HomeMy WebLinkAboutFEMA Application 1999-12-16
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a'EOERAL EMERGENCY MANAGEMENT AGENCY
.., NAnoNALFLOODINSURANCEPRO~
ELEVATION CERTIFICA~
0.M.8. No, 3067-0077
Expire~ July 31. 2002
Important: Read the instructions on pages 1 .7.
SECTION A. PROPERTY OWNER INFORMATION
for ln~~90 ~ompany Use: -
PoIJ<y ~r<
.,,'
BUilDING OWNER'S NAME
BUilDING STREET ADDRE~ncluding Api.. Unit. S,"le.andJor Bldg. NO.1 OR P.O. ROUTE AND BOX NO. Compa'!'!. f'lAlC Numller
jC'ff.i-::l" J..-"" \ta,,,.J U)O<-l ... '.:',. .
CITY . . r,; '. 1 STATE ./} Zl~ ~ODE/J . .
S.p....\"'-<..f\.i'/~t.l '. . . OK.. . "7/'f7l
PROPERTY OEilcfllPTION'<'\.bi iiid 8lo<:l< NUmIle". 'Tax Parcel Numb.r. lll9.' O...,;ption. ,17) .L. "'" Ii . . .
!-ot 31 ;\6.\O,",\L..z.. r(lhe....t f<Y'Z^(G !-J.fu 1.<{?(..~ 11W1 I&<.)('I"\.,<,P 18~03-{}'Z-?~
BUilDING USE (e.g.; ~o.ntial. Non-'esilfential. Addil"".^=/y, ote. Use Cemme",.. ..c,on 'oeeessal)'.) . T,' t 7. .
'f>(.,..~~d.e,., "h A \ . __.tA..,y; <...0 . fOO
-LATITUDE/LONGITUDe ibPTiONAll HORIZONTAl. DATUM: SOURCE; U GPS (Type\' . . ,
(d.##'.II#.##' or ##,1I#I1I#I') UNAD1927 WNAD1983 UUSGSQuedMap UOlI""::':: .::'
SECTION Il'; FLOOD I~URANCE RATE MAP (FIRM}INFORMA TlON .,: ""''''. . :., .. ('
I L~::Pc1:~UCU::~~~~~~~~~, IL~~e~~t., ":_;'I.BJ~~ri'(:)'~~;;;2;'~":'"
I 64. MAP ANO PANEL 11lli. $UFFIX I BS.'FlfW INDEX I iiI. F'RId >',.,..CL/ ~8, FLOOO I B.. BASI; F1..900 ELEVATION(S) I'
. NUMBER -,r' F . DATE EFFECTI'IEiREVISED DATE . ZONE~ (Zone AO?...e 4epth orfloodin\ll' - -
L\ ICl'?>'1('.Ilt.J.., :r~ t. 11'11 3'\oVV\l.. 1.,Jl(qq . A E' 44q; &')
810. Indicate. the source C( tpe Base Flood Elevation (BFE) d3fa otbase flood depth entered in S. 9.
U FIS Profile )1SJ FIRM U Cllmmuni~ gelermlned U Other (Describe): .
al'. Indicalathe elevationdetum usedforlhe IlFE in 89:JAI NGVD '929 U NAVD 1988 U OIlIer (Des;olbe): . .
B12. Is the building localed In 8 CoaSlal Barrier Respurce. SYslem (CIlRS) area Or Otherwise Proteeted Area (OPA)?'l:;J .Yel 9Y No
Designation Date:
SECTION c. BUILDING EI.EVATIONINFORMA'rION (SURVEY REQUIIilED) " '.
C 1. BUilding elevations ere based on.: UCOI\s\ructionDrawinlls' l..,.J8ulldIng Under ConslNction" I;l9FinlShed ConslNc:tipn
'A new ElevatIon Certificatewillbe'required wilen constructlon of the building is eomplete. .
C2. Building Diagram Number --i!b.. (Seied lIie building diagram mo..t sim~ar to the building for which this certificate is .being completed - see
paoes 6 end 7. If no diagram 3ee..mleiy rep,esenls Ihe building, prouide a sketch or photogf8Jlh.)
C3. ElevatIOns - ZoneaA1.A3Q, AE. AH. A (wilh BFE). '11:. V1-V30. V {wilh IlFE}. AA. ARIA. ARlAE. ARIA 1-1\30, ARI~,NI/AO
Complete nems C3a-i below a~rding to \he. bul1<:!ing diagram specified in Item C2. Slate the datum used. If !he dlllum is dilferent from .
the datum used for Ihe BFE it> SeCtlon S. co,welt ilia datum 10 Ihal.used forthe IlFE. Show field measurements and' datum conversion
. . . - . ... . . ..,.....
