HomeMy Public PortalAboutJones Av_1405A tLtVATION CERTIFICATE 0 M E.No, {167.6077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires.tiny 31,1999
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION:Use of the 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 con etunity floodplain management ordinances,to determine
the proper insurance premium rate,endfor to support a request for a Lefler of Map Amendment or Revision(LOMA or LOMR).You are not
required to respond to this collection of information unfese a valid OMB control number is displayed in the upper right comer of this form
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION roe INCURANCE CnRIFAMY V£E
aUILMI" NCR^3 NAr. r � POLICY NUusre
NL.ri2.
SIRE Cr AUDr UIU entiu a A�pt,y a,Suliee nor Bldg.Number)OR P.O.ROUTE Ave BO:NUMBER COi,IPAIVNAIC NUAI8EA
/dc' /7..L.42A, S .--- —. — —
k7THE EA-r.Filfs11UN( 1 And 11100, /,mb�1∎IS.Pr )/ /j` p /'�
ire C ( /1, .._._. U(�1�Y.6 -.J//,_1��._r,_ (GL1_._ ._ LICE.___,_.
SECTION 9 FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the fallowing horn rho proper FIRM(See Instructions):
Lcc lMMMuuMiY�NUM6Eft i II.PANUI NUMBER 3 SUFFIX /4.Mr Or rimM INUEC 3 /BM AM. • 6 sABC r).00di EuEVoniolu I
!�¢ C� vt"r /�06 fin AL/...., wC�lu
7-indicate ins Devotion Saturn system used on the FIRM for Base Flood Elevations(BFE):f'1T GVD 29' (Other(describe on back)
ii.For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE ton this building site,indicate
the community's BFE:_J..; I f ,..J feet NOVO(or other FIRM datum—see Section B,Item 7),
SECTION C BUILDING ELEVATION INFORMATION
1,Using the Elevation Cortiticate lhsiructions,ind(cateyla dlaoram number from the diagrams found on Pages 5 and 6 that best
describes the subject buildings reference level
214).FIRM Zones A •A30,AE,AH,and A(with BFE). The top of the reference lever floor front the selected diagram is at an elevation
of: I ' 1/1,1,A feat NGVD(or outer FIRM datum—see Section B,Item 7).
tb).FIRM Zonde VI.V30,VE.and V(with BFE). The bottom of the lowest Horizontal structural member of the reference level train
the Selected diagram,is at an elevation of i.1 .1 I I I.) 1 feet NGVD(or other FIRM datum—see Section B,hers 7y
al=UiM Lone A(without BFE). The floor used as the reference level from the selected diagram is L l I I keel above 'or
below !check one)the highest grade adjacent to the building
fd).FIRM Zone AO. The floor uses as the reference level from tie selected diagram is h I Li Teel above,I_•or below-,.(check
one)the highest grade adjncont to the building. It no flood depth number is available,is(tie building's lowest ildol(reference
level)elevated in accordance with Ins community's floodplain management ordinance?I I'Yes ED No ' Unknown
3,indiOSte the eievation datum system used in determining the above reference level elevations;E l NGVD'29'—'i Other!describe
under Comments 011 Page 2). (NOTE'if the elevation datum used in rnoasunnp the elevations is different titan that used ort
the FIRt4(see SDC(ion 8,ttern 7),,then cmtvert the elevations to ate Datum system used or?the FIRM and shmw the CORL,ars ion
equslton under Comments on Page 2)
4,Elevation reference mark used appears on FIRM: • ..Yes No (See Instructions on Fags 4)
S The reference levet elevation is based on 12 actual construction 1 1 construction drawings
(NOTE: Use of cnnsrnrclron diawuigs■s only valid it the eulidingi does not yet have the reference levet noon in piece,at which
case this certificate will only be valid for Uro building during the course of conseudtien A pest-construction Elevalion Ce tificate
wilt be required once construction is complete 1
B.The elevation of trio lowest grads vnmedietely adjacent to the building is LI I I 0,0 feet NOVD(or other FIRM datum see
Section B,(tem 7)
SECTION D COMMUNITY INFORMATION
1 It trio community official rrisponsuble to-verifying building elevations specifies that the reference level indicated in Sadism C.Item I
Is riot the"lowest floor"as defined In the community's floodplairn management ordinance,the elevation of the building's lowest
floor"as defined by nee ordinance us: ...1..1 1 1 ._I feet NOVO(or other FIRM datum—see Section B,Item 7)
2.Data of thu start or constructer.or substantial improvement_ -` _
FEMA Foim 91.31,MAR 97 REPLACES ALL PREVIOUS Ebil1ONs SEE REVERSE SIDECAR CON11NUARON