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Home My WebLink AboutFEMA Application 1999-6-2 ~l /J)\ -l ~G j FEDERAL EMERGENCY MANAGEMENT AGENCY NA TIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTJFICA TE Q,M 8 No 3067-0077 Expires July 31, 2002 BUILDING OWNER S NAME Important. Read the instructions on pages 1 _ 7 SECTION A - PROPERTY OWNER IN FORMA TION For Insurance Company Use Policy Number BUILDING STREET ADDRESS (Including AP1......Unlt SUIte and/or Bldg No) OR P 0 ROUTE AND BOX NO G BB4 'S I VVleOh -1.klV~ C1rr ( STA~ -:l. r I V)C e.. 0,.......... PROPE TY DE RIPTION (lot and Block Numbers Tax Parxel Number, legal DescnptJon, etc.) Lot 4-0 'lev, l ~ 'Zvtd.t\2 + V\.\C e 1]-02-34-l! BUilDiNG USE (e 9 Resldenllal, Non-resld tlal, Addlllon, Accessory, etc. Use Comments section If necessary ) 'Ve ~i1a' LATfTU-DEllONGITUDE (OPTIONAL) HORIZONTAL DATUM SOURCE U GPS (Type) ( ##0 - ##' - ## ##" or ## ####Ifj U NAD 1927 U NAD 1983 U USGS Quad Map U Other _ Company NA/C Number ZIP CODE CLl.!:t77 p~ CAr Ttu. Lt, t 'ZQl SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1 NFIP COMMUNITY NAME & COMMUNITY NUM8ER ..!. 82 COUNTY NAME _ Clt'1af5'p'-lV\,J;eIJ 415592.'- La au Ok!:, B4 MAP AND PANEL as SUFFIX ~ 86 FIRM INDEX I - 87 FIRM PANEL B8 FLOO ~ 89 BASE FLOOD ElEVATlON(S) NUM8ER DATE EFFECTIVElREVISEDDATE ZONE( ) "i ,;(ZoneAO use depth oflloodlng) L\ 10 3qC.!l<p - E, -- J:..",d!' 11q1 u"d -Iqq q A /;0; ,''x: , 5/lL" 5 /2-,0 +-m'f) B 10 Ind'cate the souroe of the Base Flood EI~ (BFE) data or base "- depth ~ m B9, c., ,* '5 e e "A-tt<>ct, .. "'" + )- UFI~Profi/e._ _~~I~M:_ :UCommumtyDetermmed-:~.l 19U,c. ,Lc.>Q1be) '1)~te41?~-:: ~~, '?-"O I B11 Indicate the elevation datum used for the 8FE In 89 ~NGVO 1929 U NAVD 1988 U Other (Descnbe) B12 Is the bUilding located In a Coastal8amer Resources System (C8RS) area or OtherWJSe Protected Area (OPA)? U Yes _ ~No DesignatIon Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C 1 BUilding elevations are based on UConstructlon Drawings. '~Ulldlng Under Construction. UFlnJshed Construction . A new ElevatIon CertIficate will be reqUIred when construction of the buddmg IS complete BUIlding Diagram Number f=? (Select the building dIagram most slmJiar to the bulldmg for which thIS certJficate IS befng completed _ see pages 6 and 7 If no diagram accurately represents the bUIldIng, prOVIde a sketch or photograph) C3 ElevatIons - Zones A 1-A30, AE, AH, A (With BFE), VE, V1-V30, V (WIth BFE), AR, ARiA, ARiAE, ARiA 1-A30, ARiAH, AFUAO Complete Items C3a-, below according to the bUilding dIagram specmed In Item C2 State the datum used If the datum IS different from the datum used for the BFE In Section 8, convert the datum to that used for the BFE Show field measurements and datum conversion calculation - Use the space prOVIded or the Comments area of Section D or Section G, as appropnate, to document the datum conversIon Datum ~ 12:4 ConversIon/Comments . EI$"atJon reference mark use~ S~ ((e\lev<e- Does the elevatIon referenca mark used appear on the FIRM? U Yes b(J No e' a) Top of bottom floor (Including b",,,...,,.c,,, v, encIosur~ 5" , 3 (p ft (5Jt) Iii . !1'b) Top of next h'ghe, floor C~"w\ "I'",e ::J 5/ f.tL ~ fl (..) ~ ( REGISTERED '\ W l.) 2'Oftsm gf /(l''test A6F1ZeRtal3tR:1stHml m8fRSer 01 r",.c..:. ';''':,) . _ fl (m) ~ ~ PROFESSIONAL ii1' d) Attached garage (top of slab) &:) I 5. 2- fl (JfIJ ~ ~ LAND SURVEYOR f( e) Lowest elevation of machInery and/or eqUipment f3 ~~": v"7 ~ /.L /"'"/.// servicing the bUIlding 5 I ~ _ fl (~ ~ ~ r-..e--.c '-t' ~ ~:'la/'I... ~ lowest adjacent g",de (lAG) ,C; I ~ -L fl (m) ~ ~ JUP:~~ at'fl) H'ghest adjacent g"'de (HAG) .5 L!L k fl ("'l ~ , REXA';'~ '" c;{ h) No of pe'manent openmgs (flood ,ents) _'n 1 fl abo,e adjacent gmde " ~" ~ ./ ijl",) Total a'ea of all pennanent operungs (flood vents) 'n C3h LB..':t:..