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HomeMy Public PortalAboutEleventh St_7 U.L.S DEPAcr OF N122:EILACCIEBDISROTY ELEVATION CERT [ EI© T'a P COMB No. 1660 -oone ElcOiree March 31, 2012 W-at7n., Root tnoz2Exce Rovem alltp.OltEnt F- the i an pezzE 1-9. Al. $ 4fA e�ruw�. +y °!lif AY1nr� ii t 'iyUse: Name A2. etynnts str-i memss NIL. tAc. 94' vittmt& fatyi& NAL!) cr P- %Aft mi eta cm-z- vointqm.Thymammuzatza ZIP Code A3. Property Description (Lot Sad MDAlt MunlIsm Ttx Potel fi r, L . an. r 6. es S z- S' i=• e A? La i a r- t3• u g ®, i s= S 04 o r- r-- L. o a C- , A4. 131.0 I tc ( ., Resir, Ala m-R ; ~=a , .) (� l 0 J 7-i PI— C ts.� ca '3 ■ - t' `r € Zs , ) A5. tom, >� / r f N ° g . ` 1 7 ' umsied A0 " .S' o . 't 2 . 9 ' ai- :A = ❑ NAo ltit°rr 10B3 AB. Attsclazt least 2 plicaegmotte °Ms bu ';trig €1 :,. (Cm is used to =len 109 trrossnee. A7. 0.1tVng Diagram Number 4 i A8. For r writ e s): AS. Far a brt"i1'zag c: ru an nosh= L - Esc a) forge oa - ,., , .. or s) 7, t o (o R s) Smezm footage of a > Remse © ca 2 b ) No. e p ^ _ v ,, I r l fn—r3 im a go Cra t t ar b ) Mt. a . 7 .. . Cond o ine xhre e) ',e4't":ia1.® foot above .' • r1)/bn1.0feat asx c 'zoid grelle o) Tam u= el aao _ '3 1 4 I g, Te&I net irlen onisold d) s es 1121r No (5 co r... ... -. ,,s-,..„- ) . f, .: ,' .. . 1 farad ❑ ilea &o SECTION = IFILCSD ussultAx=nAmm r -.aw I 81. � Q _i_ 5u�-n: 0 1 3 5 1 'x`9 - I C "a rN - I �6 Eiti a..cia Q n i i S.1 ice i 1 B4. B5. . . BP_ Ft tom,. tiro Rood 1S: ^a eg .$) (Zama 1 3 Os'1 c cn 32 l— l $) ! AC, food ) 9-24, -0% °I —Z. -e)� � E I ``Z. 810. todionts the stance of } ;..: Rood CT bcst t i,s.4 entsred in Sem Be. 1311. Indicate eimmaton =tan a ` BFE In Elam 0 NOVD1020 [RNA% 195 0 MI= ) 812. is the locri in a Coastal Elmter or OTheowise Prafad As (OPA)? ❑ Yr' , n Date I 0 ams ❑ CPA SEC= C- EMIWNG ELEVATION ) Cl. Btaf.ite estrotions Erie ftwissri oaa r Else Cis'" °aka+ be when aa¢na! an aline infi 0 is her. �n Mme C2. — Zan= A140, AE. AN, A (with BEE), VE, VI-V39. V tvi.lh 1 - ±a., AR. AREA, ARIA E, ARFA1 -A30. AR/Alt, ARIA° Dag twos beim according to the bads engram SilStiEst4 in ilsmn Al. the slum d an the eFE.. n 1 Benchmark . ®& ge . Vaar c t Dawn ! v C r9g r,)I Pr Check the used. a) Toil of mom ct 4 ST e arSa 1 0 .. 8 El Rico meters (Puerto a a f) b) Top of the next higher floor 2 4.. tees meters (Puerto Rico art) c) Bottom orate lowest horizankt structin : , (V Zones r• . Al -u feet © Rico city) d) Attached garage (top of ) . —NJ •�� ❑ (Puerto Rico ) e) Loci or iuLs ng f 9 ., ® ❑ *e auto Moo ve j) (Describe type of equipment and location I ) f) Lowest next to ba 'Erti (LAG) I U Il ❑ Rico only) g) Highest adjacent ( -) grade next to (HAG) I d . 8 meters (Puerto Rico only) h) Lowest attatent grix l toWeet elevation of dash ar et re. tits 1 V meters (Puerto Rico only) structural support SECTION D - SURVEYOR, a YECT wcw r e ATION This certification isle be signed and sealed by a land steveya , enenster, or architect Ellitherized by (awb certify elevation _ --_.:--r information. I certify that the information on this Ceriicale r etomn n t a my bed smuts to interpret the detaava&eble.. . ` i 11 C; • I u nae rts+rd that any false maybe by Ilan or ,... ,' r 9a U.S code, SerBon 1001. - �j b % g 7 E A 4 Che ck here if eras provided on back ahem. VS a end longitude (n = :,., A by a g 4-6 f �, surveyor? u 'Yes No , r _... • . Ce a wanes 1 ', , ne : � � � � - it C �1�_ll -� • �� 0 S u v 0 1 iv.; cP 6 f. t , i--°'9 k � "a y r Ad City State YIP Code / c, ,. , w � ii. a.a �.z� h ®caa � IN r�.� a, el 4-e 8 '• %, Pif , NTH Signature 0 l. ' ,.� `} c1..' . 10- it- I- -L t lt.1 X 205°-- 3 3 FEMA Form 81-31, Mar 09 } See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the con information from Section A. ), For Insurance Company Use: Building Sheet Address (incdudmg Apt... Unit, Suite, and!or Bldg, No.) or P.O. Route and Box No. Policy Number l�" .S rt i I 't 5 �-!