FEMA-EC970129 (2)ELEVATION CERTIFICATE .~ Expires J~oy 31, 1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only !o
provide elevation information necessary 1o ensure compliance with applicable communily floodplain management ordinances, lo
delerrnine lhe proper insurance premium rate, and/or Io support a requesl for a Letler ol Map Amendment or Revision (LOMA or LOMR).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNER'S NAME
IFc. ,.sun^.cE cou.A.v USE
Ipouc¥ .
U,~.E.--
1~
A~u~;STREET ADDRESS (Including Apl., Unit, Suile and/or Bldg. Number) O.O.~ P.O. ROUTE AND BOX NUMBER
OTHER DESCRIPTION (lol and Block Numbers, elc.)
o_ t';_ _ ........ ............. WAc_ P e i m u l,,.- otc
STATE ZIP CODE
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide lhe following from Ihe proper FIRM (See Instructions):
7. Indicate the elevation dalum syslem used on the FIRM for Base Flood Etevalions (BFE): L~NGVD '29 [~_] Olher (describe on back)
8. For Zones A or V, where no BFE is provided on Ihe FIRM, and lhe community has established a BFE for this building sile, indicate
the communily's BFE:I [ .! ! _! .I.!__l feel NGVD (or other FIRM dalum-see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicate tile diagram number from the diagrams found on Pages 5 and 6 thal best
describes lhe subjecl building's reference level _~ _.
2(a). FIRM Zones Al-A30, AE, AH, and A (wilh BFE). The lop of the reference level floor from lhe selecled diagram is al an elevation
ct! I Jq'J~5'J .J ~_J teat NGVD (or other FIRM dalum-see Section B, Item 7).
b). FIRM Zones V1-V30, VE, and V (wilh BFE). The boltom of the lowest horizonta. I struclural member of the reference level lrom
the selected diagram, is at an elevation of L_] ! J__! .! .!_ ! leer NGVD (or other FIRM datum-see Section B, Item 7).
c). FIRM Zone A (withouI BFE). The floor used as Ihe reference level from Ihe selecled diagram is J J J.[_J feet above ~ or
below J~i] (check one) the highest grade adjacenl !o Ihe building.
d). FIRM Zone AC. The floor used as lhe relerence level from lhe selecled diagram is !_~L_~ .L_! feet above L~ or below L~ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the communily's floodplain management ordinance.."/ ~'~ Yes [] No '[~ Unknown
3. Indicale the elevation datum syslem used in delermining Ihe above reference level elevations: [~"'NGVD '29 ~_-~ Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
the FIRM [see Section B, Item 7], then convert the elevafions fo 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 J.__~l'~ No (See Inslruclions on Page 4)
5. The reference level elevation is based on: __~aclual conslruclion _[-_~ construction drawings
NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate
wilt be required once construction is complete.)
6. The elevation of Ihe lowest grade immediately adjacent !o Ihe building is: L[_J_~_L~]~_J .~-J .feet NGVD (or other FIRM datum-see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
t. If Ihe community official responsible for verifying building elevations specifies thai Ihe relerence level indicaled in Section,i;C, Item
is not the "lowesl floor" as defined in the communily's floodplain management ordinance, the elevation of lhe building's "ldwest
t feel NGVD (or other FIRM datum-see Section B, Ilem 7).floor" as defined by the ordinance is: LL_..L__J _1__ i.L ..
2. Date of lhe slart of conslruclion or substantial improvement
FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUA11ON