FEMA-EC990224 (2)ELEVATION CERTIFICATE 996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NA'nONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to
determine the proper insurance premium rate, and/or to support a request for a Letter of Mal~ Amendment or Revision (I.OMA or LOMR).
Instruct]one for completing thle form can be found on the following pages.
BUILDINO OWNERS NAME
SECTION A PROPEhTY INFORMATION.
ICOM~
NY ,^~C
STREET ADDRESS (Irl(::~u~ng AIR., Unit. Suite mm:Vol' ~ ~ OR P.O. ROUTE AND BOX NIJM~-eR
OTHER OESCRIIrnON (Lot and ~ Numl~rl. etc.)
SECTION B
ATE
FLOOD INSURANCE RATE MAP (~iRM) IN."ORMATION
PCODE
Provide the following from the proper FIRM (See Instructions):