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HomeMy Public PortalAboutSeventeenth St_15 U.S. Federal DEPARTMENT OF HOMELAND SECURITY ELE AT IION CER ! iRC t 1 i OMB No_ 1660 -0008 I Emergency Management Agency Expires February 28, 2009 14 National Flood Insurance Program important: Read the instructions on pages 1-8. SECTION A- PROPERTY I' 'FORMATION y For Insurance Company Use: Al. Building Owners Name $ Policy Number A2. Buildin Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P_O_ Route and Box No. . -- i Company NAtC Number ,S- I \--\ -S eta City -e- `t G -s 5 t... A N O Staff E.. 41. Co 1 c1:7) ZIP Code 3 1 3 2 8 A3. Prop rty Description (Lot and Block Numbers, Tax Parcel Number, Lega1 Description, etc) E P s - S T E E S'S o= L.o . Z or & La-7 10'2 v4 P: , IZ) S k `I l' ilsL< -0 r A4. Building Use (e.g., Residential, Non - Residential Addition, Accessory, etc.) R 'S1 £>C a 1 6� t_ A5. Latitude/Longitude: Let N 1 I S9. 4 i t& ° Long. v./ Rot-c. 9 Go ' Horizontal Datum: Q NAD 1927 Er 1983 A6_ Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawl space or enclosure(s), provide: r g-17 A9. For a building with an attached garage, provide: a) Square footage of Crawl space or enclosure(s) sq ft a) Square footage of attached garage 0 sq ft b) No. of permanent flood openings in the crawl space or 8 b) No_ of permanent flood openings in the attachedarage enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade ��`JJ c) Total net area of flood openings in A8.b 3448 sq in c) Total net area of flood openings in A9.b ® sq in . SECTION B - FLOOD INSURANCE RATE MAP (19RM) INFOR TION B1. NFIP Community (Jame & Community Number 182. County Name 1 B3. State I .-- 'a' Pa l `-r 3 S /3 L ro4 C. , tom. B4. Map /Panel Number 85. Suffix 66. FIRM Index B7. FIRM Panel 138_ Flood 89. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zones) AO, use base flood depth) . 13S e�4 - 6 e�n�,,, C 6 -1 - 7° 8( -1 N,- 1 40 0 B10. Indicate the source of the ase Flood Elevation (BFE) data or base flood depth entered in Item 89. 0 FIS Profile [t IRM Q Community Det ined Q O 3ter (Describe) BI 1. Indicate elevation datum used for BFE in Item 69: NGVD 1929 ❑ NAND 1988 ❑ Other (Describe) 012. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes R'1Qo Designation Date 0 CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings' 0 Building Under Construction* mistterl Construction `A new Elevation Certificate will be required; when construction of the building is complete. C2. Elevations - Zones A1-A30, AE, AN, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AN, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7_ Benchmark Utilized L cl. C„Pi Vertical Datum /4,6 M 0 9 2..." Conversion/Comments N P Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) 1 d Z 1 t1 fee ❑ meters (Puerto Rico only) b) Top of the next higher floor 1 . Offset ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) ❑ feet ❑ meter (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building D O BTeet [] meters (Puerto Rico only) (Describe type of equipment in Comments) / f) Lowest adjacent (finished) grade (LAG) / ©. - 'Jfeet 0 meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 1 0 . [feet 0 meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seated by a Land surveyor, engineer, or architect authorized by law to certify elevalion information. 1 certify that the info oration on this Certificate represents my best efforts to interpret /he data available_ 1 under that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001_ © Check here if comments are provided on back of farm_ - t Ceriitie s klame License Number ` aia, (IG 4 ran c e -a- e-,-,-... ... -. 1 8 2' 2- . Z----j' ') ( Title Company Name f,.Prv->. S k c--..0 !; Ntsro, - - 7--1 0 08 /., Address , t" - City State ZIP Cod 1 L il Signature p ti r D ate °y g�Telephone �'' c E /V N u !ed s\ � . ,. 