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Home My WebLink AboutElevation Certificate - BLD Permit / Conditions - 5/17/1988 ` FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Irnportant Read the instructions on paga 1.7. 3 --ja— SECTION A-PROPERTY OWNER WFORMATION Fanxx Iance Canpany Use BUIIDIfJG OWNER S NAME SECTION Number BUILDING S ET ADDRESS(Including Apt,Urnt Suite,ardor Bldg.No.)OR P.O.ROUTE AND BOX NO. Canpany N NC Number 3 RA'n 8 L-<- CITY STATE ZIP CODE PROPERTY DESCRIPTION(Lot and Block Numbers.Tax Parcel Number,Legal Desorption,etc.) A_-C 2 u� B q'7 �t)01 Tu 9-- r i t3UILD1 USE(e.g..Res' al,Naxesidenbai,Add4w.Accessory,etc. Use a Comments area,f necessary.) �(F-S i D c NIA LATITUDEA.ONGMJDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS(T)ope): Aw-###sf or ##.A A ) ❑RAID 1927 ❑NAD 1983 ❑USGS Quad Map Cl Oftrr SECTION 8-FLOOD INSURANCE RATE MAP(FlW INF-OWTION Bt NFIP COMMUNITY NAME d COMMUNITY NUMBER 91.COUNTY NAME B3.STATE B4 MAP AND PANEL 8 5.SUFFIX 87.FIRM PANEL B9.BASE FLOOD ELEVATICN(S) NUMBER B6.FIRM INDEX DATE EFFECTIVI RPASED DATE 88.FLOOD ZONE(S) (Zane AO,use depth ofkodrig) U.2-CXD C— B 10 Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. ❑FtS Profile ❑FIRM ❑Cormxx*Determined ❑Cther(Describe): B 11.1ndcate the elevation datum used for the BFE in 89:❑NGVD 1929 ❑NAVD 1988 ❑Other(Describer B 12 Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Pt owed Area(OPA)7 ❑Yes ❑No Designation Date SECTION C-WMNG ELEVATION INFORMATION(SURVEY REQUIRED) C 1.Building elevations are based on:❑Construction Drawings' ❑Building Under Cons<nctial' KFnshed Construction 'A new Elevation Caftalle wd be required when construction of the building s conaele. C2.Bulding Diagram N rr>bete(Seled the building dagram most similar to the building for which this ccertFicate s being completed-see pages 6 and 7. M no diagram accurately represents the buidrlg,provide a skeloh or photograph.) C3.E]ev-aions-Zones AlAX,AE,AK A(with BFEr VE,V1-V30,V(with BFE),AR,ARIA,AR/AE,ARIAl-A30,ARIAH,AR/AO Complete Dems C3.-.H bebN according to the building diagram specfied in hem C2.Slate the datum used.9 the datum is different from the datum used lor the BFE in Section B,octwert the datum to that used for the BFE.Show field measurements and daturn conversion caladatiorn. Use the space provided or the Cormxsrrs area d Section D or Section G,as appropriate,to dorxrmert the datum conversion. Datum Corversiont /(�, S y ol - Elevation reference mark usedO g�►'Qo�s the elevation reference mark used appear on Glee RRM7 Yes XNo ► a)Top of bottom floor(ndudng basement or enclosure) L I(a . Otitt(m) 0- b)Top of next higher floor Z —CI k(m) M A- AJF/Cc1Z—$ ► c)Bottom d lowest horizontal structural member(V zones only) fL(m) •a ► d)Attached garage(top of slab) Z .1$ft(m) ► e)Lowest etvabon of machinery ardor equipment w F �o savicrig the building(Describe in a Comments area) 0� 15863 �v ► 0 Lowest adaml(finished)grade(LAG) i o H I 0- 9)Viest 4 ( ad)grade(HAG) LA 2 ice,v�t(m) R d1, N rr�� ► h)No.of permanent oW*xfi(Hood vents)within 111.above adjacent grade ?�L/ ► i)Total area d al puma>ert operw>gs(flood vents)inC3.tEq.in. 3.