FEMA-EC040727EiUILDING~~'S ~E
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BUILOINGSTREET ADDRESS (I
ifL~:~:'Jt?)lM.ERGE~"UJA.HAGEfjfENT A(iENCY
NATIONAt:-Fi-OOifi II~ HANCE PROGR A,~
ELEVATION C: E ,RTIFICA "(:
Important: Reed the Ir :!! :!!: :lions on ~t;2 . 7.
SECTION A . PROPERT I (.' IV 'ft!R INFORMAn 0.1
S4d/t!"~
dklg Apt., LJnIt, Suite, and/or Bldg. No.;')j: Ii O. ROUTE AND Be x "0.
I4J 00107/28/04
a.M.B. N). ~~l 7-0077
Expires [ 9 ~m :>er 31, 2005
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PROPERlYDESCR!.PTIO~(lOl agd.P\OCkNtn!lp, ~~rcw Number,~! I.€. D 18cripli(ln, elc.}~
Lt:?+ I' ~ ~1/ /< ~ .,!,~~ f'f' :Q,"":5'BUILDING USE (e.g., ResidenUal, ~tIaJ,_ Addltpn, ~~,,-re. lis, a nts area, W r ee as88fy.)M R6J c1"'/1 Y/UI' . _ _ _.
LATITUDElLONGITUDE (OPllONALj HORIZONTAL DATUM: , SOURCE: LI GPI" (Type):If'./I#'. 11#.#/1' or lI#.iI#/##tf) U HAD 1927 LI NAO 19 - 3
LI U SOS ClIJad Map U OtI1er -=== =-
SECTION S - FLOODINSl,IRANC! J ~S re MAP (FIRM) 1.!::muAnON - - -- .,
NAME & COMMUNllYNUMBER B2. COUNl/: N i ii r I I B3. SrATE ---
0 L:~:..: /4's L ~=<~~._
85. SUFFIX B7' Fi' i PANEL [at. FLOOD 99. BASE =l COI ELEVATlON(S)
I/' NUMBER
n DA ~... / EFFe;CJrPfI.~,,!!!!EDDATE <ON!O(S!.-- (Zone AC f'Bpd ,pth"offloodlng)J/7~-/)d LI ~ :l"V4 /e?,:~:~~.[ . _ .e j~~ [J
B10. Indicate the source of the Base Flood Elevation (BFE) data or 00'" Ix d depth entered II E.9.
U FIS Profile LJ FIRM U Community Oetermlne: U Other (Deserl l6):
B11. Indicate the elevation datum used for the BFE In B9: U NGVD 1! 12; LI NAVD 1988 _I Other (Describe): _ _ __ _
B12. Is the buUdlng located In I'! t;oaslalBarrler ResouR:8s Syslem (el: ~ i, llle8 or Otherwise "I :lIeeled AI'll8 (OPA)? I_I '(8, LI No
liialgnatlon Date:
SECTION C -BUILDINGELEVATIOtl :~~~ RMATION ($UR\!f REQUIRED) ---
C1. Building e/wations are based on: LIConstruction Drawings" l . .IlluDdlng Under Co 1S :ruollon" 1_IFln~ 11,d C II1Structton
j, new Elevation Certificate will be required when construction of I' e t u Iding Is complete.
C2. Building Diagram Number _ (Select the building diagram mos' ~I! I olllr 10 the building ~ If Nhlch this certiflcate Is I ~ ng . ::>mpleted - see
pages 6 and 7. If no diagram accurately rapresents the building, p')~ de a sketch or phctcgl aph.)
C3. Elev8tIons-ZonesA1-A30, AE, AH, A (with BFE), VE, V1-V30, V 'vjt.IIFE), AR,ARJA, ARiA!:, AAlA1-A30, ARJA~, ,\RIJ 0
Complete Items C3.&-1 below according to Ihe building diagram SP,":ll.><: In Item C2. Slale th" datum used. If the dal Jrlls lifferentfrom
the datum used for the BFE In Section B, convert the datum to thai ~:d for the BFE. ShO\lI raid measurements and dldlJrr conversion
calculatlon. Use the space provided or the Comments al'll8 of See i)/ 0 or Section G, as 1lp;lrnprial8, to document lIE dal 1m conversion.
Datum Conversion/Comments ,
j aElevallonref8/8nca mark used "Does tha ;~:; ior!.,,~ce mar < Ilsed appear on Ira.i ~ No
Cl a)Topofbottomfloor(lncludlngbasementorenciosura) __ ~(,'IJ _ ..a.h,m) I :~;-~"';:; ;. :!\.\Clb)Topofnaxthlgherftoor' - - ~ALt.m)
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4f"';l;Cl c) Bottom of lowest hortzonlalstructural member IY ZDI18S only) _ _ . A:.. t., m) ~ ..,
II" q~j ".) 't,,' ,~"' t:,
IJ ~A AA) $." '\,....~A , ,~,:\Cl d Attached garage (top of slall) _. ~ T C.HJ . ~ t., m ~ ."". ."...."":'~.." ':~"" ",,:~~"""',:
Cl e) Loweslelevatlonof mechlneryandlorequipment ~ .~ ':
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i:i()NALJ.~, I :;.<~:>I~-:...,
tservicingthebuilding (Dascrlbe in a Comments BI'll8.) _. ~ ~ . 2t1t.Ul1) f\~"~f'~""'~'''~ "." :. ;<~".;. :; 'W'. .".,::;t . \ l'I f) Lowast adJacent(flnlshed) grade (LAG) __/ . .JdI.lrTl) %. '. 'l~t}< "<,.,, /t~!;~t 'iI'o g) Highest adJacent (finished) grada (HAG) . _ .-148 . .2'tl-I.(11) !,~, ~~i "f' ,:' .~ ~ ~ .Cl h) No. of parmanenl openings (flood vente) within 1 ft. above ad) i 0' It grade t") ! \ ~" "!'" .:~. .
1. '1 ( ) .,'Q,II{Cl I Total area d all permanent openings (ftood vents) In C3.h -Ll..<....: _ sq. n. sq. em !
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SECTIOND-SURVEYOR, ENGINEE!~!~tARCHrrECTCE~nFlCATION ...-
n,is.:ertfflca'l.on Is to be signed and sealed by a lend surveyor, engine: r, [( arthll8ct authorin{j by law to certify e/evatkn Info mallon.
I c/J'tlfythat the Informetlon In Sections A. B. end C on /his certiffcate ~10l :801/'118 myb&st 9ffor1s ,olnterpr9t the dsts ava lab/e.
I understand that any faiN statement may be
r;zlshable by fine or /mJ ~ k;: n I'I9fIt under 18 U.f:. l})de, Section 1001.
CERT'AEVlhp #5." p.pt?~ IJ<'~ :=.=
LlCENSE~lJ~~
f'3 7 ____mLE J") . / CCI.jItY~ A 'r-r,1?-u d..p,n or _ .I.1"'.P~~ "I' L'7-"e.";OC~- .' _ _ADDRESS I?:Z ~. Y.1 7r: / Cr",1~/d' .~ ~(B~~SIGNATURE ~~~ R-}J; D~ ~ ~~" '7/b 9' TELij~~_ ~~ 2 ~~~!/ d
FEMA Fann 81-31, January 2003 See neverse sid ~ '",onUnuallon. Replaces 81 011 vlous editions