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HomeMy Public PortalAboutTenth St_3 U.S. DEPARTMENT OF HOMELAND sECURrrY ELEVATION CERTIFICATE I OMB No. 1660 -0008 Federal Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program Important Read the instructions on pages 1 -9. SECTION A - PROPERTY INFORMATION N For Insurance Company Use Al. Building Owner's Name 1 _ Policy Number _ R. . Tkei_sta te."e e . .51 --- e► \< A2. Building Street Address (including Apt., Unit, Suite. medlar Bkdg. No) or P.O. Route and Sox No. 1 Company leAIC Number :3 1 et '' .$T'C eV - CIty i `t C2 - E ' 1$ le-Per-4e State G co �G i A ZIP cod 31 3 Z $ A3. Propety Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) , a 1 : ` . . . “ = " n S 1 d0 - L 1 3 tot 1, I F3 e r.S e. Pr feno A4. Building Use (e.g, Residential, Non - Residential, Additb y�.) n, Accessor 2*- r o t 1 S '.^►- A5. Latitude/Longitude: Lat. /v 3 4 ” 01) _ (7 13' Long. IN MO 5'0, ( 6'3 ' Horizontal Datum: 0 NAD 1927 ErNAD 1983 A6. Attach at least 2 photographs of the building elite Certificate is being used to obtain flood insurance. A7. Building Diagram Number & A8. For a building with a crawispace or endosure(s):, ,q A9. For a building with an attached garage: a) Square footage of crawlspece or enclosure(s) 2 4 1 8 M sq It a) Square footage of attached garage 0 sq ft b) No. of permanent flood openings in the crawlspace of b) No. of permanent flood openings in the attached garage enclosure(s) within i 0 foot above adjacent grade ` within 1.0 foot above adjacent grade CC��3J c) Total net area of flood openings in A8b sq in c) Total net area of flood openings In A9,b —( sq in d) Engineered flood openings? 0 Yes IP d) Engineered flood openkrgs? 0 Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community:Name & Community Number Name B3. State i Y G ;3�$ I1,4-4 r I �S I' C4 f B2. County Giiz r i- o%-C v 1 1 G ea R. •G i Pt 84. Map/Panel Number B5. Suffix 86. FIRM Index B7. FIRM Panel 88. Flood 89_ Base Flood Elevation(s) (Zone D 2.C3 Date devised Date Zones AO. use base Rood depth) 13r5 9 - 2G - CA ) -2G - ®a � t4-. B10. indicate the source of the ase Flood Elevation (BFE) data or base flood depth entered in Item B9. EI FIS Profile of Community Determined ❑ • ^e er (Describe! B11. Indicate elevation datum used for BFE in item Bg: 0 NGVD 1929 IT VD 1988 ❑ Other (Describe) B12_ Is the building located in a Coastal Barrier Reso rces System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes Eo Designation Date i 0 CBRS 0 OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on 0 Construction Drawings' ❑ Building tinder Construction* g4nished Construction *A new Elevation Certificate wit be required when censtmction cline building Is complete. C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, AR/AE. AR/A1 -A30, AR/AH, AR/AO. Complete Items C2_a -h below according to the building diagram specified in item A7. Use the same datum as the BFE. Benchmark Utilized L b e e 1-- Vertical Datum N4 *] 'L 9 Conversion /Comments hY) / Check the measurement used. a) Top of bottom Hoot (including basement, crag tspace, or enclosure b 4 1 foor) v ec eet B meters (Puerto Rico only) b) Top of the next higher floor ■ e,. . 