- sq m ("",,,-:,j . L. e &4 ~ J ,I "/ / SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ThiS certificatIon IS to be Signed and sealed by a land surveyor, engmeer, or architect authonzed by law to certJfy elevatJon Infonnatlon I certIfy that the mformatlon In Sections A, B, and C on thIS certJficate represents my best efforts to mterpret the data avaIlable I unde0.itand that any false statemp.nt may be pUnIshable by fine or Impnsonment under 18 U S Code, Section 1001 CERTIFlERSNAM?ppy 'BeT2-- lICENSENUM8ER RS '2&6 T'- C . - . . COMPANY NAME ~ ~ - .<;'Ltyve \C ",,,-k Gk';I't-eer"<,,,, -I-';c AL_<<ESS 3\ 0 h C~.\oI STATE O~ llPCOOt q 7Lf7'::; SIGNATURE = c? ZLi 0 I TELEPHONE S; q I 7 ()(, 3 7 FEMA Form 81-31, AUG 99 REPLACES All PP~\IIr\' 1<' r-.....,~,_.._ IMPORT !,NT In these spaces, copy the corresponding tnformatlon from Section A BUILDING::;, TREET ADDRESS (Including Apt Unat SUite, and/or Bldg No) OR P 0 ROUTE AND BOX NO /0884 S/vYJ pOV\ Ur- \'\/P CIll' (' L ,0 STATE /J /1 ZIP CODE Sfy,,,,-::,:!:!e "" ()" '-17 ~77 SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTlFICATION (CONTINUED) , For Insurance Company Use Policy Number , Company NAIC Number Copy both sides of this Elevation Certificate for (1) commumty offioal. (2) Insurance agenUcompany, and (3) building owner COMMENTS p ~ * C.i t,~ '" '::;p'""", ~ e l0. ~e .""'1,- .lkri<:., he, "', '" cl""e\ ecR S'j!dfl re c,,,t "" ~ -top -%.:e o.t a<rb ,,+ -1h" "" ,~.,..;:. 1- ,-J -\'I. e '< ~ Ou. e t Car"er of 6>?-fL, cf: -r"'-lAysT .'" b~VC.;"'" Slz,B I C, , "t" r,~A C.JI'~sk,,( 10 ..el~vtL:-h^^ S r~, I \ tJ G,V f)' 2 q !..V" <; ,,~ {J. ::huz- 'B.., I ~ d GI "''' At "w s "!,, ?iLl J '" I, <Y'- """ ~ S <!e. (l t\-" <-I-t e,,( 'S -\z. teW[ ...,;t d.. \e~ 'De<: e '"' ~...- (::l, I 2L> 0 \ \l1'Checl< here lfaltachments SECTION E _ BUILDING ELEVATlON INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO and ZONE A (WITHOUT BFE) For Zone AO and Zone A (Without BFE), complete Items E1 through E3 If the Bevabon Cerldicate IS mtended for use as supportJng mformabon for a LOMA or LOMR-F, Secbon C must be completed. E1 BUIlding Diagram Number- (Select the bUilding diagram most similar to the building for which thIS certIficate IS being completed- see pages 6 and 7 If no diagram accUrately represents the bUlldtng. provide a sketch or photograph) EZ. The top of the bottom floor Oncludlng basement or enclosure) of the bUIlding IS I I I ft.(m) I 1 hn (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 top of the bottom floor eleva!ed In accordance wrth the community's floodplain management orchnance? L'J Yes' U No I j Unknown. The local offiaal must certJfythlS ..{.v."""I."n In SectIon G SECTION F _ PROPERTY OWNER (OR OWNER'S REPRESENTAT1VE) CERTlACATlON The property owner or owner's authonzed representatIVe who completes Sections A, B, and E for Zone A (wrthout a FEMA-tssued or commumty-Issued BFE) or Zone AO must sign here PROPEKI i uWNER'S OR OWNER S AUTHORIZED REPRESENTA11VE'S NAME STATE ZIP CODE CITY ADDRESS SIGNAi"ljKI:: DATE TELEPHONE COMMENTS '-J Check here If attachments SECTIONG_COMMUNITYINFORMATlON(OPTlONAW The local offiCial who IS authonzed by law or ordinance to admInister the commumty's floodplain management ordinance can complete Sections A. 8, C (or E). and G of thiS Elevation Certificate complete the apphcable rtem(s) and sign below G1 U The Information an Section C was taken from other documentation that has been sIgned and embossed by a licensed surveyor, engmeer, or architect who IS authonzed by state or local law to certify elevation Info, ",ol.on (Indicate the source and date of the elevation data 1[' the Comments area below) G2 U A comm~mty offie,l compleled SeGbon E for a bu,ld,ng located on Zone A (wrthom , FEMA.,ssued or commumty.,ssued BFE) or "" Zone AO G3 U.!he follOWing information (I!ems G4-G9) IS prOVided for community floodplain management purposes \ G4 ""KMIT NUMBER G5 DATE PERMIT ISSUED G6 DATE CERTIFICATE OF COMPUANCE/OCCUPANCY ISSUED G7 ThiS permIt has been Issued for U New Construction U SubstantIal Improvement G8 Elevation of as-bUIlt lowest floor (lndudlng basement) of the building IS G9 BFE or (an Zone AO) depth of flooding at the bUilding site IS LOCAL OFFICIAL'S NAME _ ft.(m) Datum _ ft (m) Datum TITLE TELEPHONE COMMUNIll' NAME SIGNAT'UK~ DATE COMMENTS 1-1 Check here If attachments , REPLACES ALL PREVIOUS EDITIONS