FEMA-EC990305 (2)ELEVATION CERTIFICATE No.
FEDERAL EMERGENCY MANAGEMENT AG'ENCY Expires July 31, 1999
NATIONAL FLOOD INSURANCE PROGRAM
A'I-rENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirefnbnt. This form is useci only to pro*
vide elevation informatioFt necessary to ensure compliance with applicable community floodplain mana~Jeme'nt ordinances, to determine
the proper insurar~Ce premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR)r. YOU are not
required to respond to this colleCtion of information unless a valid OMB control number is displayed in the upper right corn'er of this form
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
BUILDING OWNER'S NAME
I FOR INSUR,~NCE COMPANY USE
I
pOLIcY NUMBER '
NAIC NUMBE, -STREETADDRESs (IncludingApt., Unit, Suite and/or Bldg. Number) ORP.O. ROUTE ANDBOXNUMBEROTHERDESCRIPTION (Lot
andBlockNumbers. etc.)SECTIONBSTATEFLOODINSURANCERATEMAP (FIRM) INFORMATIONZIPCODEProvidethefoll~3wingfromtheproperFIRM (See Instructions):1. COMMUNTYNUMBER ' I 2. PANEL NUMBERI3, SUFFIX -~ DATE OFFIRMINDEX5. FIRMZONE6. BASE FLOODELEVATIONinAOZones, usedepth)7. Indicate theelevationdatumsystemusedontheFIRMforBaseFloodElevations (BFE): ~---~'I~GVD '29 ~ Other (describe onback)8..For ZonesAorV, wherenOBFEisprovidedontheFIRM, andthecommunityhasestablishedaBFEforthisbuildingsite, indicate thecommunity'sBFE:! ! i ' feet NGVD (or otherFiRMdatum-see SectionB, Item7).SECTIONCBUILDINGELEVATIONINFORMATION1. UsingtheElevationCertificateInstructions, indicate thediagramnumberfromthediagramsfoundonPages5and6thatbestdescribesthesubjectbuId. ~r~'~ referencelevel / .2~a,.r ~ FiRM ZonesA1-A3Q[....,~._, ~,;~',~'FJ.~ ~ A _~,.,,~. _ (with BFE). The topofthereferencelevelfloorfromtheselecteddiagramisatan'elevation o,' zl/:7~J,~..~GT~.~.~.~_EIRM datum-see SectionB, Item7). //b). FiRM ZonesV1~,;'~E~, ~.n~'~i.~). The bottomofthelowesthorizontalstructuralmemberofthereferencelevelfromtheselecteddiagr~?,~is a~i~ele~/~''of'~\i~' 'r .~-- feetNGVD (orotherFiRMdatum-seeSection B, Item7). __c). FIRMZone'A (wt~,~,~ ~i~~'~ ~:~'~'s;'~'as'd~ thereferencelevelfromtheselecteddiagramis .__ feetabove _ orbelow: (Checkope)th~'Rtl.~'~de-a~acenttothebuilding.d). FIRMZor3eAC. The/dooi~ed =.~'t~e,/ref. erencelevelfromtheselecteddiagramis !.~ feetabove _dorbel, ow, _ (checkone) thehighestgradead~a~ehttot.~8b~ilding. Ifnoflooddepthnumberisavailable, isthebuitding'slowestfloor (rererencelevel) elevatedinaccb~'dance(Witffthecommunity'sfloodplainmanagementordinance? __JYes !~ No ~Unknown 3. Indicate theelevationdatumsystemusedindeterminingtheabovereferencelevelelevations: ~ NGVD '29 ~ Other (describe underCommentsonPage2). (NOTE: IftheelevationdatumusedinmeasuringtheelevationsisdifferentthanthatusedontheFIRM [see SectionB, Item7], thenconverttheelevationstothedatumsystemusedontheFIRMandshowtheconversionequationunderCommentsonPage2.)4. Elevationreferencemark usedappearsonFIRM: -;- Yes ~"~"o (SeeInstructionsonPage4)5. Thereferencelevelelevationisbasedon: ~__C,,~actualconstruction ~ constructiondrawingsNOTE: Use ofconstructiondrawingsisonlyva/idifthebuildingdoesnotyethavethereference/eve/floor inplace, inwhichcasethiscertificatewillonlybeva/id forthebuildingduringthecourseofconstruction. Apost-constructionElevationCertificatewillberequirecionceconstructioniscomplete.)6. The elevationofthelowestgradeimmediatelyadjacenttothebuildingis:: .~// . ~ feet NGVD (or otherFIRMdatum-seeSectionB, Item7).SECTIONDCOMMUNITYINFORMATION1. IfthecommunityofficialresponsibleforverifyingbuildingelevationsspecifiesthatthereferencelevelindicatedinSectionC, Item1isnotthe "lowestfloor" asdefinedinthecommunity'sfloodplainmanagementordinance, theelevationofthebuilding's "lowestfloor" asdefinedbytheor'allianceis: . ! iiI ! feetNGVD (orotherFIRMdatum-seeSectionB, Item7).2. DateofthestartofconstructionorsubstantialimprovementFEMAForm81-31,