HomeMy Public PortalAboutBay St_1312 \ X\ FELP - KAL tMtKGtN(:Y MANAL tMtN 1 Alit Y O.M .B. No 306T
TONAL FLOOD INSURANCE PROGRA, Expires December 31, 2005
V ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION 1:`Forjrsyrange company U a :;•
BUILDING OWNER'S NAME ' • Polioy;Nurythef- �¢� y (i .,.
,•.,!. .A f ,! ti . ..- ..
ENNlS O L`gY
B UILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company PAIL Number
)312- Ray 5rr,ge-r 4 "
C ITY STATE ZIP CODE
Ty BEE 2 .SLA 1JD Gi} 313 28
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lo7 4- . 6 A-"/ (AJft2D 5 U.BD• .
B UILDING USE (e.g., Resideritial, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
K.65I DE/J Ti AL
LATITUDE /LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1 GPS (Type):
( ##° - ##' - ## ##" or #4#4#1444e) 1_1 NAD 1927 1 1 NAD 1983
11 USGS Quad Map 1-1 Other
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
���
B1 NFIP COMMUNITY NAME & COMMUNITY NUMBER 1 B2. n .n -- - I` I B3. STATE
/351(42 - 1 TYBgg /AL.-A> 1 4 c,--E02_6-1/4
- 84. MAP AND PANEL 65. SUFFIX B6. FIRM FIRM rND INDEX X B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) 1
NUMBER
EFFECTIVE /REVISED DATE ZONE(S) (Zone AO, use depth of flooding)
13511 4 - 0001 C. 31AYl1L- I1, 19$ V9 el- 0-/
810 Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
( FIS Profile I — I FIRM I_I Community Determined I .gI Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: IXI NGVD 1929 II NAVD 1988 I — I Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? <J Yes II No
Designation Date:
• SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: I Drawings' I {Building Under Construction* IIFinished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number ID (Select the building diagram most similar to the building for which this certificaT'e is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
03. Elevations - Zones Al - A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR /A, AR /AE, AR /A1 -A30, AR /AH, AR /AO
Complete Items C3.a -i below according to the building diagram specified in Item C2. 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 /4 5 L Conversion /Comments
Elevation reference mark used 6M Does the elevation reference mark used appear on the FIRM? I I Yes IZCI No
O a) Top of bottom floor (including basement or enclosure) - 1 . 5 ft.(m) , ,
❑ b) Top of next higher floor j fo . 0 ft.(m) `o oeo R G /
❑ c) Bottom of lowest horizontal structural member (V zones only) MIA ft.(m) `4',,,,t) o os TFR�
CI d) Attached garage (top of slab) NIA _ ft.(m) a °
❑ e) Lowest elevation of machinery and /or equipment w ; N q r9E �
3 • �r
servicing the building (Describe in a Comments area.) 15 . L(( ft.(m) . o .
O f) Lo adjacent (finished) grade (LAG) to . 7 ft.(m) z 5 'A 1 'i � 1Q
0 g) Highest adjacent (finished) grade (HAG) 1 . 9 ft.(m) ce 'Q�N �S S
O h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade µ po
❑ i) Total area of all permanent openings (flood vents) in C3.h � in, (sq. cm)
SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
I certify that the information in Sections A, 8, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
I,✓ A/ 5, P Y THiZEss � (953
TITLE d COf� �f
L.AAA SIA.e1IEy
- E (' , VOd r lHZE$S LRND SL& UE\11I)6►- _
CITY S A E Z CODE
9 HuuTE12S A RoAD S�ILVANIA G O�ta1
ADDRESS
SIGNATURE il /01/ //a y /�I2 jEL P�IQN 2 -
FEMA Form 81 - 31, January 2003 / See reverse side for continuation. l / ] Replaces all previous editions