HomeMy Public PortalAboutVeterans Dr_5 02 -80 -98 09:53 MICHAEL E BART CPR 3E0 P01.
ELE,VMi ION CER11FICJFE C.M.B. No. 3067`0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement, This form is used only to pro-
vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine
the proper insurance premium rate, avid /or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).You are not
required to respond to this collection of information unless a valid ((Mt3 control number is displayed in the upper right corner of this form.
Instructions for completing this form can be found on the following pages,
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SECTION A PROPERTY INFORMATION Fee INSURANCE COMPANY USE
N AME POLICY , —�, NUMBER
B C. r\ R 4 H tJ t c )- / .! .1 . e
STREET ADDRESS (In Apt., Un.t, ::udrr ,1n(1'i ` eilrki Numt r) OR PO. ROUTE AND 0OX NUMBER COMPANY NAIC NUMBER
- - 5 _ - V , -L • (L c n. S (72 U
OTHER DES (Lot and Block Numbers, cIc
o ) C 4 ' 4 / � Fc � 7rY , t / . i i Ark) • r • , 44 $GVC CV C rtS -.
CITY STATE ZIP CODE
'Y
Ui C 1 f G • - it c G14 / .A
SECT ION I;3 FLOOD INSURANCE RATE MAP (FIRM) INFOF JI'ATION
Provide the f ollowing from the proper FIRM Irlt
•_ M (sec .. _._..e_. _...
rt.r!ion.,)
t. COMMUNITY NUMBER 1 2. tANLL NJ,MUta t t. NW LATE Or rlriM ;NUtX 5. FIRM ZONE 6. BASE Ft.004 E . VATtON
(In AO Zones, use oepth)
1 35 1 4 A 5 12.0
7. Indicate the elevation datum system u,nd on the FIRM for Base Flood Elevations (i3FE): NGVD '29 _JOther (describe on back}
5. For Zones A or V, whore no BFF i provided on the FIRM, anti the Cornrnunity has established a BFE for this building site, indicate
the community's BFE: 1 1 I I . fact NCVU (or other FIRM datum -see Section 0, Item 7),
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SECTION C BUILDING ELEVATION INFORMATION
1 Using the Elevation Certificate Int;lrec:tions, indicate lhrr diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level 7
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 L L._L. 1/ 131.1 feet NGVD (or othcnr FIRMi datum -se Section B, ik:m 7).
(b). FIRM Zones Vi -V30, VE, and V (with BFE). The boltorn u' the lowest Horizontal etructural member of the reference level from
the Selected diagram, is ei en devotion of' 1, ', .. I ' I ,1 ! feet NGVD (or other FIRM datum -see Section 0, Item 7),
(c). FiRM Zone A (without DFE). The finer us { ?ri as the referc:ncolevel from the selected diagram is 1. I--_I.0 feet above ❑ or
below 11 (check one) the highest grndc ndjneent to the buildin,rl.
(d). FIRM Zone AO, The floor used ;.is tltu refurr:,rce level from the selected diagrttrtl Is I I feet above LT1 or below ❑ (check
one) trio higho,t grndo adjacont to N huilt;ing, it no flood depth number is v { is fhb building's lowest floor (reference
level) elevated in accordance will) the coinrnunity':; flout /plain management ordinance? L .. Yes [T No ❑ Unknown
3. lndicate the elevation datum system used in determining the above reference level e,'evatiorts: LtrNGVD '29 El Other (describe
under Comments on Page 2). (NOTE: 11 the elevation datum used in measuring the elevations is different than that used on
the FIRM [see Section 8, Item ?], then convert titG rtktvrstront, to the datum system used on !fte FIRM and show the conversion
equation under Comments on PRge 2.)
4. Elevation reference mark used appears on FIRM Yes No (See Instructions on Page 4)
5. The reference level elevation In hisnd on: !!".ractuai eonstruotlon 1 .1 construction drawings
(NOTE: Use of construction drawings is only valid it the buildi'ngg 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 of construction. A post- construction Elevation Certificate
will be required once construction i complete.)
8, The elevation of the lowest grade immediately adjaconl to the building is: i_ .1. 1...1 I.11 feet NGVD (or other FIRM datum -See
Section 8, Item 7).
SECTION 0 COMMUNITY INFORMATION
i. If the community official responsible for verifying budding nicvatjrins specifies that the reference level indicated In Section C, Item 1
is not the "lowest floor" as defined in the comm,t,n floodplain managgem.nt ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance Is: • I 1 i ! .! I fnett NGV[) (or other FIRM datum -see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81 -31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONI1NUA1IOY
urz 1. - ti Ot: 59 IIII -HttL t HHH I L.1 libal P112
-- - n
SEC] ION E CERTIFICATION
This certification is to be : ;KinuU uy ,1 V ..i:ici i r nriim.: ill iarcltllc,cl who i5 authorized by slate or local law to certify elevation
information when the eievt,lIiri inic srtlutfot for /ones AI -A30I, Al-_, A11, A (with OFE),V1 ..V3Q,VIZ, end V (with C3FE) is required,
Community official, who nrE, ni :Inon =fad by local law in 01 dinance. to provide floodplEtin management information, may also sign the
certifleation. In the case cif Zones AC) r.nd A (without a ,=LIMA or community issued BFE), a building official, a property owner, or an
owner's ieprr ,nnt ttivc: (ru:y also r,Irlr; the certification.
Retcrnnce level drulrranr; Cl, i ,in:8 - Dizti+lifuis uit1 V ozitureti -Ir ll'i+ usirtifie, is unable to certify t0 breakaway /non- breakaway wail,
Cnelosuro sIzo, location :)f :;tavit :Irl 1 e 1ca'I: !11. .i;'' it a su, woll ul oli r ift;;, or unfinished area Featurc(s), then it the Feature(s) not
included in the certification : .inch ? :r t below low The rlingrnnt !lumbar, Section C, [tom 1, must still bC entered.
i ccrtdy Neat the rn(ormutrc >r ;rr ,,,ottr>rt_: t ;•tart' (. can tiles curlrftLaatcr r :{ r &:,cants flay best efforts to interpret the; data ovallabte.
1 vnd(:r$ttihd 1hY ?! ,Iny 1. /so ! ;;,tt :w<i;■ II;;!)/ be! l; ni.c.liathk1 by Ow or urrprrsorunr.rrt under 18 LI.$ Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal,
1 iZ LE ,C )Wt' fvAML
7 A .c-' tom -.
—G _ _• -.... f\. i-....4::„ G\-, ci : _21,..,, , _ l ac` -.. v , 4r• C. ...- . ' d e , (%- C C'/L )
ADDRESS r . i ;J f <;(!'`.' �- STATE ZIP
f -- Li1� 0 /..-1171)" e,
SIGNATU (' DA'I PHOUP _
Copies should to made of t1'ii' errtifi>;;;llei fw; •1) C:th inanity official, 2) insurance agent /company, and 3) building Owner,
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COMMENTS:. -.
- Q t% l l r f r '� r , t C r C. - 7�it v ray ....`- , , G fi l d.
_
O N wlTtt ON PILES.
gp.0 I,ASEMNNT PIERS, Orr COLUMNS
A t• _ A A V
1CN!L•S a. :,. k ZOilt , 2CNES ]ONES tr
nEFERENC `` �F 9 •, , • -. f On�li i F. vE l a. REFERENCE ■
,I EVAllf1N
.s....,,,, lb t t
lust
( '„ ! G I eRr NL E' f L000
Ft CO „ iiyr, ELEVATF N •
I ivy AOi ...
f 3,1i i A61ACiNT
( (T h,,, CAA DE '
The (flag Lens ubuve Elie n: ItL: IiC mlri ;t; N.hfcl Chia: ale v,:ittCr : shook/ l :,c mortsurOc) in A Zone; and V Zorms.
Elevations for all A -clan : +t)ould bi: nil ; :fsuisic1 at the top oI the rrtnrencc level floor.
Elevations for all V :one.$ z..tlo tict 1 m ;ty. :re:cJ at the bott0.m Of the lowest horizonlel structural member.
Wage 2