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Home My Public Portal AboutTwelfth St_10 ll,),. a.) llc .L ...)J !d1. ila. Jlo lu l: •JVl. 1aa ia«,+i oava.r — — --- --- — _ — 9 1 152 77137 p. 1 ` Ru 28 J L it1ey Reynolds 02 0 1 6 49p ( A[C[ I� wwrrc oon�n w a• I I NATIONAL FLOOD J 1 , ,. > ,`" ELEVATION Post -ir Fax Noto 7671 I981erS /ZTJ (pages ' ' ( ✓1 �� ✓1 • ,,s"" Imp Read the li To l.�" r iF °m 1 11 -- ..--, " -- _ SECTION A - PROPERT I Co./Dept. Co. euILDIry,p OWNER'S NAME l (Phone 8 / / Pnona u ( a 4 ! /iAkjr ' y BUILDING STREET ADDRESS (Includ A•t., Unit, Suite, °nd /or Bldg. No, IFex* '2)--) 77 1c' k °\ 'Fax it 1c9 r7 Ta - r7 7 ,c CITY __ 7-" � d1Y 64 7 l PROPERTY DESCRIPTION (Lot and B1ocX Num m, Tax Parcel Number, Legal Description, etc.) Z- O 7 �i . _ >� ,-j'7 . r) t3UiLDING E (e, Residential, Non-nesidentinl, Addition. Access° . etc. Use Comments section If neoess ?ry.) LATITUDE/LONGITUDE (OPTIONAL) -.O1 DATUM: SOURCE: i__; CPS (Type) ( for - #1f - ##. or #- #,#Not# °) LI NAD 1927 I 1 NAD 1983 L _I USGS Quad Mop LI Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION I � NFIP COMMUNITY NAME & COMMUNITY NUMBER 18.2, C�NTY AS B3. STATE _ g4 . MAP AND PANEL ' 95. SUFFIX fi 86. i FIRM INDEX � B7. FIRM Y PANEL BS_ B. BASE FLOOD ELEVATION(S) II / � N U ER AT6 EFFECTt/(ElR6/{SED DATE S_ _ FLOOD (Zane AO, use depth 0{ floodins) V a_ o�az_ G l� / / �rS �i7`Al ..4 810, Indicate the source of the se Flood Elevation (BFE) data or base flood depth entered in 69. LJ FIS Profile ( FIRM 1 1 Community Determined L Other (Describe): 911. Indicate the elevation datum used for the BFE In 99: 1GVO 1929 1 1 NAVD 1989 11 Other (Describe): 312. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (QPA)? 1J Yes 1 - 1 - Nd Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ,. C1. Building elevations are based on: 1 _ IConstrudion Drawings" 1 Under Construction finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. 02. building Diagram Number / (Select the building diagram most similar to the building for which this certificate is being completed - see pages 8 and 7. If no diagram aocuretely represents the building, provide a sketch or photograph,) , C3. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA. AR/AE, AR /A1 -A30. AR(AH, AR1AO Complete Items C3a - below according to the building diagram specified in Item 02. State the datum used. If the datum is different from the datum used for the BFE In Section B, convert the datum to that used for the BFE, Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G. as appropriate. to document the datum conversion. ' Datum s v /? 24 Conversion/Comments , Elevation reference mark used Does the elevation reference mark used appear on the FIRM? Li Yes 1�'No O a) Top of bottom floor Including basement or enclosure) 4 . ft. O b) Top of next higher floor , _ ft, (m) 4 (? ,S ; ❑ c) Bottom of lowest horizontal structural member (V zones only) , 14 11. (m) '' o ti0 EgFa '\ •❑ d) Attached garage (top of slab) 111 CA ______ ft. (m) A rt' 4 O e) Lowest elevation of machinery andlor equipment : t servicing the building , Z ft.(at) E e * ND. 2� ,y i .. . y � Ic o O t) Low / est adjacent grade (LAG) 1 ft.(� z v 'tf L L O� ❑ g) Highest adjacent grade (HAG) I ', .7 ft.(rfit} r l:,I4 4 ' SUPS • 6\ O h) No. of permanent openings (flood vents) within 1 ft above adjacent grade 11/Cr '�, h'N 17LE 4 / ❑ 1) Total area of all permanent openings (flood vents) in C3h n(C& sq, in. (sq. Cm) SECTION 0 - SURVEYOR, ENGINEER. OR ARCHITECT CERTIFICATION . This certification is to be signed and sealed by a (and surveyor, engineer, or architect authorized by law to certify elevation information. t certify the( the infomlation In Sections A, 6, snd C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement ma y be punishable by fins or lmorisonm under 18 U.S. Code. Section 1001. CERTIFIE�t , E r LICENSE NU BER TITLE COMPANY NAME ADDRESS ` / 4 11 (t A ZIP / Li - C 7 --- SIGNATIJFlE / /1 ,(SANE ) (2 f TELEPHONE ? 7 D 4 'EMtA F / 1 -31, A46 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS ll f Si Lf)i Ui: 1i: J.N 1'AA 014 J1J 1.Ul0 ,JU1111 11\L,1 11y11 uu I tle� Re 91F '1.52 77S fs-2 Flue 28 02 O1:49p J • APORTANT: In these apnoea, copy the correeponding Information from Section A. } For insurance Company Use BUILDING STREET ADORES`' (Inclu Apt. Unit, suite R endior Biog. No.) O P•O. ROUTE AND BOX NO. Policy Number cm, ' 5 ^TE _ 13 zl C� i company NA1C Number Z i/ e- tat At SECTION 13 - SURVEYOR, ENGIN!~ER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agentcornpany. and (3) building owner. COMMENTS Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete items 51 through E4. If the Elevation Certificate is intended for use es supporting information for a LOMA or 1 OMR -F, Sect /ort C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building for which this certlficate is being completed — see pages 6 and 7. If no diagrbm accurately represents the building, provide a sketch or photograph.) 52. The lop of the bottom floor (including besem,nt or enclosure) of the building Is 1 L_1 ft.(m) L I ( above or L_( below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is ) I I R.(m) L jIn.(cm) above the highest adjacent grade. Ed. For Zone AO only: If no flood depth nuirtber is available, is the top of the bottom floor elevated in accordance with the community's flo'odpIaln management ordinance? L.1 Yes L_I No L) Unknown. The local official must certify this information in Section O. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, 8, and E for Zone A (without a FEMA - Issued or community issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTAT1vE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS • • I Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, 8, C (or 5), and G of This Elevation Certificate, Complete the applicable item(s) and sign below. G1. L The Information in Sedlon C was taken from other documentation that has been signed and embossed by a licensed surveyor. engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and dale of the • elevation data In the Comments area below.) G2. II A community official completed Section E fora building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. i) The following information (items G4 -G9) is provided for community iloodpiain management purposes. G PERMIT NUMBER G5. DATE PERMIT ISSUED I GS. DATE CERTIFICATE OF COMPLIANCE /OCCUPANCY ISSUED - G7. This permit has been issued for: Li New Construction 11 Substantial Improvement GA. Elevation or as -built lowest floor (Including basement) of the building is: _ ft.(m) Datum: • G9 BFE or (In Zone AO) depth of flooding at the building site is: ft.(m) Datum: LOCAL OFFICIALS NAME TITLE COMMUNITY NAME TELEPHONE - SIGNATURE DATE COMMENTS • Check here if attachments AUG 99 _ REPLACES ALL PREVIOUS EDITIONS