HomeMy WebLinkAboutFEMA Application 1999-6-2
MAY-06-2003 rUE 10:58 AN
BRA~CH ENGINEERING 5417460389
FEDERAL EMERGENCY MANAGEMENT AGENCY
NA TIONAL FL.OOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
p, 04
,::.,
eM 8 No 3067-0077
E<plres July 31, 2002
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lmccrtallt. Read the Instructions on p;:i!ges1 - 7.
~----sECTlONA - PROPERTY OWNER INFORMAnON
BrJll.OING OVVNel:1'S NAM5 "'- r -n II", "
\... "'\t\~\.U~~
SUI LDlN~ STB.EEi ADOFiE$S (In~l.idm9Apt Urot, SUlte llnd/Ql' 6klg NQ} OR ~ 0 ROUTe AND BOX NO
0'.;::.; t.., e ,~ SlV't"~t-
CITY~py~ -h ~\~i . ., S.A~)'Z
F~OPEr=(YV~. CRJPT.ION IL.Q.t iand Slade Numoer.t., TiD( Par~ NIlIt1tIIK. Lpg:ll D~.. !HI;:,)
a \....bi'"' ~ Cc_bc.e'V..L l(-:'\".di~'-" %.'~1 Mug ~ ~ .
SUIL,DING ~(e 9 , Re,Tllaenllal. NOll-1'e$idenllaJ, Add1bcrt. Accessory,l!tC. Use c..,.."......:. SedQl, ~ )
. l"\@"G Cd&...... -r~ a.. \
~1ITUOf.;/LONGITUDe; (OPTIONAL) HORIZONTAL. DATUM SOURCE. U GPs (T:,rpe).
(##"o##-##.#1f' Qr If#~ UNA019.27 UNA01963 LJUSGSQuadMap
I For JII$Ur:l1lQe CQmoany Use
Pouc I Number
j ~l;'ln\, AAlC Nllmeer
ZIP CO~
C12lf7?
LJ C,U;;;-
_ SEcTiONS. FCOOo INSURANCE RATE MAP CFlRM)INFORMAnoN ~
, 81 N.FIPGOM~UNITY. NAME&.9JMM.. UNm'NUMBER.1 n.COUNTY.~~ l .. I S3.SrAte 10. _ I
Cl.~ ~ ~rv.."1:hd~ 415;;'12,.. La"lP I..:t>U",,-,\'1 _ ..~ Of'.... I
/:l4 MAP AND PAN'L .. as, SUFFlX 85 FIRM INDex' 67, F1R'M PANEL I BIl. flOOD ""--aAslii. FlOOD El.EVATION(~
NUMBt:P OATE Ef'r~OATE z~ ~AO,u:sedej)!hofffoodins)
L\ 10 3'i c... llLo(P F :T~'Zli 1"7'1 :J1~ t, l1~'1 X ~
810. IndIcate the &ource of the Base ~d-~..n CSFE) cIaia or base flood depth 4 .......J a'l B9 -c)J ""u.!' ~ -::z~ X-
U FIS Profile ~IRM LJ Commumty Oet..i......ed U Other (Oesc:rlbe) _
e'1 I ndicate the eJeV:iltlon datum used far the BFE Ifl as: Qi. NGVD 1 gag U HAVO 2SG8 U Other (Cescnbe)'
812 Is the bulldmg located In a Coastal Darner Re:iources System (CBRS) area or 0tI1ertnre Protected Area (OPA)? U y~ ~o
De$lgl'latlon Cate:_
. SECTION C a BUILDING El.EVA1lON INFORMATION (SURYl:"'Y REQUIRED)
C1, BUilding elevatJ; .are baSed orr UConGtNcbDn OnIWlngs'" U&.'~I..~\:'ii UnderCanstrucbcn* ~-m~ Construdlon
aA new EJevaflon Certmcate WIll be required when _, .....Jc:Uon of the DuilduIg IS compjete.,
C2 BUIlding Diagram NUmber A (Select the building diagram most Similar m the bUlldir1gfotwhlch thIS c:erttl'ieatt is bemg CQITlpieted a see
page$ 6 and 7 If PO dlagr.am Sc:c:Jrat&ly replll5ents tI'Ie bUilding, pf"OVlde a $l(etr:h or photograph)
C3 Elevations - Zones A '~A30. ME. AH A (WIth 13roE), VE, V1-V30, V (WIth SF:), AR, MiA. AAJAI:.., ARIA 1-~O, AAJAH. AAJAO
Complete Items C3ii1-1 below aeccmlln9 to the building dlBgram speofied In Item C2. Slate the Catl.Jm Used If the datum is dmeren11rom
the datum used for the BFE In Sedlon 8, c:omrert the dl!ltum to tnat IJ5ed fer the 8FE. SbDw fiekj messurements ,lnd datum CQn\'e~IOli
r::alc:u!atlon Use the space provided or the Convnents area of 5edJon 0 Of SecirCln G. as i!pPmPrnite, to dacurmnt the datum eonverSlQr
Oatum!..lbV () IZ'L Canvlill'SlonICornments. ._
i:l~t1Qn reference mark US/ild =* <;".e~ f.2~WT~Qes the elevation re#erenc:anr.n. In:iBd a~~ an the FIRM? U Yes ti:J. No
Ila" jij Top 01 cottom flcor Cl1lCiurlmg ~mant orenclostJre) .51#. :it..tl( j . _ . _ _
Wb) Top or nexthJQherfloor 51b 2ft i.. r ... REGISTERED '.
