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Home My WebLink AboutFEMA Application 1999-6-2 FEDERAL EMERGENCY MANAGEMENT AGENCY NA TIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE o M B No 3067-0077 ExpIres July 31, 2002 Important: Read the InstructJons on pages 1 _ 7. SECTION A - PROPE.~TY OWNER INFORMATION =r For Insurance Company Use BUILDING OWNEQ S NAME B (\~. ~ POi;;;j Nunoer .r-~ Y;e'f) 1 CC~ c-- BUILDING STRE"T ADDRESS 0"""',,, hot, 'u"< 'So" ,""'~ .,,,,, No) OR P 0 ROUTE AND BOX NO j Comp,"Y NAle No_, t;, 60 q S, WJ~ 0 Y\ UY""\v E'-- CITY c C \ ,0 5TA~ ~ ZIP CO~ . -; '( 11' <: Go{ Ur,_ c-; 7 '17 7 PfOPE;::UY DESC PTION (Lot and Block Numbers, Tax Parcel Numoer: IJaJ DesClpllOn, e'e.) \..-.D;- e \ L 4111d'1 II I \.PV'\ BUILDING USE (e 9 , Re';;ldenlJ I, Non-resldenllal, mon, Actessory, ete. Use Comments sec:ron If necessary ) 1?E?S C.d'~ Q ~ \ LATlTUDEiLONGITUDE (OPTIONAl) HORIZONTAl DATUM ( ##0 - #II! - ## #:If' or ## ~ U NAD 1927 U NAD 1983 SOURCE. U G?S (Type) U USGS Quad Map U Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION N~IP COMlIAUN1TY NAME & COMMUNITY NUMBER B2. ~ NAM71_ L ' 83. STATE .0 I. od- S l'\'\ e l -lH 5 ;;'7' z.- . La. L.O u"" T _ () f'.::.. '. B4 MAP AND PANEL .85. SUFFIX B6 FIRM INDEX B7. ARM PANEL B8 flOOD B9 BASE flOOD ElEVATION(S) NUMBER ~ DATE EFFECTlVEJREVtSED DATE ZON~ '_ ~ (Zone AO. use depth of flooding) LlI 0 3q C:lll.lp ., ,cF' 'I J~ 1" 11'1 ::JLvvl& t, t H q ,A 5" ) 3. 9 B10. Indicate the source of the Base Aood Be....!."'. (BFE) data or basefJood depth e.,""",.:..J Ul B9 - U r:IS. Prl?fi~ _~IRM - - _~. u can;'munity DeterTnmed ~ U Other (Describe)' B11 Indicate the elevabon datum used for the BFEln 89' ~NGVD 1929 U NAVD 1988 U Other (Descnbe). B 12 Is the bUdd,ng located In a Coastal Sam... R""""","" Syslem (CBRS) area '" """"- _ An>a (OPA)? U Yes ~o Oeslgnabon Date ~ SECTION C - BUILDING ElEVATION INFORMATION (SURVEY REQUIRED) '. BUlldmg elevations are based on' L:JConstrudron Drawtngs* UBuilding Under Constructlon* ",shed Construction * A new Elevation Certificate ~ be required when construction of the building IS complete. _ C2 Buddmg Diagram Number >-f. (Select thE! building diagram '!IlJst SIl11J~ to the building for wluch thIS certificate IS belOg completed _ see pages 6 and 7 If 00- diagram accurately represents the building. provJde a sketch or photograph.) C3 Elevabons - Zones A 1-A30, AE,-AH, A (with 8FE), VE. V1-V30. V (with BFE). AR, ARIA, ARlAE, ARIA 1-AJO, ARlAH, ARJAO Complete Items C3a-1 below aCCOrdlOg to the buildmg diagram speafied In Item C2. State the datum used If the catum IS Olrfere.,t TT-Gm the datum used for the BFE In Section B. convert the datum to that used furthe BFE Show field measurements and datum conversion calculation - Use the space proVided or the Comments area of Section D or Secnon G. as aopropnate, to Oocument the datum conversion Datum pr,.,v 0 121 Convers/OnlComme'J1.s EI!J"abon refe,ence marl< Use!I "\(. ~{ /C"v'eneDoes the ele"""on,.;"."nee mad< used appear on the RRM? U Yes tif-No ~ y) Top of bottom floor (indUCIng basement or enaosure) 5 I 5 L ft( ~ ff b) Top of next higher floor 5" I -, 5. ft( " ~ / REGI~ lI::RED " -s.