1 feet meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) feet Q meters (Puerto Rico only) d) Attached garage (top of slab) /In feet 0 meters (Puerto Rico only) e) Lowest elevation of machinery or equlpmentjservict ng the building 1 . S 11 st ❑ meters (Puerto Rico onty) (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to buffing (LAG) 7 4 FP...get p meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) Is - Q 1:74_46.t. 0 meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including 7 9 IgKet 0 meters (Puerto Rico only) structural support . SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Thls certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by lawto certify elevation information. t certify that the information on this Certificate represants my best efforts to interpret the data available, efei it (a / .41 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001_ / 0 c f g x e p ': Rt here if comments are provided on back of form. Were latitude and longitude in ectton A rovided by a 4.6 • licensed land surveyor? Y Li No I .1582 Ce fier's Name License Number ,C-",n, . I I i. I."! , 1 8 . v i A,....< - z ® 9 = r �` {� Company Name . , � G li , l a � v � ` Address City i u r, j , Pt t3 r, et r. R, a w b 510,v I.. ra ea A, et State co • ZIP C ode 3 11 C 6 i 1 i � � Si i r ) R , , Dats E - Z.0 tz �Teiep - ( . - 12:1 c)2..5 3�s . ' �: ,_... s Imo= FEMA Form 81 -31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building Street Address (i ing Apt., Unit, Suite, andror Bldg. No.) or P.O. Route and Box No. Policy [Number .3 I r-r rP- -- Chty� State ZAP Code ; Company NAtC Alumber 1 "E"E" . SL,.F 0 exaG f 3 (3 z, SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) commhmity official, (2) insurance agentfcompany, and (3) building owner. Comments n z. = t( t {(2 G 4s r4 ®r 71 Or f-••• tJ o f i P t .{� -� {`-ice �r NN. T E-", C3 er C o cam. 1 -'f' -S A 1 to S esk J L � V - r S t Signature k `J Date ® Check here If attachments SECTION E - BUILDING ELEVATION 1NFORMATICi (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5, If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C_ For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters, E1 _ Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawispace. o - - • ❑feet ❑meters ❑above or Dbetow the HAG. b) Top of bottom floor (including basement, crawtspa '- • en.. • is . Qfeet Omelets Dabove or ❑below: the LAG. E2. For Building Diagrams 8-9 with permanent flood op • ed in Items 8 andfor9 (see a es 8-9 of Instructons), the next higher floor (elevation C2.1) in the diagrams) of the building is ___ Q feet meters ❑ above or below the HAG. E3. Attached garage (top of slab) is Meet ❑ meters ❑ above or ❑ below the HAG_ E4_ Top of platform of machinery and /or equipment servicing the building is - 0 feet Q meters 0 above or [3 below, the HAG. E5. Zone AO only; If no flood depth number Is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local 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,13, and E for Zone A (without a FEMA - issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address \ ( State ZIP Code Signature INA, - Date Telephone Comments ❑ Check here if a -tediu ents SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to admtnisterthe community's ttoodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable Reams) and sign below. Check the measurement used in Items 08 and G9. 01. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation informaflon. (Indicate the source and date of the elevation data in the Comments area below.) G2_ ❑ A community official completed Section E fora buiidmg located in Zone A (without a FEMA - Issued or comrrumity- issued BFE) or Zone AO_ G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. I G4. Permit Number I G5. Date Permit Issued I G5. Date Certificate Of Compliance/Occupancy Issued 07. This permit has been issued for: ❑ New Constructkom ❑ Substansat Improvement 08. Elevation of as- built Lowest floor (including basement) of the building [ 1 feet ❑ meters (PR) Datum 09. BFE or (in Zone AO) depth of flooding at the biding site 0 feet 0 meters (PR) Datum 010. Comm sue ign flood etevalon ❑ feet ❑ meters (PR) Datum • \ h • Local Oticiars Name ` Title Community Name V Telephone Signature Date Comments ❑ Check Here if attachments FEMA Form 81 -31, Mar 09 Replaces all previous editions FROM :tJINCE HELMLY FAX NO. :912 9253523 Sep. 24 2008 16:36AM P1 j - U DEPART ARENrOF HOMELAND SECURiTY ELEVATION CERTIFICATE 1 OMB No. 1680 -000e Federal Einerpancy A . • Flood , Agency moires February 28.2A09 National Flood insurance Promom Important Read the instructions an pages 1-8. elEC'TIOM A • PROPERTY INFORMATION ( For keeurence Company Use: At. ; C)rvi d f4'I! M PrS 6: . �FFO a YK. Number A2. tang Skeet (Including Apt, Ur& Si, te ant for Sidle lio j of PA. RotAit and Boa No • I Cementer 113AIC Number 3 ! ® - -- City, 'IS " 17$ t a G 0.4 i 7./F code '3 1 1 8 A3. Prorarbe Rot and t � s Numbers, not Parcel Number. Legge Deecdpeon. etc.? I .- 1..� s_ �av 0 t $�.� <_ o rs CII' 6 , �-i-D 3 �1 1 s`.. o A4 Use (e.g.. . �c.) le • • - ; : i fa le A5. leatudefLongibide. Lat. tet 3 Z. °. f)1 . V2 I- ' t.orte. 1AL ' rif? • Hostrental Drain ❑ NAV 1927 1,3F4AD 1803 Ati. Attach at least 2 of the bolding tithe Certeicole ie be raid to obtain Rood A7. Wart; Nurribef A8. For a buldbig with a crawl specs orenclosure(s). provide A9. Fora building with an eirtrted garage. provide a) Square of cote a s) 2 ® e?t a) � b) No. of permanent food opera* in the crawl spats or b) N. of pentranant'liood openings b the g8rag tea) wale w 1.01oot siceacent grade i i waRewiliern 19 ties above adjacent simile i c) Totaf net ems of fool openings to AB.b Xidi art ire c) Total rest epee diced openings in Alb sq in SECTlO$ NI - FLOOD INSURANCE RA11E MAP (FIRM) PNFORMATtON . Bi. RR!' Community Icahn & Centro uney Number 1 BZ tlegne H3 Stabs ��� l4` 1S �e — rte. 1 41E42,046 s a B4. Nurnber I .&i6x W. Milt Mem Panel BIL Flood Base Flood Ele�rja (s) (Zone 13 t C 02.13 t Dab Date ) AO. base food depth) F I Milt 1 -2� di � . 1 B7. Flak) I A te - I 89.. B a I+ Bt O. Ind source of the Base Mood Be�ion (6FE brae data or be food depth sneered in Ne 168. . El FIS Pmt ectRell 0 Communily Determined El Other (Describe) BI 1. i elevation drawn teed fur Wee in item B9. 0 ?4WD 1929 PfaerD 18ee p over ) 1312. Is the building located in a Coastal eiarr1arReseurcee System (GIMES) erne or Protected Area (OPA)9 0 Yes RI& secinoN p - lemma e_EVAT$ON PWORNAT1ON (SURVEY ) G1 _ Building eiewutlonm we based ens • [rroonsln,dcn El Buieeng Under Consfihceon* 0 Fetched Construction A new T'1c a alion wet be heOiarOd when correntraon of the ba,ia„ g is compiew. C2- Elevations -Zones At,A80. AE. AH. A (w0h OF VE, V1 V30, V (wilt tom), AR AR/A, AR/AE. AR/A1 -ASO, AR/AH. ARONO. Camptete items C2-a-g bakmr socnnlihp to the budtfeep dereram speared er fern A7. A e� ® Q Berdmwrh 4tile L l _.