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FEMA-EC961015
O M B. l~). ELEVATION CERTIFICATE f996 FEDERAL EMERGENCY MANAGEMEN1- AGENCY NATIONAL FLOOD INSURANCE PROGRAM AlTENlION: Use Gl Ihis cerlilicale does,nol provide a waiver of Ihe flood insurance purchase requifemenl 1his Iom~ is used only Io p~ovide elevalion inlormalion necessary Io ensure comDliance wilh applicable communily floodplain managemenl ordi;~af~es~ {o delermine Ihe proper insurance premium tale, and/or Io suppod a requesl for a Leller Gl Map Amendmenl or Revision (I_OMA or LOMR). Inslrucllons lot complellng Ihls form can be lound on Ihe following pages. SECTION A PROPERTY INFORMATION BUILDING OWNERS NAME j~ r r o S ............ o. SIREEI ADDRESS {Inclul:ling Apl., Unil, Suite and/o~ Bldg Numbe0 OR PO. RC), UIE AND BOX NUMBER ZIPCOOESECTION BFLOODINSURANCERATEMAP (FIRM) INFORMATIONProvideIheIollowinghornIheproperFIRM (SeeInslruclions):7. IndicaleIheelevaliondalumsystemusedontheFIRMlotBaseFloodElevations (BFE): [_~ NGVD '29 [iJOIher (describeonback)8. ForZones AorV, wherenoBFEisprovidedonIheFIRM, andIhecommunityhaseslablishedaBFElotIbisbuildingsile, IndicaleIhecommunily'sBFE:! [..I._ !_.JJ.l_ IleelNGVD (ofolherFIRMdalum-seeSeclionB, Ilem7).SECTIONCBUILDINGELEVATIONINFORMAIIONI. UsingtheElevalionCerlificaleInsl[uclions, indicatethediagramnumberhornIhediagramsfoundonPages5and6thaibesldescribeslitesubjectbuilding'srelerencelevel _~ ._ .2(a). FIRMZonesAl-A30, AE, Alt, andA (wllhBFE). 1'helopGlIhereferencelevelfloorhomIheselecleddiagramisatanelevationotI_I.JEI¢ II~ feetNGVD {oroff,e, FIRMdalum-seeSectionB, Ilem7).b). FIRMZonesVI-V30, VE, andV (wilhBFE). ThebollomofIheIoweslhorizonlalslrucluralmemberGlliterelerencelevelIromliteselecteddiagram, isalanelevalionGl [..J [_ I__! ! .!.. } leelNGVD (orolherFIRMdalum-seeSectionB, Item7).c). FII~MZoneA (wilhoulBFE). ]hefloorusedasIherelemncelevelIromIheselecleddiagramis [_J_J .LJleelabove [] orbelow ~ (checkone) IhehigheslgradeadjacenlIoIhebuilding.d). FIRMZoneAD. ThefloorusedasIherelerencelevelIromliteselecleddiagramisII _! .l_ ! leelaboveL'] orbelow [-_~ (checkone) IhehigheslgradeadjacenlIoIhebuilding. IInoflooddeplhnumberisavailable, isIhebuilding'sIoweslfloor (relerencelevel) elevaledinaccordancewilhIhecommunily'sfloodplainmanagemenlo,dinance? [__~ Yes [_~ NoI~} Unknown3. IndicaleIheelevationdalumsyslemusedindelerminingIheaboverelerencelevelelevalions: (~r'NGVD '29 [~.-~ Olher (describeundeTCommenls on Page2). (NOIE: If tireelevationdatumusedirtmeasuringtireelevationsisdifferentfhanthatusedontheFIRMlseeSectionB, Item 7~, then converttheelevationsfothedatumsystemusedontheFIRMandshowtheconversionequationunderCommentsonPage2)4. ElevationrelerencemarkusedappearsonFIRM: [~ Yes !_~ No (See InslruclionsonPage4)5. The relerencelevelelevalionisbasedon: L~"aclual conslruclion -[--~ conslmclion drawingsNOTE: Useofconstructiondrawingsisonlyvalidiftirebuildingdoesnotyethavetirereferencelevelfloorinplace, inwhichcasethiscedificafewillonlybevalidforthebuildingduringthecourseofconstruction. A post-construction ElevationCertificatewillberequkedonceconstructioniscomplete.)6. '[heelevalionGlliteIoweslgradeimmedialelyadjacenlIoIhebuildingIs: L]__~_~-~ .[~ .leel NGVD.. (or olherFIRMdalum-seeSeclionB, Ilem7). ~SECTIONDCOMMUNITYINFORMATION1. IIIhecommunilyofficialresponsiblelotverilyingbuildingelevalionsspecifiesIhalthereferencelevelindicaledirtSectionC, ItemisnolIhe "loweslfloor" asdelinedinIhecommunily'sIloodplainmanagemenlordinance, IheelevationGlIhebuilding's "loweslfloor" asdelinedbyIheordinanceis: [. [ l . [_ I._ I.! ! leelNGVD (orolherFIRMdalum-seeSectionB, Ilem7).2. DaleGlIheslarlGlconslruclionor subslanlial improvemenlFEMAFormIll-31, MAY 93REPLACESAILPREVIOUSEDII1OIqSSEEREVERSESIDE