-",) Sett9~ "f Igwc:3: 1."'.04.....<.:,; ""u Ul,;1Uld; ",emIr,,- ('f~R8i ~nllY: -- _ fl( ) ~ ~ PROFESSIONAL ~ d) Attached garage (too of slab) 51 (P -L it ( ) 8] LAND SUR~OJl ife) Lowest elevabon onnadlmery and/or ",,,,,,men! . " d.. /:/ /..h4- . servicIng the bUilding 517. 5 ft( ) ~ ~ ilt' ~ (d:,:.../fI/'" / if~ Low", ad)acenl grade (lAG) '7 IS .Q ft ( ) ~ &. .....; OREGW ~) Highest adjacent arade (HAG) 51(p ...L fl( } ~ J; . JULY 20, 1993 (3 h) No 01 pennanent 'opemngs (flooo vents) Wlthon 1 ft aoovo aapeen! gr.oe ('0. :!i. REX A. BAt: I" .I u;Y;) Total a'ea of all pennanon' operungs (flood vents) In C3h :3 {P't sq on (.. ..:.::.. I'- "'.~ G:;m, ZO' 103 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Tms certIficatIon IS to be SIgned and sealed by a land surveyor, engineer, or ardutect authonzed by law to certify elevation InformatIOn I certify that the mformation m SeciJons A. B, and C on thIS certIficate represents my best efforts to mterpret the data available I understand that any false statement may be pUnishable by fine or Impnsonment under 18 U S Code, SectIOn 1001 r"RTIFIER S NAM'1(e A _ '8cl'2..- LICENSE NUMBER PL <) u::~ COMPANY NAM ~6 G - UyVe l( Y'u. ~I'" {'co...- "'J 'J--k,- ADDRESS 3 \ I') ..-::::-- Ctl <:' l_ CITY S ... YY\ he l.:1s AT~ 1(/ zjp CODE I 7 "7 "\ \ .-J.:. V\ ....)1Y . - () 7 . I.......... q 71.f SIGNATURE . - - DATE: f, '7,",,\ TElEPHONS--._) r; ~c.~~-r- vv t>07-- 6'1/ 7tf&-{)fo CJ 7 FCI\t'A Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS FnlTlnl'JC: . ! For Insurance Company Use Polle'f Number IMPORTANT In these spaces, copythe correspondIng IOformatlon fr~m_ ~ec~~~.~ __n ..- BUILDING STREET ADDR~(IncludtngApt UnJL,.Sude andlorBIdg No) OR P U KUUIt::.MU tlUA NU (.-, 9(0 q ':::?DV' to O~ '\h--\\) <- CITY . - - - ~ "STATE Z!P CODE . ~ pr )-Y'l~-h~(.d' {)f2..- qllf7/ Company NAIC Numoer SECTION D _ SURVEYOR. ENGINEE.~ OR ARCHITECT CER!lF!~TI?N (CONTINUED) Copy both Sides of this Elevation Certificate for (1) commuruty offical. (2) Insurance agent/company, and (3) bulldang owner COMMENTS f I l I "" (' '>1 () /Sp,v..') E'C' It! B<,,-"~ )J.~v\t~ y.-e''''1 '" CIA \ ~e "'^ "''''1"''''" ( ~A-L+ ,'^ -r~ :D-iJ ft.,,,- or Cu ,b '" t f\,p ""~ r ~,..h ...",fu.-" (,t ~ <; '1'-< tLt wed c.,YI1 "'V o,f ~.J-t'k CWl.tJ ~(A_Y<+6,^- ~ ~v"" ~ aVl ek"a.t~dV' ~t 51'2-. g \ C I~\~ Oll.f4."", ~d e<d J l.I <, .lec-( -{o e,(~Vu.ntv\ 5'9.