONAL FLOOD INSURANCE PROGRAl Expires July 31, 2002 j ELEVATION IO �jj ERTIFICAT i i important: Read the instructions on pages 1 - 7. SECTION A - PROPERT'f OWNER INFORMATION 1 for insurance Company Use; 3LtILt;4NG CWNER'S ;A Number 3U1LCING STRq"'r ADDRESS (inctuain• Apt., tin , Suite an.. Side. 4o.) OR ..'2OUTE: AND BOX NO. C+arnpany NAIC Number / // eztei'%.r• _ /s.4. t. .. '.' l Dt 4/ 1 vfTY /c..f ,,.4..e. 7 /QLt ri (.. a F PROP PROFVY DB6CRIPTION (Lot an Bloce N hers, Tax Par Number, ' Oestxip etc.) 31.11L0if e.g., ,3esidentiai, Nerrerestoenual, ,addition, Accessory, ate -Osb a Comments area, if necessary.) I ..ATITUDEILCNGITUDE ICPTICNAL) ciCRIZONTAL DATUM: SOURCE: ? _ GPS (Type): t#" - ' - -i#.##' �r ##.mil##°) ; 1 1927 1 I NAO 1983 1 I USGS Quad Map LI, Other SECTION A - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 31. NEI.P CCMMall -9Y NAME & COMMU�II ITY NUM94R 1 i 3 S.Z. COUNTY NAME . 33. STAT 1 _ y LOC 34..'JIA � PANEL PANEL � . : :u+rt - tX � 3 b. ; = tKN i I 3 tr'dN t'l4tit>_ 13. � !_CAD j 39. SASE FLOOD �.�c'1JATtCN {5) `J UM BER a ,DATE, I FFEC /1�7 DATE ZC ' (S) I (Zone AO, use depth of flooding) 310. indicate the source of the i see Flood Elevation (BFE) data or base flood depth entered in 89. ' ! FIS Profile i 1 FiRM 1_1 Community Determined 1_1 Other (Describe): 311. indicate the elevation datum used for the 8FE in 89: 1T 1929 11 NAVE) 1988 ) lather (Describe): 312. !s the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (CPA)? iJ Yes 1 –)-ettl Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ;_;Construction Drawings* 1 Under Construction' - Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. 3utlding Diagram Number ( (Select the building diagram most similar to the building for which tale certificate is being completed - see pages S and 7 . if no diagram accurately represents the building, provide a sketch or photograph.) 03. elevations – Zones 41-A30. ,AE, aH, A (with BFE), `!E, '/1 -a/30, '! (with 8FE), AR, AR/A, AR /AE, AR/A1 -x130, AR /AH, AR/A0 Complete items C3.a =i below according to the building diagram specified in Item C2. State the, datum used. If the datum is different tram :rte datum used for the BFE in Section 8, convert the datum to drat used for the EWE. 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 /'),fit("? 'V Conversion/Comments • • r .. Elevation reference mark used Ooes the elevation reference mark used appear on the FIRM? L_ _1 Yes I - erNo Q a) Top of bottom floor (including basement or enclosure) ,C2 . 13- ft•(r'r)' 3 ' - " .: b) Top of next higher door t ' .( $ /' ' c) Bottom o f lowest horizontal structural member (V zones only) . _114m) % Cq,� / ' f / Q .D a) Attached garage (top of slab) 4" . �ft.(W't) � [J .2) Low I est elevation of machinery and /or equipment , \ *'1 ,'. servicing the building (Describe in a Comments area.) /;2 . ✓ ft. i a "' Q 0 Lowest adjacent (finished) grade (LAG) Q • ..de. f1.(Ry 2 a \ 77 4. ,,,..____ �n '7' f ly Q g) Highest adjacent (finished) grade (HAG) , . 47 ft.(rtt) 1 4 ,s ° 3 UT 1 �, a`� Q h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade ^ T – HITLE`l� • 3 i) Total area of ail permanent openings (flood vents) in C3.h / sq. in. (sq. city) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. cattily that the information in Sections .1, 3, and C on this certificate represents my best efforts to Interpret the data available. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code. Section 1001. CERTIFIER'S j E LICENSE NUMBER_ A /A4(-7L5--,/ cvf i ‘ ' Z42iq TITLE CCMPANY NAME ADDRESS a�' i 44 7 CI 4it , 31 TURF' DAJPE PHONE .7 ss — RT- a}E4 rm :11:11 3 it •ln - -IF;:: 7 F PS ine erl. reehr feu ie i lee Pgr-%1 ..lr'r -^. ai 1 Pttr^ruir.t m ,'711TirsN1C iMPCRTANT: In these spaces, copy Me corresponding information from Section A. I For in$urancs Company Ilse: 31J /LDING Sj REE;;Ar i7RESS iinaua pt. Unit, Suite, na! r Akig, ) R PR. CUT AND BOX NO. Policy Number -0 I l CITY SECTION D - SURVEYOR, ENGINEER, OR .ARCHITECT CERTIFICATION (CONTINUED) ::opy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. �CW1AEN1 S I i Check here if attachments SECTION E - 3UILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT 3FE) For Zone AO and Zone A (without BFE), complete Items El. •through E4. if the Elevation Certificate is intended for use as supporting .nrormaiion for a LOMA or LOMR-F, Section C must be completed, Z 7. 3ut ding Diagram Number (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.) E2. The top of the bottom Root (including basement or enclosure) of the building is 1 _jj tt.(m) I_L;in.(cm) ?_ above or (_; below check one) the highest adjacent grade. Use natural grade, if available.) 3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is ; ft.(m) l„ in.(cm f above the highest aajacent grade. Complete items C3.h and C3.I on front of form. r4. , :or Zone AO only. If no i*ood depth number is available.s the top of the bottom door elevated in accordance with the community's loodolain management ordinance? t i Yes ! ! No ! ! Unknown. The focal official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A. 3, C (items C3.11 and C3,i only), and E for Zone A without a FEMA issued or community-issued BFE) or Zane AO must sign here. The statements in Sections .4i, 3, C, and € ere correct Po :tie best ofrny knowledge. �tcc srtr� rY uwtit 2'S 0ri UvvNtrcS AU i H0i4iLtt.r r ttriltkStN I A r lvt i IN DIXKLSS :r`TY S1AM LIP CODE :irGNA i Wit OA it i tikeiriUtit �:.101111try is • I Check here if attachments SECTION G - COMMUNfIT'Ni ORMATION (OPTIONAL) The local official wno is authorized by law or ordinance to earninister the community's 7loodplain management ordnance can complete Sections A, 3, C f or E), and G of this Elevation Certt$cate. Complete the applicable items) and sign below. Gt . 1j The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation infortnaliOn, the source and date of the elevation data in the Comments area below.) G2. ; ? A community otficiai completed Section E for a building located in Zone A (without a FEMAiesued or community - Issued BFE) or , Zone AO. G3. ;I The following information (Items G4 -G9) is provided for community floodplain management purposes. :34. PERMIT r4 UM H (is. ,3Art . t 4MI it utO + e» .)Ale lia.Ft174i(JAIE C a- t:..DMPLIANC UANC A3cCY j ISSUED G7. This permit has been issued for: I1 New Construction Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: ft.(m)Datum: G9. BFE or (in Zone AO) depth of flooding at the building site le: ft.(m) Datum: UF AL'S rvP ML 71 tit. COMMUNITY :4IAME TELEPHONE GNATURE SATE :' Uri AENTS 1 ? Check here if attachments =wawa r�.m A-r_11 . a it nn a r=ill aJ S . 1 : ,oPIdnrn is gnrrinruc