( 1! F v 13 8 S Nit L� Chide the used. a) TO of borate Door (indudki creed cr spate, or ent3osure Seer) g 1 P. : ' (Puerto Rico only) b) Top of the need higher So :. ❑ ❑ nh meters (Puerto Rico only) c) Bo9om d the lowest hwtmntet streets eel n (V Zones only) . All. .: 0 ratans (Puerto Rico only) d) Atta od garage (ber of steire ' r ❑ meters (Puerto Rico only) e) Last elevation Of machinery or eterament servicing the balding JalEll Q meters (Puerto Rico m96 f) Lowest adierare Meshed) grade (LAG) . . / meters (Ps ace only) g) Highest grade (HAG) -- 7 .`� i F meters (Puerto Rico only) SECTION ID ...., 1 4 , I. OR ARCHITECT (RUFICATION TFie eessetteeion its to be atoned end seated by a lendarinayor. engineer. or irciire t authorised by saw to center elerefon infotmatlon. 1 certfytltat the Rrh'n nett n on OW (aonlecat* moments myDeo teOWN to interpret the cast: awe oblo. / 4 E understand t hot any fats* statement may be pramefwbio by ioe c+rhrgartscramnt under la U.S. Coda, Qo Section IOW . > . is r, J . Check here if corrmnterts are provided on back of /ohm. / C.; o' a 1 ' ' 8 n License Numb er a IRS -. 2.. c . I.Pr. -eel g to lie ,, 'sea. ` '` � ° 4 - ® : d � Address .44' �-r p ,e, ''':, m et• r-e On let ate 4. - Z7:11 C �, 4. F 1 ° a u Y+ � �v $t4} t e f ' is . • • rm. �-° Z.4 e ri 9"LS' --.1.S2:5 `6-N v\...-. - 1 .. FEMA Farm 81-31, February 2 See reverse side for tomtit ern. Replaces Oil previous editions FROM : VINCE HELMLY FAX NO. =912 9253523 Sep. 24 2028 12_37AM P2 INPORTAMT kitbag. apc.i. Dopy lira . . 1 , litimaitliit *um iiaelbe A. 1 For lommOcr Carports t1Me: Baal Seed Aaliroe firml Jipt., Uei Soak a.atbraft. Tie.) ar PAL Nome aid Orr No. d Number PrateNumber r--� Grammy RAC Number ` ! ye: .. S�r2-: -►o e ,y r 3 1 To •imodm 3' S= r .•. • VI -SURVEYOR, 19119111E01, OR ApICHIMICT ceuricAnori(oom . Copy bele aides dials Elmodo S Canine. Imp) anw.e.+Tlr ai i aQ►i�tw.ase., . , , , ai+ , M»r • • . • ( ' ' t d Di' , 9) " , „e$ o CAaOt bee y h..dmnic , • Fe mesIVJaed AlellNdOi . ' Mw1ib.0rtsEf isti. Gael .lts01l.aM0i1aaIAttainAMru0lt Fempoo a opiele SrdiumA, and C. FM ONO Elf:kesi NOONSIrrtOLa■11O11 CMae r` . *r .. !lwrlalroa►�a�;a�erra�s, et: Amy+i.m i bwi i.)re: rswl .iitsaidillil > t dr..s..MtiMrfi.arwS..iGa simmommmumii �tiwe.r 1P�irkams,:,.s rd*la+tsi 0.00f l• imi i �iltitibmit.ot iw i smeliKa.ripto� 's asem ar m,*F Q RI* • as iiet mil* Ili�re LlWiwirlriAe. 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Y m..r.RfiiettW a. adoaaM r Mammy omit* Mr ,e . aewad dmsrs.d� dab so aroor a�.mo (32. ❑ Acaiwi. ./eiMtBitepidrd w El4. NliiirsabdliabwaA aFa91K1wMetorcoew1iaMroaaiF 'EjorbusAO. G3.0 The NbabsW wr0..rOlom ei.rslli *r .Iporpa.os. I EA. Peed *OM 1 els. oa.a.,r.lis«..li . • 1 GS. peribl.of '..'era G7.. Mk peal! psar ur treed for 0 tt.. crmlr oche [] abb.iaid r , , , . GS. Elembro *s r peckelbs i.a..tenal Ob. boNONX - D but ©.rarer -per Comm GS. SPE fili zee" AO) doper arilembaeatt#e_iceoboe 1 - 0 ❑ ..area - Loc.l o Norm 11 f Tale • Ctrospnetv i%-alt si . t corr.msds • • _ D Med hitIt if aittdvTlenit -- - - . - . -