<:lIleulatlon. Use llIe SPSeB provided 0( !ha Comments area of ~edion D or Se.>1!on G. as appropriate. to d<><;umel)i lhji <!alum conver". ;oQ.
Datum .' COnv"",ionlCommenl~' ~ <<:t. S-.iY,....._'$',d~-g~rc... ,U"'....lk '_<;;I)> (l.,.......~}:.l.
Elevation referents marl< uud ,,/ 00... tOe elevation reference marl< used appear on !he FIRM?) L..J Yes ~ No
o a)Topofllollomnoor~~udinglla$emenlorencJosure) J1~ q .kfl~ 'Ii L ,............ ..":
o b) Top of next nigher floor WC:;Z ...ctll(~ ~'1,.' :':;Re-.,~@ :';'" ~.;o.
o c) BOllom Oflow6$lhon"onllll sltudural member (V ZOn6$ orJy) . VIA :.:....:../I.(loij--t~ ,--"p. R..OfESSIONA.L..
o d) AlIiI<:llad garage (top of slab). A) 0 VI.... . _ ft.(Iat' fl!, ~.P Sl.!RmqA~: .
o e) Lowes.1 eievelion 0.' machinery and/or equipment ; '5 ,., . ~ a'. '/.).'. /./ ,-f'-
.erv1c,ny 11,,, ouildln9 ~ ~ .Ji.1\.{~ t'jl /~G;','~"
Q ~Lowe.tadJaeentgrade(LAG) . l.lLl't ..:[ft.~ 1; J ~N -. j"
o g} Highest adjacent orade (HAG) Q " 0 , .k. fI.(ml.... ; ~~ r'e~
o h) No. of permanent openings (ftood vents) withIn 1/1. abo~e adjacent grade . /4 . ~...... . . ~ .
Q i) Totatarea or ell permanent openings (flood ventS) In C3n ~ '7U sq. In. Eso;=n) F' ....'olir"-S 12/'3/ /7''7. .
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ., ..-
This certification is to be' signed and '.slad by a land surveyot. engIneer. 0' architect authorized by law to c:artify elevation Information.
I cerlify thar /he information in Sections A. B, and C on this celfi/lca/e represents my best efforts to Interpret n,e data av3ITable: .
1 undel'S/and Ihat 8Ilv "'I"e s/a/emenl mav be CIJIl/shable bv fine or ImMsonment under 15 U.'S. COde. Section 1001.
CERTIF'ER'SNMl~Fv J}~};- LICENSE NUMIlERpI..S. 1.t;,deo
lITLt: S . . -. COMPANY NI\Ml:' 'J ".
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ADDRESS31n C::;~ <;..~=---t- CIl~(M<~~ \d. :i1).TEor< bP~'7 Y 1/
SIGNAIUHb . ~ .' c .'l 'I' DAlC.:. - . TECEPIiONE" '. .... ., - ..
./7."-;'<' c::? /'!)..-/L, ..1>;('. (h 14<11 .... . (:;If( ):'7'f.IP -O~''37
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FEMA Form 51.31, AUG 99 ~. ~ SEE REVERSE'SiOEFOR CONTINUATION REPLACESALL.PREVlOUS EDl'l'lONS
JAH-03-'!30 THU
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IMPORTANT: In tho" .pae". copy .ha corre.ponding Inrol'11""O" Irom S.eliM A.
SC'LOtNG ST~eT ADD""S ('oeluding A.I.. Unil. Su"'. "d10' e".. No.\ OR 0.0 ROU'fE AND tox NO
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Po:icy Numb.~t. .
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SECTION D _ SURVEyOR. ENGINEER. OR ARCHiTEc1 CERnflCA TIO~: (CONTINUED) ...,.,
COPY bolh-;;;;;'-;;llhiS EICv~';lon Ccrtifata for (1) communi'" official. (2) Insu,ance agenVcompeny. aed (3) bu.ldlng ci~ner..
":;OMM'NTS \:. .... C L [. ~ r, , r "" / II. I /~ - :,/. -"- l' -
'n"""'''- r~t...-.:~~\\.....<;" i.~{lr~..t'L1I ~1~'''' f\o<~r c... r.,r?l!=>~~"'~'if"-~\ "'- .""'"-
-=l:ll1^ "",..M~' c~~"'? y'c.h.'rr+ -IW c;.....: c_~';"''''' "rJ{/<!"'~"'\.f -!"" <".. ,1 :~'" Ib.{uf <-d(.LI
.-h,,-!!.v..-.. a~ {!(~v"J2;... -.. 4-1..0.(,,0 (!.c~!S;K.",~.f.,.!J.J2t<~k---' -.,,~j?,r,.J..,,<kel.
