FEMA-EC950908ELEVATION CERTIFICATE °"'"Fxp~res May 3 I, 1995
FFIPFRAL EMFRGFNCY MANAGFMFNT AC, FNCY
NATIONAL FLOOD INSURANCE PROGRAM
TENTION: Use of thi~ c~rtif cat,', doc, q no! provide a waiver of the flood insurannp p ~rchag¢, rc, quimment. This form i~ used only tov,de elevation informahon necessary to ensure compliance with applicable community flnodplain management ordinances, toi~;rmine the proper insurance premium mfs, and/or to support a request for a letter of M~p ^mendment or Revision (LOMA or LOMR).Inslruclions for completing lhls form can be found on Ihs following pa~. es.
SECTION A PROPERTY INFORMATION rob INSHRANCF COMPANY USE
lNG OWNER'S NAME
POI ICY NI IMBFR '
t' ET ADDRESS {Inr:ludmq Apl, I,h~t Slnl¢, ;~n,f ,)f Rldq Numbt3r) OR PI) ROIITE AND ROX
SECTION B FLOOD INSURANCE "ATE ~flP (FI"M)ItIFORMATION C()Mf'^NYhi^lCNUMBERvidethefollowingfromtheproperFIRM (See Instructions):i.. o,0,, o ,¢ /s - 74' ,,.. u,.,,,., .¢¢2Ih~dicate theelevationdatumsystemu~c,dontheFIRMforBR.~eFloodFlevationsfBFF)' L,~(f'NGVD '29 iIOther (describe onback)g-or ZonesAorV, wherenoBFEisprovidedontheFIRM, andlhecommunityhasp~Inhli~'.hc, d aBFEforthisbuildingsite, indicatethecommunity's BFE: L ! IiIrif~efNGVD (orolhPrFIRMdatum-se~SECTION CBUILDINGELEVATIONINFORMATION1risingtheElevationCedificateInstructions, indicatethediagramnumberfromlh~ di~nrams foundonPages 5and6thatbestdescribesIhssubjectbuilding'sreferencelevel / .falFIRMZonesA3-A30, AE, AH, andA (withBFE). ThetopofIhsreferencelevelfloorfromtheselecteddiagramisatanelevationt,'-~"'"oftIL~:2~.! ! .I,:~ feetNGVD (orotherFIRMdatum-seeSectionB, ItRm7).h) FIRMZonesVl-V30, VE, andV (withIBFE). The bottomoftheIowe.~thorizontal ~true, t iramemberofthereferencektv,elfromtheselecteddiagramisatanelevationoftII ~, I !.! If~.etNGVD (oroth~rFIRMd~tum-s~e SectionB, Item7).FIRMZoneA (without BFE). The floorusedasthereferenceevelfromthes~lc, nt~d diagramisIIi.I tfeetabovef ~ orbelowJl] (checkone) thehighestgradeadjacenttothebuilding.Id/ FIRMZoneAO. The feotusedasthereferencelevelfromthesc.k, ctc. ddiRqrami~ ! ! i.iIfeetabove ! ! orbelow [ -! (checkone) thehighestoradeadjacenttothebuilding. If noflooddepthnumberisavRiaf)l~ i~ the huilding'.~ lowest floor (reference I~vel) elevatedinaccordancewiththecommunity'sfloodplainmanagemenlordinnnr:~? iIYes ! t NoI ] UnknownIndicatetheelevationdatumsystemusedindetermininqtheabovereferenceI¢,v¢1 ,~lgvntions: ! ! NGVD '29 ! ! Other (describe underCommentsonPage2). (NOTE: Iftheelevationdatumusedinmeasurinpth¢ ¢lpvation.~ i.~ differentthanthatusedontheFIRM [.~
ee SectionB, Item7]. th~.n convertthe ~,levation.~ to thedatums.v.~temusedontheFIRMandshowtheconversionequationunderCommentsonPage2.)Elevation referencemarkusedappeamonFIRM: [- ! Yesi~ No (See Instruclion~ on Pane4)Thereferencelevelelevationisba~c,d on: !/~actual conslruction !'-] construction dmwinqsNOTE: Useofconstructiondrawinosisonlyvalidifthebuildingdoesnotyethavethc, reference levelfloorinpl,~ce, in whichcasethiscertificatewiflonlybevalidforthebuildingduringthecourseofconstructionApo.~tconstructionElevationCertificatewillberequiredonceconstruction ¢s complete.)Th~ elevationofthelowestgradeimmediatelyadjacenttoth~ building is:[ I i ¢ : ' ~ feet NGVD (or otherFIRMdatum-see SectionB, Item7).SECTIONDCOMMUNITYINFORMATIONifthecommunityofficialresponsibleforverifyingbuildingelevationsspecifiesthatth~ referencelevelindicatedinSectionC, Item1mnotthe "lowest floor" as definedinthecommunity'sfloodplainmanagementordinancetheelevatonoffloorasdeflnedby