o ;;} Bottom of lowest hOrIZontal stn.!l:tUraj member (II zone5 only) L' Pt 'IT tl. :::! PROFESSIONAL
~ d) Attached garage (top of slab) ~ IS: .!:L. It ( ~ ~ L.AjlIO SURVEVd :
~) Lowest elevation or machinery a'1d/or eq1JIOmElm ... : ...,".' . . . ;; _ __
/ :servlcrng the bUildIng 5 L5 ~ ft.( ) .g ~ ' ~ r . ..
r;r}) Loweshdjacerrt grade (LAG) J:; I ~ -L ft. ) ~ $ OREa .. .
iit'...g) /-IlgnelittidJacent grade (HAG) .5JE ~ 11. ) ~ \IJ JULY 20,1993
er)1'5 No of pen'nlilnen1 operllngs (flood vents) w!!hm 1 fl aoove :ad]2C(jnt grace -! 3 ~. ~ REX ~ I ~ ,/
e( I) Tota! area of aU permanent openings (tlood vents) III c:3f1-4-b <q ~ sq./n (~~IJ) .....L' t' - ('=~""".P~ 2{lJ.!/" ~
ScCIlONQ . SURveYOR, ENG1NEf(. OR ARCHITECT CEFmF1CA nON
Tnzs certJf/eatJon 1$ to be SIQned and Sealed by a land SlJrveycr, engineer. or arctutea authcnzed by law to c:eruty elev"ton InformQilon
I cemf.t that the InfOtmatJefl In Ser;tions A, B, ana C on this cer11ffcatfl f9p~sen~ my best eIforts to m.'Ptet!he ~tl'J EJvatla6/e
I undel7$tand that al7v falsI'! STatement mal" be pUnishable by fine or Imprisonment under 111 U.S Code, Sachan 1001
CERTlrlfiR'S NA.\o1~e'" f\... 'H~;\-"2-- . LlC~E NUMBeR PLS "2ft,,() (0 -
Tn'" . - ~ COMPANY NAME.-, .,
I ~ SUJY"'(@~ Ual.<\ 0... (tV" _ t>Y-alA.~ ~l '" < c.y v-.."" ~c'
ACORESS3\D 1,;'ftt; 'St(';P ern S ("vV\ hel~~'AT~JZ "~C.OOE471.f71
SIGNATURE.. a./':/ /J' ...:'.::-.r-... - ,-' OAJ5- P / 2.',0?>-. TE!.EPHCNE,o...---:-,,",\ -j-a.
/42-'Y.i Yi. / ~ f.: /kJ &..1-1 (;.";u v ;..-' (<';''T.!....L 7.!f& -0 I,p 7
FEMA Form 81-31, AUG 99 - S~E~VERSE SIDE FOR CONTINUAilON - REPLACES AiL oREVIOUS EDITIONS'
MAY-06-2003 TUE 10:59 AN
BRANCH ENGINEERING
5417460389
. p, 05
For In:lUf'llnct CQmp~ U$~
?oll':Y NumbN
IMPORT ANT In these space5, copy the corresponding In10nnatlon from Section A.
.' .J3UH.OiNG j.'TFi.!ET AODA.~'f;fi ~n;.iuQ1t;9 Api Umt SUlte~Dr ~ ~) OR P 0 ROIJTE AtI0 BOX NO
f..153 G:>b tk ~1y-~
:liY C ' STATE ZIP CODE;
.:s Of" )'Y'\c.,il~(J oJZZ Q,1I-r7
r ;" ,
~3n)' 'lAIC Numcer
SECTIOND _ SURVEYOR. eNGINEeR. OK ARCHITECT CStTIFlCAnON (CONTINUEO)
Copy beth Sides of thIs E1e'labon Celtliicdte for (1) c:ommLll'llty officlal, (2) Insur.!lnce agenli\......'fJany. and (J) buildll'lg OW,ler
. ca~M!NTS ,n " r . ~"l l ~ I "
Lt' ',,+1..1 u" r'"'?_pn.....l.:'.~\.d 'P~V\(.rlliv\!...- 'rel~ 0.. Clo\~')e (:4l. 'O:"~II.ut.Jt.$" ('.LoLl IV, -\-'kG-
~ r j:ii./<c ,;;" C<<;-b '" t -I1..E "'" J 0"" t ,)C c ~ '*' ":,fc;.",,, ,,1 ~ ~ "~ t\.tw< d <'J '" "'Y" '" f
~ 7fk tNVtd 1"\-\UVS+bY\ ~ OV~ ~V1 ele\la.t~o""" ~S; 51'2-. g\ ('~OlA.~\N\, /'lMd ad ~ {J ",r::(
19 ei cv" n tV\ .; I'~ I l \ )J {;, V D I ~ \,v/iS u. <.d titS k Q,k'So~4 ~ I EN A hOl1<, ~t eV"e~'"
_ U Check here rf attachments
SECilON E . BUILDINGE;J..~'.A iiCN'iNFORMATlON (SURVEY NOT REWIRED) FOR ZONE AO andZONE ,A'(W1THOUT 8FE)
F;Zone AO and Zone A (wrti'lelut 6F5), complete Items E 1 thtOUgn E3. If /:hit E1f:val1Ofl CM1fiI;ate /$/rDar:Jed for use as suppodmg -
mrol'trlatJOl2 far a LOMA or LOMR-F. Set::tion C mU3t be ~
61 aulldlng Diagram Numw (SeIed the buildlng ~..... most 5Il11llar to 1he I:IlIildinU forwhtd'l ttus cerilfjcata l.'S belng almpletad-
Sl:lfl pages 6 and 7, If no Olagrafn aecUrawly repre=;ena the building,. proIIKIe a sketch or photograph.)
=.2. The top ot the bottam floor (lndUdIng basement or endasIn) of the buikfing LS I 1 \ tt.(m) I I ~n.(cm) U above or - U below
(checle one) the hlghestadjacenf. grade.
E3 For Zone AO only" If no flood depth number IS avadable, I! ltIe tCIp mine 11.,.,""..< llocr elevated III accordarawrth the ..........uroty's
_f1oocplaln ~"aqemant ol'dlrianc:e? I_I Yes .b' No '-ll..lnkl"lCMR- The local afIici;d must cerUfY this J..A.......;..,n 111 section G.
SECTION F . PROPERTY OWNER (OR oWNER'S REPRESDTATlVE) CERT1FlCAll0H
The propertY owner or owners auIhon:z:td repr_ta1JtIe who .......,.dites Se..J.-.. A, 8, and E for Zone A (WJlbout :II FI:MA-lssued or
commUlilty-lSSued BFC) or Zone AO rt1Jst :ilign here
PROI"~1'Y (J~;~Ci\ :; UK ~R'$ AtmlCRIZED ~Si.HTAl1VE'S NAME
AOORESS
CrrY
STALE
ZIP <..oOE
SIGNATURe
- COMMENTS
DATE
~H()Ne
1...,J ChecK here If attachmenhi
SECTION G . COMMUNrrv INFORMAilON (OPTIOHAl-l
The local offiCial who 1$ auUlonzed by law elf orcilnatlC8 to admmlSter1he cammuMY's lloodplam management ...di....nea can complete
Sec:tlcns A. a. C (or E), and G at ttus Elevateln Certlflcate. Complete the applicable Jtsm(s) and Stgn below.
G1 U The lnTCrmaton In SedJon C was talten from other c1ocume..;...t...1I that has'been 8J9ned and ef1IDOS3ed by a 6t:ensed $1JlVeycr.
engineer, or archttect who Is aJJthorized by state or IoCai law to certlfy eJeIIaIIOn 1rT.\.. ....J.....l. (Indicate 1he SOlJt'Ce and date of the
elevation data In the Comments erea beloW)
GZ U A ctlmmunrly offiClat ......",,;ettd Section E for a bUilding IQe:rted In Zone A (wttho'.Jt a FEMA-1$$Ued 01 eommunrlv-issued BFE) or
Zone AO
G3 U ihe follOWing Info,..~(...1l (Itams O-l-G9) IS pfOVlded for commumty fiQQdclalfl management. J:l1.llll0$e5
I G4 FERMIT NUMS5R I GS OATE PERMlTISSUEJ I ~ DATI: :;:eri.i'IF1CATEOF CQMPUANC!iOCCUF'ANCY
I \ ~S~D
G7 ThiS pennlt has beenl$Sued for .LJ New ConstruclJOf1 U substWlSllmprovement
G8 Elevatl:m of as-built lowest f1QQr Onc!oolng basement) of the bulldlli9 IS:
GS. SFE or (In Zone AO) depth of flooding at the bwkflll9 site 1&"
LOCAL OFFICIAL. S NAME
_ fi (m) Datum"
_fL(m) (.atJjm
111~
COMMUNITf'NAM!
-s!GNATURI;;
COMMENTS
j~E
!:lATE
I ChiOCk here If attachments
R.EPLACeS ALL PREVIOUS eOITIONS
~MA Form S1.31\ AUG 99