.Y ,d~'lUL~..4l,1o ,IJCotlD'7.C(. -- .!.:;.
U CheC~'hW,; if atta,iiiiieii.ts
SECTION E. BUILDING ELEVATION 'NFORMATION (~IlRV"Y NOT REOUIRED) FOR ZONE AO and ZONE'A'('MitlOvT BFE}
..- '
For Zone AO ond Zono A IwilhOlJI IlFE.). complete \tcrM E, t/l(OIlSh oJ. 11th. 80",,6011 ceMfcalol> in/ended/oruso ..:iu,'pot1ifIIJ
in/o"".6on lor 0 ~OMA or ~OMF<-F. Seclion C must Do ~ple/.d. . ',,, .....:
1;1. Building O",g'om Number __ (Select the building diagram "..,st sImilar to the build',ng for which this certificate I. ~9 c:cmplel,d-
.ee pag.. e and 7. II no dlagr.m oeclJ,olcly ,o",...nt.."" buile;ng. provide a ,ketch 01 pholograph.) .: ,;: :-',.
ez. The lOP ol.h. bOttom 000< (ineluding ba,em.nt or cOO",ur.) 01 tho buile;fllJis L-U ft.lm) LUin.lcm) . U aliov:e or U ~eioW
(cMelton.) the high." edjacen' grade. .. i ~'.:: : ..
E3. For Zono AO only:. If no Oood deptll number is a.ail.ble. is the top 01 the bOttom Hoor elevaled In acc.ordancewi\li\ti~'Q,inmunity.s
~oOdplain manaoomaht ordinance? I I Yes I 1 No I I UnJ<nown. The local 01110.1 mu>t eellif)' \his I_~nll\' Section G.
. SECTION F. PROPERTY-iiWNl,R (OR OWNER'S REPRESENTATIVE) CERTIFICATION' .... .
The property own.r o.r owna(s authorized ,epro,enl.U.o WhO complete. S.<:llon. A. 5. and E for Zone A (,..;u,out. FeMA-Issued or
convnunity-iSSulIXi SF-E) or Zone AO must slgn hetR.
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. f>ROPt.RTY OWN'l::J.n~ 0s:.i. Ui"-~E~ AUfMURlZt;.O Rt;:PRkSI:N1Allvt'SNNJIe.
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seCTION G . COMMUNITY INfORMATION (OPTIONAL)
Th. lOCO' olf,cial whO i. .u,"o,;<<d by I.w or o,dinanee I~ "d;.ini,'orlhe communi"'" eOOdplain management ordin~n",'iln complele
Sections A. 8. C (01 E). anc1 G of thi, Elevation Cettificale. Complele the applicable ilem($) and '190 below. .'
Gl. LI The inlormation in Soelion C waS I"on Irom otherdo<umeOlallon thaI ha. been ,;good and embOssed by · Iio.'~,.d 'UNayC'.
engineer. or .~t.ct who \$ aulhorlzed by ,lalo or loca' taw 10 ""ru!y elev.60n Inrormauon. (Indicale!he Sdll&<l's!id dele <if 1M
elevaoon data in the Comments ere. below.) . . <+ .;: '
G2. LI A oommunity offici., completod Sec.tinn F. for a building located in Zone A Iwilhout a FEMA~..ued of c..;.;;,;,J;;~;'s;;,ed'eFEfo'-
ZoneAO.' .... .
G3. U The following information (Items Q4.G9) is provK!ed lot community floodplain man~geme"t purpeses.
I' G4. PERMIT NUMBER . 'I GO. 0A1E PERM~UW-- -~n; CE"TIFICAT~ of-CO~w.a~6ccUPANCY
. II~UEO" "
G7. Thi. permit has D.en issued f~r: U Ncw Con.trUction LI Subslanuat Improvement :,,':.'
G8. Elcveuon ot as-buUt lowoat (lOOt ~F'ldud1ng ba:seME:nt) of the building 15:
G9. eFE Of (in ZoneAO) deo\h ol1tQOding at the buildin9sl\e is:
-LOCAL Ot-f"IC1A....~ NAME
. _ ft.(m) p..t~m:
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TITlE
1ElC:PHONE
DATE
... COMMuNliy NA;";~
~IGNATUF(~
""'CQl;1MENr~
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~E""AFormSl-31 AUGi9 .......'.--:.,."...'.',.. " :.:;::,.....,--
. . .. _ __ . __ __ _ __ : _ __ _ _ _ __ _ __ __. __ _ . RI\Pl.ACES A:'l P"E'/IOUS EDITIONS
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