1— (a- r„� ( *3.1 ...) ,92,s- s-352 ` '4, FEMA Form 81 -31, February 2006 ' See reverse side for continuation. Repiaces all previous editions • WANT: in these spaces, copy the �m !T information from Section A. For Insurance Company Use I Building Street Address (iriducling Apt, tint Suite. Briar 13kig_ Na.) or P.0_ Route and Box Na. I Polecy Number `S - 1 .3 .S'nZet I State ZIP Code Company NAM Number Et_ sc-10 - vD. 3 - SECTION D -SURVEYOR, ENGINEER, OR ARCHTTEOT OEM (CONTINUED) Copy bath sides of this Bavarian Ceraficate far (1) cornownity official. (2) inserrance ,terrtfcarrtparry. and miner_ Comments 9. eg Nye 14 4 5 Ft' C rpt- 1 4- Ite-ecefF c9 r- Date Signatum s 1.9 here if attachments SECTION E ELEVATION INFCIRMIATIOtay(SURVEY NOT REQUIRE)) FOR =MAO ALASD ZONE A PRIM EFE) For Zones AO and A (without BFE), complete Hems El-E5. Ware Cedilicee is intended to await a LOA or LOXR-F resprest, cempleUr Seems A. B, and C. For Items E1-E4„ use (natural grade. gonNable Check Se rneeernernent used. in Puerto Woo artV, eater metewe. El_ Provide elevation inferoureera karthe 'Wowing and (greet The appnopriale booms to show whettm- the eeaSair. a aferare bagaar Om highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a} Top of bettrmr few (inducting basement. wad space. ..1. is 0 feet 0 irneL. 0 above Or 0 Wow the HAG_ b) Tap of act= tosr (including basement. cranaA 71, Li feet lameters El alum or 0 below the LAG. E2. Fri S dDtagarn-8vitth , :Hoed . in Kens 8 andfos 9 (see , pa, ,, ,Ire a of Instmetions), the nad higher (elevation c2J tn the diagrams) of the buliding is feet 1111 motets 0 above or Li below the HAG. E3. Attached garage (top of stab) is 0 0 above or 0 betaw the HAG. El. Top of platform of machinery anre mnaMg the building is Epeet Einvetals 0 above or Dtow the HAG. Ea_ Zone AO only If no good depth number is a Fs the lop 011ie bobbin Sow elevated In 4 ww. ts-ZI the conarturely'sloodpiain management ordnance? lJYes 0 No CIUMOGIBIL "The local official rrte: certifyarts" . In Section G_ SECTION F - PROPERTY OWNER (OR OMINEFTS ttat-rae....*cit AMP CERTRRCArON The property =mar or frg.rar's cellusized ireence trino - SecgonsA„ B. and E fur eA (wWiouta Falik ar `sued BFE) Or Zara AO must ate tare. Tha 1?3, earl Eat:tea/motto Me best of my knowledge. Propaty O's or Owner's Authorized Represenlathaes Wane Address INA I -1Pt try Slate ZIP Code Signature - Dale Telephone OrriThnentS. • 0 areas here ff attachments SECTION G - COMMUNITY INFORMIAMON (OPTIONAL) The local official who is authorized by law or ordinanceto ' theammiunny's Hoodplain management ordinance am complete Sections A, B, C (or E), and 0 of this Elevation C.ertiricate. Complete Hie appricable em(s) and sign below_ Cbedc the measurement used kr Items GB. and G9. n The , in Secitun C was taken from other dod that turs been signed and sealed by a Hemmed =mayor. engineer, or added who — is authorized by law to ceMfy ekell8VOCI information. (Indicate the smarm and dates( Iheeleerafion duke lathe Commits area below.) G2_ 0 A °mummery official completed Section Era helcHng located in Zone A (velhout a FEW-Ism:ad or curememitrissued BFE) (Kr Zcate AO. G3. 0 The foaming ", ()ems G4..-G9.) is pmvided for communityllooriplain paposes. G4. Pane Number 65. Dale Flame ismad I G6. Deft Cafgeate Of CompaanatiOccupancy Issued G7_ lids peen* has been issued los: New COOS111=fftlIt 0 Subsintial improvement Ga. Elevation of as-buit lowest Hoer (tailuarta basement) of the intlenzg: 0 feet 0 meters (PR) Deem 69. BFE or (in Zone AO) depth olleafreqr at the buicang 0 feet 0 maters (PR) Dattnn ji Local Official's Name 1 it 1 Wife Community Name 1 ‘41 u Taaphane Signature Date Comments n Cher* tieoe if attachments 04 , >4 .IfttfLe