\\ )J0vl)'Z4 WILSU.<'~) as ~Q,"'SIl<scSe-levA.how'S ~leyeOVt. U Checl< here If attachments SECTION E _ BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO and ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete ItemS E11hroUgh E3. If the Bevation Ce...J~ IS Intended (or use as supporllng mformation for a LOMA or LOMR-F, Section C must be compleled - - - - E1 BUilding DIagram Number - (Select the buikIing diagraITl most sunilar to the building fcrwhich this certificate IS being completed- see pages 6 and 7 'If no diagram accUrately represents ~ building, pro-Y1de a sr.~. or pJ.....~~"'ph.) E2. The top of~~e ~Clttorry loor (mdUdUlg baSement ri end~fO! the building is --- - , I I ft.(mJ , I ~n.(an) U above or - U below (check one) the highest adjacent grade. .: - - -:: - :. --- E3. For Zone AO only: If no flood depth number IS available. IS the ~p !?f the b~m ftoor ~ in C1.........Jance wIth t!te_ community's floodplam management oramance? U Yes ..u No ~ r J Ummovin- The-local ofticiaJ must certJfy ttus ;..f......ation 10 Sechon G. SECTION F _ PROPI:KI {OWNER (OR OWNER'S REPRESEHTAT1VE}CERTlACAnON The property owner or owner's authonzed repre5c.>J.J..,e who completes Sections A, B, and E for Zone A (WIthout a FEMA-lssued or commumty-Issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'SAiJfHORJZED ~ENTAllVE"S NAMe tili ~jin-f: ZlP CODE ADDRESS DA~ JdEPHONE SIGNATURE COMMENTS 1-1 Check here If attachments SECTlO~G_COMMUNITYINFORMAnON(OPTIONAL) The local offiCIal who IS authonzed by law or Ordlo.........:;. to adnurUSterthe commumty's i1oodolam management ormnance can comolete Sections A. B, C (or E), and G of thIS Be...,!..... ee.~e- 'Complete 1he applicable Jtem(s) and SIgn-below. G 1 U The information In Section C was taken from other docume..la!.un that hasileen SIgned and'emoossed by a licensed surveyor, engineer, or archltectwno IS authonzed by state or loCal law to certify ele\.,~.... ...~v....aolDn . (IndIcate the source and-rlate of the elevatIOn data 10 the Comments area below ) G2 U A communrty offiCIal completed Secnon E for a buildmg located In Zone A (WIthout a FEMA-lssued or communny-Issued BFC) or Zone AO > G3 U The followmg information (Items G4-G9) IS provtded for commumty f1oodolalO management purposes -- --- -~--_. G4 PERMIT NUMBER G5 DATE pERMIT ISSUED Go U.....I ~ ~c.-I1lfICA IE OF COMFLlANCEJOCCUPANCY ISSUED G7 ThiS permIt has been ISSUed for U New Construdton U Substanttallmprovemem G8 Elevation of as-bUilt lowest floor 0ndudmg basement) of the budding IS G9 BFE or (In Zone AO) depth of flooding at the blDldlOg site IS LOCAL OFFICIAL'S NAME jYI~ _ fl(m) Datum _ _ fl(m) Datum . COMMUNITY NAME '1fW'tiUNf UAIl: SIGNATURE COMMENTS 1-1 Check here If attachments REPLACES ALL PREVIOUS EDITIONS FFMA Form 81-31. AUG 99