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Home My Public Portal AboutMILLER AV_112 _ ------ U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB N. 1660-0008 Expires February 28. 2009 Federal Emergency Management Agency National Rood Insurance Pnogram important: Reed the instructions on pages 1-8. SECTION A - PROPERTY INFORMATICIN : For insurance t Lise: A1 BUlidine Owners Name D AP'. CAIL Z ,44 .___ Policy Number A2. Euilaing St fe Stet iciress Apt„ejne, Suite, andlot 8tirig. No ) or P.O. Ratite and Box No Company ttlAC Member Cy _- .--- 'V A3. Property Destelptton(Lot an;1.:Oiock Numeere, isit rano& Numbef, Legal Descripeoe, etc.) .__.---ZZe--_,Z1/ ./; __ V.ctet________ _______________ , ,l' l i __—._____ A4. Building L160 (e.g „ FersIdeoesii, likin-Residentisi, Addition, Acceeecry, etc.) A. LalitticielLongitude: LAY __ Long. Horizontal Datum: 0 NAD 1927 E l NAD 1963 A6. Attach at least 2 photcgraphe of the utiding if the Certificate is being cased to obtain flood iesurance. Al. Building Otegrarri Ntanber AB. For a buileing with a crawl specie or enclosure(e), provelse A9. For a building with an attached garage, provide: a) Sq.isre footage of ere* apace or Wit laSucl9(3) _ rizi ft a) Square footage ot attached gareese . sq fi, e) No, ot pernerient flood opeeinet in the creed speee or b No. of permanent flood openings in the attechecigarage enolosure(s) wails witt'ilri 1.0 fool tibeve adjacent grecie _._ walls within i 0 foot above adjacent grade c) Total net area of flood openings in A61 __, aq in c) Total net area of flood openings in A9 b sq in 4- 7ffiasaNua - . SECTION 2 - FLOOD INSURalleNCE RATE MAP (FIRM) INFORMATION ....,.. ........_...._ I NFI qdraseirtity Nem iii Cominuntty Number _ , 1 S2. County Name - '.• • j , I/ -- • • 1 83. State , --' i :L_______ A .v ,1 /:.1-4.6.:...J C:: ii4 i 1 84 - . Map7IPinel Number i 85 Suffix 1 86. FIRM Ird6K 1 , , , .r" DEAC5 I37. FIRM Panel B6 F 89. Ba Eleuelve/Ftetial±d Date 1 lood Ao se Flood Elevation() (Zone e Z * . se ase flood depth) I 4 ..:•••• / tr I e- - / ; Th 810. Incite-ate tne r.sourte of tey Base Flood Elevation (8FE) data or lease flood depth entered in item 89. [3 F IS Profile PI FIRM 0 Community Determined 0 Other (Deseeibt) .________„_______ -- Bit. Indicate elevation dation used far BFE in leen 89: 01 NGVD 1929 0 NAVD 1988 0 Other (Desette) .• E2 Is the building located in a C-oastai Barrier Resouroas System (CBRS)area or 0thetwlse Protected Area (CPA)? D 'Yes rge‹o Designation Date CBRS 0 °Pi. -- . „ . . . .. . . SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ,,_,,,, C 1 . Building elevatiens are based on: D Construetion Drewings' 0 Building Under Construction' r Cinished Construotion A new Elevation Certificate 'ai l! lie required when uctn at the building is complete C2. EleYetlens - Zones At -Kele AE, Ali A (with BFE), VE„ V110, V (with EFE), AR, AR/A, ARJAE, AR/A1-A30, AR/AH, AR/A0. Complete Items C2,a-g below edaording to the building gram seedbed in item A7 Benchmark Utilized _ / Z. 0 Conversion/C-ornrneers ____ ____ _ — Check the measurement used el Top of bottom floor (inciuding basement, crawl space, or endoisure floor) /2 . ( ['eel 0, meters (Puerto Rico only) b) Top of the next nighei Piece /1/ A , .... L] fee r LJ meters (Puerto Rioo only) c) Bottom of tee lowest horizontal structural merneer (V Zones only) ./V• - feet 0 meters (Puerto Rio° only) d) Attached garage (top of Watt') _____A./ . _0 feet 0 meters (Puerto Rico only) e) Lowere elevation of machinery or teztuipmeet stmeicing ttle building J Z' ,[31eet 0, meters (Puerto Ric* only) (Deserts) type et equipment in Comment.) f) Lowest adjacent (finished) grade (LACi'; q • •____aleet El meters (Puerto Rico onty) gj Highest adjacent (finished) grade (HAG) e A' • .,....._._....._ait,e 1. fl, meters (Puerto Rico rutty) BECTON D ,- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This centeketion is to be eigned and sealed by a tend surveyor. engineer, or arohnect authorized by law to certify elevation lotarrnatIon. I certify that the inturrnation on this Certificate represents my best efforts to Interpret the data aveilabie, . . • - i understate/Mai any false stalemept rnoy he purfieliable by 15rre o, imprisonment under 18 U. .S Code Section 1001 ' i - In Cheek here if centments ere provided or' beck of form ' . ,-- f 15:. , r,7, lc ; ' ti ‘ '. .. i-,? __.. _..4,, ..,.....:.- -±„,-- - 4p: ,, ,: e' fi. .