The URL can be used to link to this page

Home My Public Portal AboutPolk St_50 B • ,4, A� 7 " /// . o.M.e. NO. ?06r -00 E C V ON CERTIr$ tExpttQrr.Iay3), l sa Frt Ef AL EMEF%OENQY MANADEMENT AGENCY • NATIONAL FLOOD INSURANOE PROGRAM TENTION: Use of this certificate doe* not provide a waiver of the flood In*urence purchase requirement. This form is used only to wide elevation information necessary to ensure compfl *nee with Applicable community floodplaln management ordinances, to lerrnine the proper insure i cp netruali l an for completing PIN form can bee or on the p chow ir g pages Revision (LAMA or LottitR), SECTION A FROpEMT IN FORMATION FOA INSURANCE COMPANY USE _ Ul O g r h�. POLICY NUMMI , ;tR J A ORESS ( dpi,. Unit, 8ui • Nor eft NumbOr) Oft RO, (ROVIII ANO IOX NUMBER COMPANY NATO NUNIAER —5 „VQ24. ) ER 0 ell /pi SCRIPTI (let on nod oe NUM Vf, eta) � i • / l /1 a 14 4 M > t t � �iT E ZIP COOE G �. _ SECTIONS FLOOD iN$URANOE MATE MAP (FIRM) INFORMMATION . rovide the following from the proper FiRM (See fnstructian$): • I. COr.IMUNITY NUMB En t. PANEL NUMBER It.IUf 4. 011Tt OF FIRM IUOEX It. FIAi.i ZONE 8' BASE 1 E FLOOO O EL V 1I N { . / 5 .11 41 L t i / 6... 40-06, '. Indicate the elevation datum system used on the FIRM iot Arista Flood Elevations (SFE): U NGVD ❑ Other (describe on back) 3. For Zones A or V, where no FIFE is provided on the FIRM, And the community has estabfshed a EWE fo' this building site, indicate the community's BFE: U 1 1 1 1.0 feet NC:1VD (or dthir NAM datum —see Section FI, Item 7), . SECTION C BUILOINQ i'tLEVATIQN INFORMATION 1. Using the Elevation Certrficate Instructions, (ndtceU.the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject bultd'rng'* reference level .0- 2(e). FIRM Zones 1 -A30, AE, AH, and A (with BFE), The top of the reference Level floor from the selected diagram is at an elevation of! 1 1 V V It feet NGVD (or other FIRM deturn Section b, Item 7). (b). FIRM Zones VI -V30, VE, end V (with FIFE). The bottom 01114 lowest horizontal structural member of the reference level from the selected diagram, is at an elevation oil 1 1 1 1 1,U Net NOVA (or other FIRM datum —see Section B, Item 7). (c). FIRM Zone A (without Pi"E). The floor used at the titerenee levet from the selected diagram Is 1 JJ.1 feet above 0 or below 0 (check one) the highest grade adjacent 1014 building. (d). FIRM Zone AO. The floor used es the reference tbvet 1reM the *elected diagram Is 1JJ feet above 0 or below) (check one) the highest grade adjacent to the building. It lid f60d depth number fa available, is the building's lowest floor (reference level) elevated to accordance with the community's Iloddpiain Management ordinance? 0 Yes ) No 0 Unknown 3, Indicate the elevation datum system used in determining the Above reference level elevations: 3VD'29 ❑ Other (describe under Comments on Page 2). (NOTE: l / the elevatlort ditit►rIl Mead In mea*uring the elevations 1s different than the! used on the FiRMl (see Section B, Item 71, then convert the O WVltlerl! lo Ma datum system used on the FIRM end show the conversion .' equation under Comments on Page 2.) 4. E=levation reference mark used appears on FIRM: El Yet rOttIo (gee Instructions on Page 4) 6, The reference level &evation Is based on &WWI a ldlttuctton 0 construction drawings (NOTE: Use of construction drawings Is only valid 11 NI building does not yet have the reference level floor in place, in which case this ccrUficete will only be valid for the building dt,AnO 14 Course of construction. A post - construction Elevation Certificate will be required once construction Is complete.) . ,/, 6, The elevation of the low,ve'st grade Immediately adjacent to the building i1:1 1 1 1 of ,t feet NCVD (or other FIRM datum -see Section B, Item 7). • SECTION b COMMUNITY INFORMATION _ _ 1, U the community °Hic!a! responsible for verifying building elevation* specifies that the reference level indicated In Section C, Item 1 Is not the 'lowest floor" es defined in the Community'A (Id dpIA1n management ordinance, the elevation of the butlding's'lowest " defined by the ordinente i 1 1 1 �. feel NOVD (or other FIRM datum see Section E3, item 7), t. b Iloor es o ! th s t a rt o r cons or subs t Improvement ...... • era trt4 Ail . SFF kE1rtRSE SIDE FORCONflNUA11ON `�� SECTION 0 CERTIPICATION This certification is to be signed by a (And aurva�y' 61, 44414 Or drahlt4Cl who Is eUthorized by state or local law to certify elevation Information when the ele'vatlon Information for zon,S A1 AE AN, A (with 13FE),V1— V3o,VE, and V (with EWE) is required. Community officiate who sr4 Authorized by local few Or Otdln$nee to provide (loodpiain management information, may also sign the certification. In the cm of Zone's AO and A (without i PEMA et Community Issued SPE), a building official, a property owner, or an owner's representative may also sign the certification. f eference level diagrams 6, 7 end e - bistingutehtnq P**turel -II the c$rttfier Is unable to certify to breakawaylnon•breakeway wait, enclosure size, location of servicin equipment, Area U1e, Wen Opening*, or unfinished area Feature(s), then list the Feature(s) not Included in the certification under Comments belOW. TM diiprftfll number, Section C, Item 1, must still be entered. • 1 certify that the Informal/en In Secllon' S and 0 ofl I CIrttl►ciI r�Ipros *nts my best efforts to Interpret the data available, 1 understand that any false statement may be punts able by Ilse Or ImprIsonment under 18 U.S. Code, Secllon 1001. u . n . CERTIFIER'S NAME MINI! NUMBER (or Affix Seel) Terry M. Coleman I e N97-2485 TrT COMPANY POAM Land Surveyor /Th tMrA_ rngtneerit --S.e vjses —lac AMR ='• g CITY STATE ZIP 2 i - - Ch. 6 . Bet Salm ntm h .. , GA 31401 ON T • - � �T Q PHONE Its ��,' 111____ 1 h ( .0 n G ., -[ . . Co e s e . • W. be made of this Certificate lots 1) 6OffiMUi tIy official, 0) insurance agent/Company, and 3) building owner, COMMENTS: ON WrrN ON PIL6s, •LAN IAeaMIHT PIERS, OR COLUMNS ZONES ZONES ' t UMNf ZONes 204E9 }" •Ertq[Nct _ r mtytRtA;t - `- L[VIL l Mt% .� I ( "rr n000 I . 4 ^ . ':. ' • %, \ -- IttVAtION tar ' `i t it' , r r p., It i tj(� r e'l • � ) < ��,A• .1' ,y : • The diagrams above (Ilustrate the points et wh the elevations Should be measured in A Zones and V Zones. Elevations for aft A Zones should he mee l I the top of the reference levet floor, . ptevattons for all V Zones should be mealUted 1114 bottom of the lowest horizontal structural member, Page 2