FEMA-EC961015 (2)B..o.
F-LEVATION.CERTIFICATE-
t996
FEDE,~AL EMER'GEN"CY MANAGEMENT AGENt,
NATIONAL FLOOD INSURANCE PROGRAM ~,
ATTENIlON: Use ol Ibis cerlilicale ~loes nol provide a waive( oflhe Ilood insurance purchase requiremenl: lhis lorm is used only Io
provide elevalion inlormalion necessary Io ensure compliance wile applicable communily Iloodptain managemenl ordinances. Io
delem~ine the proper insurance premium rate, and/or Io suppod a tequesl lot a Leller ol Map Amendmenl or Revision (LOMA or LOMR).
Inslrucllona for complelh~g Ihls form can be tourtd on Ihe following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNERS NAME
SIREET__ADDRESS flncluding Apl., Upil, Sutle 8nd~o~ Bldg Number) OR PO ROUIE AND BOX NUMBER
OILIER DESCRIPIION ttol and Block Numbers, elc I
SlAtE ZiP CODE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide tim following Irom lite proper FIRM (See Inslruclions):
7. Indicale Ihe elevalion dalum system used on the FIRM lot Base Flood Elevalions (BFE): [_.~. NGVD '2g [']Olher (describe on back)
8. For Zones A or V, where no BFE is provided on Ihe FIRM, and lee communily has eslablished a BFE lot Ibis building sile, indicale
Ihe communily's BFE: [ _[_ 1._ !_ ~ I.I- J leal NGVD (or olhe~ FIRM dalum-see Seclion B, Ilem 7).
SEC'lION C BUILDING ELEVATION INFORMATION
I. Using Ihe Elevation Certificate Inshuclions, indicate life diagram number from Ihe diagrams found on Pages 5 and G that besl
describes Ihe subjecl building's relerence level _( _ .
2{al. FIRM Zones Al A30, AE, AH, and A {wilh BFE). The lop ol Ibe relerence level Iloor horn Ihe selecled diagram Is al an elevallon
ol I_ 5'L("I.I _¢"l leel NGVD (or olher FIRM dalum-see Seclion B, Ilem 7).
b). FIRM Zones VI-V30, VE, and V {wilh BFE). The bollom ol Ihe Iowesl borizonlal slruclural member ol Ibe relerence level Irom
Ibe selecled diagram, is al an elevalion ol [..J [ .] ! .! .!.. I leel NGVD (or olher FIRM dalum-see Seclion B, Ilem 7).
c). FII~M Zone A (wilhoul BFE). The floor used as Ihe relerence level Irom Ihe selecled diagram is LEi .U_l leel above L~ or
below ~ (check one) Ihe highesl grade adjacenl Io Ibe building.
d). FIRM Zone AO The Iloor used as Ibe relerence level Irom Ihe selecled diagram is I I _!.~ ! leel above l_'.l or below [] (check
one) Ibe bighesl grade adjacenl Io Ihe building. II no flood deplh number is available, is Ihe building's Iowesl Iloor (reference
level) elevaled in accordance wilh Ihe communily's Iloodplain managemenl ordinance? [-~ Yes [_~]_ No [~] Unknown
3. Indicale Ihe elevalion dalum syslem used in delermining Ihe above reference level elevations: I~"NGVD '29 [_~ Olher (describe
under Commenls on Page 2). (NOTE: Il lite elevation datum used in measuring tire elevations is different than that used on
the FIRM [see Section B, Item 7/, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: [~'__] Yes I_~No (See Inslrucllons on Page 4)
5. The relerence level elevation is based on: [_/~"'aclual conslruclion _[-_] construction drawings
NOTE: Use of corrstruction drawings is only valid if tire building does not yet have tire reference level floor in place, in which
case this certificate will only be valid for Ihe building during the course of construction. A post.construction Elevation Certificate
will be required once construction is complete.)
6. The elevalion ol Ihe Iowesl grade immedialely adjacenl Io lee building is: LJ__J?L~'._~. L~ .leal NGVD (or olher FIRM dalum-see
Seclion B, Ilem 7).
SECTION D COMMUNITY INFORMATION
I. II lire communily official responsible for verifying building elevalions specllies thai lite reference level indicaled in Section C, Item I
is nol Ihe "lowesl Iloor" as delined in Ihe communily's floodplain managemenl ordinance, Ihe elevation ol Ibe building's "lowesl
Iloor" as delined by Ibe ordinance is: J. I I.~..[ 1.1_. ! leel NGVD (or olher FIRM dalum-see Seclion B, Ilem 7).
2. Dale ol Ihe slarl of conslruclion or subslanlial tmprovemenl. %
FEMA Form BI-31, MAY 93 REPLACES ALL PREVIOUS EDIIIOIqS SEE REVERSE SIDE FOR COI'4flNUAflOI'4