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Home My Public Portal AboutTaylor St_29 • FROM : PHONE NO, : 1/ / P02 (11111111.1111.7 AL? Jci-z-g- ---.. OA. 1511.0011 ELEVATION CERTIFICATE Expires Moy31, lPba FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL PLOOd INSUfANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the hood Insurance purchase requirement. This form IS used only to proms elevdlon Information necessary to ensure compliance With applicable. community tloodpl8ih management otdinences, to determine the proper insurance premium rate, and/or to support a request for d Letter of Map Amendment or Revision (LOMA or LOMR). ,Instructions lot completing this WPM belt bit found tin the following pages. SECTION A PRQPEPTY INFORMATION FOR INSURANCE cOMPANY USE BUILDING OWNER'S NAME POLIOY NUMBER bay •E r/>vL u9 STREET ADDRESS (Including Apt., Un11, Buffs end+or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER AOMPANY NAIL NUMBER OTHER DESCRIPTION (Lot end Block Numbers, arc.) LIP 7 - ) . t $ L o K 2) Fe /LT _ 5 c iz- E 1/ a VI 00 Ar it. cP CITY r STATE ZIP CODE 1"-(' ( EIS t c t _ A -tJ Q , & A . 'S 1 3 li r SECTION la FLOOb INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FiriM (See instructions): . I. COMMUNITY NUMBER Q. PANEL NUMBER 3. SUFFIX i 4, DATE OF FIRM INDEX 8. P RM ZONE C. BABE FLOoD ELEYAT'ON l 3.r i 4 4 c o o ! C 6D �/ 7 RC A S En AO Vries, bed depth) I � l c7) 7, Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): C NGVD'29 0Oihet describe on back) 8. For Zones A or V, where no EWE Is provided on the FIRM, and the community has established a BFE lot this building elle, Indicate the community's BFE:1 1 1 1 1 I . L !eel NGVD (or other FIRM datum -see Section 131, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certtticate Instructions, indicall the diagram number from the diagrams found on Pager! 8 and 8 that best ' desorlbss the eublect building's reference level 5 2(a). FIRM Zones At - A30, AE, AN, and A (with BFE). The top of the tetetence level floor from the selected dtagtam Is at an elevation o f I 1 112ICILl feet NOVO or other FIRM datum -see Section B, Item 7). (b). FIRM Zones Vi -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, le at an elevation oil 1 1 1 1. 1.11 test NGVD 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 L .0 feet above L.1 or below ❑ (check one) the highest grade adjacent to the building. (d). FiRM Zone AO. The floor used as the reference level from the eetected diagram is . 1 I ,U feet above ❑ or below Cl (check one) the highest grade adjacent to the building. 11 no flood depth number is available, is the building's lowest floor (reference level) elevated In accordancQ with the community's tloodptahn management ordinance? ❑ Yes ❑ No 0 Unknown 3. indicate the elevation datum system used In determining the above reference level elevations: r ^t NGVD 29 ❑ Other (describe under Comments on Page 2). (NOTE: II the elevation datum used In measuring the elevations Is different than that used oft the FIRM jeep Section B, Item T), then convert the elevations id the datum system used on the FIRM and show the conversion equation under Comments on Pape 2.) _ 4. Elevation reference mark used appears on FIRM: LI Yes . 1: No (See instructions on Page 4) 6. The reference level elevation is based on; f.actuat construction ❑ construction drawings (NOTE: Use of construction drawings fs only valid if the building does Not yet have the reference level floor in place, in which case this certificate will only be Valid tor the building during the course of construction. A post - construction Elevation Certificate will be required once constrUCHon Is complete) a. The elevation of the lowest grade Immediately adjacent to the building Is: I 1 I 1 1 L .feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION a COMMUNITY INFORMATION 1. II the community official responsible for verifying building elevations specifies that the reference IOW indicated In Sbctibn C, Item i is not the lowest !loot" as defined in the community's itoodptaln management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance le: 1 1 1 1 1 1.1 leet NOVD (or other FIRM datum -see Section E, Item 7). , 2, Date of the start et oonatruatran or substantial Improvemsitlt ' ' FEMA Form 51 31, r,rA ( 93 REPt) CES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTioN E CERTIFICATION This certification Is to be signed by a land surveyor, engineer, or architect Who is authorized by stale or local law to certify elevation Information when the elevation Information for Zones A1—A30, AE, AH, A (with f3FE),V1— V30,VE, and V (with BFE) Is required, Community officials who are authorized by local law or ordinance to provide floodpialn fnanagement Information, may also sign the certification in the case of Zones AO and A (without .a FEMA or community Issued t3FE), a building official, a property owner, or an owner's representative may also sign iris certification. Reference level diagrams 6, 7 and 8 - Distinguishing f=eatures —if the certifier Is unable to certify to breakawayrnori breaka*ay wait, enclosure size, location of servicing equipment, area use, wail openings, or unfinished area Feature(s), then list the Feature(s) not included In the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. 1 certify lhet the information In Sections f3 end C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by tine or imprisonment under 18 U.S. Code, Section 1001. ,es 7— Jt3 , t3 4 rr, s+a—, Off., l 2 COMMA'S NAME LICENSE NUMBEi tot Alrlx Seel) — — ,Q • -... L " • 5 , hi A. T N D gUie.vF y, psi G 1 J� rine COMPANY NAME p,s 00x. I D O C Y I s p.vA hI N A N (16A 3r41 AbOntea o1TY __ STATE ZIP i J • t : / / 9 7 l i 9 n-r44. 81QNAiURE DATE PHONE Copies should be made of this Certificate for 1) community official, 2) Insurance agent /company, and 3) building oWnsr. 'COMMiENTS: ___. cm *1114 ON rasa, sue IIASUMBNT PisNS, orr bolUMws • A v A A V roNES toNEB 1 ZONES mkt!' Z011te , � i . esetmeet IMVK ( • RLOOO ' ) • v to 1t ' r ASV 1 now moo' 4 1 Noce EIEVA_ION NETS tNCE ADJACENT ____ J t.1v . 4IvAId1 utra orfACE SAN R� h, � f , • i f . ,,if �,, r i 1. • i l ; : AC3AOtHY pi CIAAbg The diagrams above illustrate the points at which the elevations should be measured In A Zbhes and V Zones. Elevations tor ail 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 member.