�r I� D e ®R. G. c A � 3 Code Company tea is Number SECTION D - SURVEYOR, ENGINEER, CERTIFICATION ( ED) Copy both sides of this Elevation Certificate for (1) corrommity owl, (2) , and (3) Wading owner Comments Coy\ ° � , ec e -- r ! E l 2, l� 4 b (Pts'7�► o v� S S Prat: ' i t C., ir r� � i5 e - � (S nn 9. 1l� , C � 12. Ca^ ®a fl (f r4 - 1 ' W�5 Lim 4 o ��T�,� ' l F'L - A-a - )--r„ R. tvA� Signature V > \ 1 Date SECTION E - BUILDING ELEVATION INFORMATION "(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (lllffTHOUT BFE) For Zones AO and A (without and C. For Items E1-E4, use natural grade. if available. Check the measurement used. in Puerto Ric Me nter request, complete Sections A, t3, El. Provide elevation . foram 1nMowirg and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowestarntgtade (LAG). a) Top of began 9aor (including basement, _ ; :. r .. „ or ) . Dteet Cimetwrs 0above mmx Dbeiowte HAG. b) Top of bottoms floor (inclu ding -.¢ , or . ) is G - add Ometers 0above or pbelew the LAG. E2. For Bidding Dams 8-9 with .:.:, r in -11 Items 8 9 (see 8-9 of ), the next higher floor (elevation C2.bIn the diagrams) of the bt ding is � led • meters above or the e HAG. the HAG. Ea Attached garage (top 54. Top platform of machinery mrd/or equipment servicing D `8re building ® above or ❑ � ❑ 0 meters 0 above °r ❑ below Be HAG. E5. Zone AO only lino flood depth number is available, bitter top differ bottom floor elevated In with the corm amity's itoodpialn management ordinance? 0 Yes ❑ No 0 Unknown. The local offitdal must cetffiy this inform in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S 'iraor -s sr / AT1VE) a.cee r a - n.AMON The property owner or owner's authorized . .:a� ::... se who completes Seems A. B. and E for Zane A ( a or BFE) or Zone AO must sign here. The statement; In Sections A` B. end E ale conact to the best of any knoteterkta Property Owner's or Owner's Authorized Represents Neztm 1 n Address " y State ZIP Code Signature 111 uDade Telephone Comments 0 Check heret¢ ,..., SECTION G - COMMUNITY INFORMATION (OPTIONAL). Tire local o who is authorized by law or °faience loadmbisterthe comrmrnky's foodplain .. :. , t ordi anc:e can complete Sections A. B, C (or E). end G of this Elevation Certificate. Complete the applicable kends) and sign below. Check the measurementi used in Items GB aad G9. Gl . ® The irdotmatiOn in Section C was talent Loa other damn that has been signed and sealed by a licensed suveyor, engineer, or architect who Is authorized by law to eerifyelevaion infomnaimt. (Indicate the source and dale Otte elevation data in the Comments area below.) 432. 0 A community ofacial completed Section Elora building located ke Zone A (without a FEMA- issued or BFE) or Zone AO. G3. 0 The following Information (items G4-G9) is provided for oommrmdy floor/plain a t purposes i 134. Permit Number J GS. Date Pestle Issued J 68. Dale Issued G7_ This pemdt has been Issued ken: ❑ New Construction ❑ SubstarCall r G8. Ern des-bunt lowest door (including basement) of the biladttg test p meters (Pi) Datum G8. BFE or (in Zone AO) depth of Gooding at the bubffng silo ❑ few' 0 meters (PR) Datum G10. CO nn rs design tiood elevation \ , 0 0 (PR) Dalton Local Official's Name \ t1 \ T1e Community Name � Telephone Signature Date Comments 0 Check here If attachments FEMA Form 81 Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. I For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 7 11 STREET City TYBEE ISLAND State GA ZIP Code 31328 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. FRONT VIEW 10 -11 -12 ' 1il R_ EA_R VIEW_ 10 -11 -12 i t • ;': r P 1. 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