FEMA-EC020508CITY
( W - ##'- ##.##" or
FE IAL EMERGENCY MANAGEMENT AGF 'Y
NATIONAL FLOOWNSURANCE MGM..
ELEVATION CERTIFICATE
306j-0077
Expires July 31, 200'2
r Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION I For Insurance Comnanv U-na.
Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
STATE
etc.)
nVracUN I AL UA I UM: SOURCE: 1_I GPS (Type):
4K,NAD 1927 L1 NAD 1983 1_1 USGS Quad Map I Other: F 1
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUMBER
B2. COUNTY NAME
B3. STATE
" E -1- (90
B4. MAP AND PANEL
B5. SUFFIX
Be. FIRMINDEX
B7. FIRM PANEL
88. FLOOD
39. BASE FLOOD ELEVATION(S)
NUMBER
s
DATE
EFFECTIVE/REVISED DATE
ZONES)
(Zone AO, use depth of flooding)
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26 �i
AU4 ?'MI
x
r
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
1-1 FIS Profile 1krFIRM 1_1 Community Determined L1 Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9:J,1e53 NGVD 1929 1_1 NAVD 1988 1 1 Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 1_1 Yes WNo
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 1_1Construction Drawings' Building Under Construction* 1_117inished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number __I_ (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO
Complete Items C3a-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 NAM 65 Conversion/Comments LttY OF C 700LA� 45)6oi>&rtc— nkmer
Elevation reference mark used .9"fi4t ID0 9 Does the elevation reference mark used appear on the FIRM. Yes No
El a) Top of bottom floor (including basement or enclosure) 4J5$ .4r7 ft.(* o
LI b) Top of next higher floor A ft.(m) a ....
/� Gs
❑ c) Bottom of lowest horizontal structural member (V zones only) Pr _ ft.(m) � A �• f%•Q� Fp
d) Attached garage (top of slab) . _ ft(m)
E2E.,• , ...„,;,,,
❑ e) Lowest elevation of machinery and/or equipment w ” AR ES
�d
servicing the building........ •' ...
'
E c '
LI f) Lowest adjacent grade (LAG) . JTO ft.(wr) z.5
Tom':'
()
❑ g) Highest adjacent grade (HAG)•'L �i
O h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade � y
• i) Total area of all permanent openings (flood vents) in C3h �sq. in. (sq. cm)
SECTION D - 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, B, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by rine or imprisonment under 18 U.S. Code Section 1001.
FEMA Fofall'81-31,%eUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
IMPORTANT: In these spaces, copy the , tesponding information from Section A. For Insurance Cotnoarw Use:
Dur r z I i nr� uuncoa tm( aC u�g Apr., unit, `ou�nwor Ding. no.l un r.v.,nvu I c nnu ovA Nu. I Policy Number I
CITY �-•��i STATE ZIP CODE Company NAIC Number
GCpEY7 [ _ iG]rA�11S '74n Act
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner.
COMMENTS
• ' � I I Check Here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (W 4gUT;$IFV)
For Zone AO and Zone A (without BFE), complete Items Et through E4. If the Elevation Certificate is intended for use as supporting
information fora SOMA or LOMR-F, Section C must be completed.
E1. Building Diagram Number _ (Select the building diagram most similar to the building for which this certificate is being completed -
see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is LLI ft.(m) LLin.(cm) LI above or LI below
(check one) the htgtieskedjacent grade.
E3. For Building Diagrams 6.8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is
LL -1 ft.(m) LLlin.(cm) above the highest adjacent grade.
E4. For Zone AO only: .If Ito flood depth number is available, is'the tod'of the bottom fldore*Vated,irl'acoordar ice with the cbmmunity's,
floodplain management ordinance? LI Yes U No U Unknown. The local official must certify this information in Section G.
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or
community -issued BFE) or Zone AO must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
SIGNATURE DATE TELEPHONE
1_I Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who.is %Ogdzed bylaw or ordinance to,adr)rimister,the commynity's,floodplain management ordinance cap corm)?lete
Sections A, B, C (orE), and G of this Elevation Certificate. Complete the applicable Rem(s) and sigh balm.
G1. L1 The information in Section C was taken from othe(:do�mentation that has been Signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state or..ycal law to certify elevation inforination. (Indicate the source and date of the
elevation data in the Comments area below.) .HY1
G2. LI A community official completed Section E for a builrfing kxwted in Zone A (without a FEMA -issued or community -issued BFE) or
Zone AO. :,-
G3' LI The following information (Items G4 -G9) is provided Jor community floodplain management purposes.
.
G4. PERMIT NUMBER G5. DATE PERMIT G8. DATE CERTIFICATE OF COMPLIANCE10CCUPANCY
i ISSUED
G7. This permit has been issued for: LI New Construction LI Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: —ft.(m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
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COMMENTS
�;+'?'.L�.Iti ._.•�!' its.
`. I I Check here if attachments
FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS