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HomeMy Public PortalAboutTeresa Ln_16 ell r 1oi 1'T34 Al: by y12 -351 _00163 ALLIANCE CUSTOM HONE PAGE 62 O.M.8_ NO. 3067.0077 ELEVATION CERTIFICATE Expire: May 31, 1996 FEDERAL EMEFROENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ►TTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to Irovide elevation information necessary to ensure compliance with applicable community floodpiain management ordinances, to ietermine the proper insurance premium rate, andJor to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR), Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSUPANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER L AVE D. 1i\„) k'. Co MT STREET ADDRESS (including Apt., Unit, Suite and/or Bldg, Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NA NuMeER _ i(a T OTHER DESCRIPTION (Lot end Block Numbers, etc.) L-01 140 (.>zm wick vGS ,& CITY STATE ZIP CODE ' E IS LA X) GE Ole cA l A 3 C3 >~ $ SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FiRM (See instructions): 1. cOMMUNITY NUMBER 2. PANEL. NUMBER 3. SUFFIX 4. DATE of FIRM INDEX 5. FIRM ZONE 6 BASF FLOOD ELEVATION (in AO Zones, use depth] 1 S 5 I C6 ©1 XU �►C (7 its V c t . 0 7. Indicate the elevation datum system used on the FIRM for Erase Flood Elevations (BFE;): ❑ NGVD '29 ❑ Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE far this building site, indicate the community's BFE: ! 1 i 1 (.. Li feet NGVD (or other FIRM daturn -see Section 8, Item 7) SECTION C BUILDING ELEVATION INFORMATION t. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams round on Pages 5 and 6 that best describes the subject building's reference level -h_ 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of 1p-Lb.1 L X51 ii feet NGVD (or other FiRM datum -see Section B, item 7). (b), FiRM Zones Vt -V30, VE, and V (with BFE), The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of (i 1 1 1 1.0 feet NGVO (or other FiRM datum -see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is 1_ 1. J . i .J feet above . i or below ❑ (check one) the highest grade adjacent to the building. ('d). FIRM Zone AO. The floor used as the reference fowl from the selected diagram is . Li feet above El or below i. (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's tloodplain management ordinance? ❑ Yes f~ No [ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations' LNGVO '29 L,.-] Other (describe under Comments on Page 2). (NOTE' If the elevation datum used in measuring the elevations is different Man that used on the FIRM (see Section e, Item 77, then convert the elevations to Me datum system used on the FIRM and show the conversion equation under Comments on Page 2,) 4. Elevation reference marls used appears on HMI: ee Yes Yrio (See instructions on Page 4) 5, The reference level elevation is based on: t r actual construction r .1 construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course o f construction. A post - construction Elevation Certificate will be required once construction Is complete,) 6. The elevation of the lowest grade immediately adjacent to the building is: P (9LololJ .0 feet NGVO (or other FIRM daturn -see Section 8, Item 7). SECTION D COMMUNITY INFORMATION 1. if the community official responsible for verifying building elevations specifies that the reference level Indicated In Section C, Item 1 is not the "lowest floor" as defined in the community's floodptain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance Is: I s I ! I. Li feat NGVD (or other FIRM datum -see Section 8, item 7), 2, Date of the start of construction or substantial Improvement FEMA Form et -31, MAY 93 REDS All PREVIOUS EDITIONS SEE REVER5C SLOE FOR CONTINUATIO0 131 J <YiJ 1 `±ytr lh; 7y ALLIANCE CUSTOM HOME P AGE 63 SECTION E CERTIFtCATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local taw to certify elevation information when the elevation information for Zones A1—A30, AE. AH, A (with BFE),V1— V30,VE, and V (with BFE) is required. Community otficiais who are authorized by locai law or ordinance to provide floodpfain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and i3 - Distinguishing Features —if the certifier is unable to certify to breakaway+non• breakaway wall, enclosure size, location of servicing equipment, area asap waft openings, or unfinished area Feature(s), then list the Feature(s) not included in the certlficaiion under Comments below. The diagram number, Section C, item 1, must still be entered. 1 certify that the information in Sections E and C on this certificate represents my best efforts to interpret the data available. i understand that any false statement may tie punishable by fine or imprisonment under 18 U.S. Code, Section 1001. M AEI;,. E.. Moclt (=A. 2971 CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) P2e5 i oEX -)7 MraOZE. + - AND -4UZV r I) 4& TITLE COMPANY NAME D i. _ X r 3 C»S SAV Aro Art-f AR►, -, SS % CITY STATE ZIP siGNA, DATE PHONE Copies should be made of this Certificate for: 1) community official, 2) Insurer agent/company, and 3) building owner. COMMENTS: ck l teal E t. E v Y1 %f o f S G _Pjz.M Q - 0C 1`7 ON Wf$ ON Pfl E9, SLAB 8ASEMEN'r i1EAb. OP CCt.UN NEI A V A A ZONE° 30HE5 zo s 13 ZONES ZONES t P �, gE ra4 RFFEREHGf SASE � ,�._y y � „ LEVEL - -.. + ELE _ BASE � vA r F6 W i j REFER {Y: ELE"TICyr+ Al1,l/,CENT A L3Ft�E IEVE E ' ELP.vATON - OWgE 1 t 1 ) wawa C. , -) AWACEI(i The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for alt A Zones should be measured at the top of the reference level floor, Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural rrernber. Page 2