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HomeMy WebLinkAboutFEMA Application 1999-12-16 I q q-Z& 5 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 ". _ .....yo".:..... ):..{c..V\e',?e,.- ..' IJYu\<\c..'" C:')...,;It-,eeYJ....,., :i;".C 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 I _ ~.._ . _ ~ _ _. _ _ ... " FEMA Form 51.31, AUG 99 ~. ~ SEE REVERSE'SiOEFOR CONTINUATION REPLACESALL.PREVlOUS EDl'l'lONS JAH-03-'!30 THU 12 :5~.:.~. .H.~~~,~~~~_~.foC~9"':"'=!=-.ft~y. .,. . ~u." O;;7....,..,~. . ,.,. :..... . -'. .' ,". . :.~. !,,'~.' : ,". .:... .' .''':'..': 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 I .(.;~ .~,,,-\&..c,,,,,1 (11<:L"( . -- 1 CODE C.~ r srATE .'J ? .\0 .,. . r ('J" /J-: 1fT..., Silt ,_'_"'-c\t.A ,~ 1 fO( In6lJIlnc.e CQrhs>'OI'\1 U~o; Po:icy Numb.~t. . .' ..' I \ 1 COtTIp'ilf\Y HAl?' ~1J':nber ,'. ..:\: 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. .;.~~:~.:: ';.: . f>ROPt.RTY OWN'l::J.n~ 0s:.i. Ui"-~E~ AUfMURlZt;.O Rt;:PRkSI:N1Allvt'SNNJIe. ._-~ --.- .. .SlAn . -frWl"HONO: z~~~,r--'~-'- . '!..Io:.... ...., WORt.~ 1..1;\lE. SIGNA ruR~ .,.,',.' . f.;f,JIloWll::N-IS LI Chl"cl<.h~f 8ttachJTl~nts .:.,.... 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: , _ !l(m) tl~liiiTi: (....--- TITlE 1ElC:PHONE DATE ... COMMuNliy NA;";~ ~IGNATUF(~ ""'CQl;1MENr~ .,...- "~".'~ ;. '. ....~_. . _, .;, ".1 ch~ac'heie if ;,ttach'i!:enI5 ~E""AFormSl-31 AUGi9 .......'.--:.,."...'.',.. " :.:;::,.....,-- . . .. _ __ . __ __ _ __ : _ __ _ _ _ __ _ __ __. __ _ . RI\Pl.ACES A:'l P"E'/IOUS EDITIONS -. - - -- - -. - - -. - - -. -- --+ - -. -.. -. -. -.. -. -- -. .~.: ~_.. .'-- ~.:.~ ~.;.: ~ -'';. - - ~'. ;.,:'