(sq.ton) 9 2(,a Ste, l K, SECTION D-SURVEYOR,ENGINEER,OR ARCHTEt:T CERTIRCATION 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 8, and C on this certificate represents my best efforts to i(serpret the data available r understand thal any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. CERTif FRS NAME �� LICENSE NUMBER �� c✓ 3 T(TLE o w i�j COMPANY NAME ADDRESS -� CfTY S/ STATE n LP C SIGNATURE DATEOl/p ZDU.L TELEPHONES• ,) j'qC(o FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS (: In these sPXM copy the corresponding infiorrrti6on tram Section A. For Faroe Ccr p L;se STREET ADDRESS Unt,Skite,ardor D%.Na)OR P.O.ROUTE AND BOX N0. p N log STATE P Canes NA1C Nunbec SECTION D-SURVEYOP ENGINEER OR ARCHTECT CERTIFICATION(CONTINUED) C00y bcLh sides Of the EJEvabOn Certfrate for(1)corrrnunity offiaai,(2)M ra- e ag V=npany,and(3)bu7dng owTmer. C�.It.tE'ITS 5k2OM2-50d 15 A /S o273,t0 Z q �Z�r/.�nu�/ _ z-7 01�Z m /�?/ Gov/�/h,r�✓ v�4 ci S c l f PvrYI� v CT``' Check hererf ate F�✓. 'StCTiON E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(wiftxut BFE�oxrOete hems E 1 Uvax E4, H the Be rdbon Celcate is intended for use as supporting rimnabon for a I"or LCMR-F Section C must be M-pided. E 1.I3 W9 Diagram NuTmberaSeied the bulling dag<w most uAar to the bulling fa which tics outific�.ate is being completed-see pages 6 and 7. ti no dragram ax uratey Wes"the bLMN.prooide a sketch or pfxtograph.) E2 The by ci the bottom floor(rdudng basement or encimxe)of the bulling s 1 iL(m)Zn.(crm)❑above a below(c)eck one)the hq)est a4acer4 grade. (Use raw grax if awalable). E3 For bib;ng Diagrams,"with operwn (see page 4 the next tqw floor or elevated floor(elevation b)of the t kk-g is?ft-(m)�ein(cm)above the hJ)est a*cent grade CaTOete term C3.h and Cl on front of form. E 4.Fa Zone AO ontf $no flood depth number is aaalatle,is the top of the botom floor elevated in acoordaxe with the oommunllls Noodpain management ordnance? ❑Yes ❑No ❑Un kromi The local offioal must oati Its dormstion in Section G SECTION F-PROPERTY OWNER(OR OWNERS FEPRESENTATNq CERTiF=TION The property om)er or omWs authorized representative who oampldes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(wdhout a FEMA-sued or cormun4y- sx,ed BFE)or Zone AD must sign here. The stataments in Sections A.B,C,and E are coned to the best of my VrWedge. PROPERTY ONtERS OR Ovrr+ERS AUTHORIZED REPRESENTATIVE'S NAME ADORE SS CrTY STATE ZIP CCOE �v C2 3 7 StGHATURE OATS b � �TELEPHONE 6,12 q�' Lq� COtiV.tE�lTS L,-7-- A13Ol1-C, ❑Check here if attad nts SECTION G-COMMUNfTY INFORMATION(OPTIONAL) The bcaf oFcd who is acttaized by law or Wcfuhaxe to alTvrista the oaTvwtys boodplan managemmert adnarce can ow-ode Seci;as A B.C(or E).and G of the Elevation Certfcate. Compete the 40cable ilea(s)and sign below. G 1.❑The rtormabon in Secion C was taken from otter doamertabon that has been signed aid embossed by a icersed surveyor,ergncer.or aid*d who is arthor>zed t y state or bcaf law to certify elevation hfomTation. Qnd:de the source aid date o(M elevation data in the Cammrments area below.) G2 ❑A canrnLrAy offcd completed Section E for a building located in Zone A(without a FEMA-iswed or camxxlity issued BFE)on Zone A0. G3 ❑The foioramg information(ftems CA-G9)is prodded for coma miy fbodplan management p poses. i-C PfRA4 NL"KR GS DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CCMPUANCEKCCUPANCY ISSUED G7 TTs wTTA has been sued for❑New Construction ❑Substantial Imp mmeN G8 Elevation d as-0ul beest boon(indudng baserment)c(tte bunking is: _._It(m) Daum: G9 BFE a(n Zone AO)depth of foodng at tte bulling s4e s: — _fl,(m) Dim LOCAL OFFICIAL'S NAME TiTLE CO►.M.l1NITY NAME TELEPHONE SIGNATLRE DATE ^DAMENTS ❑Check here i(attactxments FEMA Form 81.31. JUL 00 REPLACES ALL PREVIOUS EDITIONS