__ '- c ' Ad 1166- / - ik-r,2°` Trre ' 1 kZ__ . : Address / \ 7 Stater___ , ZIP Gotie ' - .7...., te-e. ee-t•- e. I ' \ - - L._ Jedi - 3 /z4.3' . 4 k r . Signature N 17 .... ---, Telephone re ,4.--, - ei / ve ' --, '-' i ) L 1/•=f *L.: •-• -- 1 e. _. . -- \ ------ — FEMA Form el -31 , February 2006 See reverse side for continuatic n. Replaces all previous editions l'( d( i Ad j/L /44;fir. jr Co vi 'e d -// • s.1 c a, izo 4 El /2 0- q 1 6ce 1/ 4 / . . _ Aic - , IWORTANT: In these paces, cop7thecorrespondIna Information from SocUon ....F7orlinr.orNvoi" -- , — . .-- . .. ... , . . Bulldteg (Incluqng Apt., Unit, Suite, andlor Bldg No.) or P.o. kotite and Box No. :::..-.0140:NOtici. - State ,-- e ee eeP (-7 5/ -5C-el •... ... ' ' • • , .. / SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Cortificete for (1) community offliesi, (2) l ...e, a -, actent/compa9y, and (a) building owner, a-, - •.4a lea r - --, .._ . — • _ i i — , .... e + i r ez-, t .._,Ikc..1 _____ 1 ■ ■ .• ---_--___- —_____-_— SignatUrea4(, / ! e' \al e o _ . a ' 4 - A ee- e X. - 12: ( 0 Check here If attachments ._ , .. .. . .. . . . . . .. .. . . . .... . SECTION - BUILDI G • 'ATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BEE), complete Items E1-e6, if the Certificate is intended to support a LOMA ur LOMR-F request, complete Sections A, B, and C. For items E1-E4, use natural grade, It available. Cheek eta measurement used. In Puerto Rico only, enter meters. El. Provide elevation informabon for the %flowing and eheck the appropriate boxes to show whether the elevation is above or below the highest adjacent garde (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (Including basement, crawl space. or enclosure) is _ _. D feet 0 meters 0 above or below the HAG. b) Top of bottom floor (including basement, crawl space, or eeclosure) is - 0 feet 0 meters D above or below the LAG. E2 For Building Diagrams 6-8 wife permanent flood openings provided In Saco items 8 W/or 9 (see we 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ . 0 feet l meters U above or U baker the HAG. E3. Attached garage (top of slab) is . - -0 feat -. 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing tee budding Is __ — .0 feet D meters 0 above or 0 below the HAG. E5. Zone AO only: If no flood depth number is avaiiable. is the top of the bottom floor eleveteel in accordance with the community's floodplain managerineni ordinance? [3 Yes 0 No 0 Unknown. The local oftloial must certify this information In Section G. --- .. • — • • , . SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION ..--- — — The property owe or owner's authorized representative who completes Sections A, 3, and E for Zone A (withoot a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sectiont A, t3, end E we vowed (o the best of my knowledge. ......_ Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code _ Signature Dale Telephone Comments 0 Check here if allachreente . — SECTION G - COMMUNITY INFOINIMMON (OPTIONAL) The locel offielet Who is a by tar:a Or'didleinCei le administer the caminuney e fleodelein management ordinance can complete Sections A: feC (or E), and G of this Elevation Certificate. Complete the appiicable Itern(s) and sign below. Cher* the measurement used In Items (38. and G9. 131. El The information in Section C was takers from other documentation that has been signed and sealed by a tic surveyor, engineer, or air.hitect who is authorized by law to certify elevation information. (indicate the soune and date of the elevation data el the Comments area below.) G2. El A oommunity official coneeeted Section E for a building located in Zone A (without a FEMAessued or eornmunity-isseed BEE) or Zone AO. 133, 0 The following infoneation (Items G4 -(39.) is provided for community floodplaln management purposes. . 1 G4. Permh Number I 06, Date Permit issued I (36. Date Certificate Ot Compliance/Occupancy Issued G7. This permit has been issued for: 0 New Ceinetruction 0 Substantial Improvement Ge Elevation of as-oulit lowest floor (including basement) of the building: - 0 feet 0 meters (PR) Datum G9. BFE or (in Zonra AO) depth of flooding at the building site: • ___ 0 feet 0 meters (PR) Datum__ ___ Local Official's Name 'title Cernmunity Name Telephone Signature Date __________________ — — „__ _ _ — • - -------- - Comments _Q. catecislikrittlentti ._......--. ....._.... FEMA Form 81 Felortiery 2006 Replaces ail previous editions