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Home My WebLink AboutBLD2012-00046 Flood Certificate U.S.DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency ELEVATION CERTIFICATE OMB No. 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-8. Exoires February 28.2009 SECTION A-PROPERTY INFORMATION For insurance Company Use: Al. Building Owner's Name A2. Building Street Address(including Apt.,Unit,Sui e,and/or Bldg.No.)or P.O.Route and Box No. Policy Number I • i�L I.a --t.. gq,• Pi N i O City o.., Company NAIL Number 13�'i ivN or-, State A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etA 1 ZIP.Code l-:.aT 5 .. 3 -4--8 q. n Tit t_Rar 1, 8 34$ A4. Buildiri Use(e.g.. • -- AZ`� C'•� 2 AnJLN 9 ( 9• Residential,Non-Residential,Addition,Accessory,'etc.) '2� • t.V A5. Latitude/Longitude:Lat.J J s}Z, j 9„` � t �, 1 A L. o Long. \rk! l Z Z. Zs;,1-c A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number Horizontal Datum: NAp 1927 ® NAO 1983 A8. For a building with a crawl space or enGosure(s provide: -L ca..A i "'z � �' St7E f`) ow a) Square footage of crawl space or enclosure(s) A9. For a building with an attached garage,provide: b) No.of permanent flood openings in the crawl space or sq ft enclosure(s)walls within 1.0 foot above adjacent grade a) Square footage of attached garage b) No.of permanent flood openings in the attached garageft walls within foot above adjacent grade c) Total net area of flood openings in AB.b sq in c) Total net area of flood openings in A9.b SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION sq in 61.NFIP Community Name&Community Number -� Co ' -z-. l 2. 3 S c_ 62.County Name B4.Map/Panel Number Ft(02r EFFE.4Sow.i 85.Suffix 66.FIRM Index Date 67.FIRM Panel 530e)49-I Z 3S (3 Effective/Revised Date 68.Flood B9.Base Flood Elevation(s)(Zone 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item A Zone(s)4 AO,use base flood depth) 2. Now, ❑FIS Profile (��`'.FIRM ❑ gg J B11. Indicate elevation datum used for BFE in Item ggty Determined ❑Other(Describe) 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area OP Designation Date ❑NAVD 1988 ❑Other(Describe) El CBRS El OPA (OPA)? ❑ Yes ® No SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: p 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE), Building Under Construction' below according to the building diagram specified in Item A7. ❑ Finished Construction tI " ) VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g Benchmark Utilized T t3 M Vertical Datum 1 9 2.Conversion/Comments " a 1Z-E v art s g a) Top of bottom floor(including basement,crawl space,or enclosure floor) C.3 Check the measurement used. b) Top of the next higher floor --_ .4®feet ❑ c) Bottom of the lowest horizontal structural member �Z _C'�feet meters(Puerto Rico only) d) Attached garage(top of slab) (VZones only) _____6,2_z_ ____ feet ❑meters(Puerto Rico only) e) Lowest elevation of machine ❑meters(Puerto Rico only) (Describe machinery Comments)ement servicing the building ----�feet ❑meters(Puerto Rico only) type of equipment in ---- ___-_Q feet Lowest adjacent(finished)grade(LAG) ❑meters(Puerto Rico only) 9) Highest adjacent(finished)grade(HAG) �' [ feet --� � .feet ❑meters(Puerto Rico only) SECTION D- ❑meters(Puerto Rico only) This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certi SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION information. /certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Section 1001. k "„"`O�_ „""' fy elevation '' ®Che here if comments are provided on back of form. P. rwAs.,.! +� 2.1Jnc.p �. -.410u0 /,t, O Certifier's Name �' \'R f?S License Number 1 Title \.t!o S u ravayi o V 3 C t �r S.C.o V /Y. Company Name 'l "�a ` ! ' Address 2 O. o ' �� \ F x 1 2 To w+v : D wA _- / City `� 6 3 GB .. ;f c• 2.;,i t i �� .<v Signature ~i G y 0 3`S ate ZIP Code ' -As!, '.tsl ti\-- �� Date 385- S- ` Telephone g 4� / "L . - k 10 . FEMA Form 81-31,February 2006 `EXPIRES i/17/pg •• See reverse side for continuation. Replaces all previous editiokik ns Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number N c, Ya 'A -4- Ea 4� 1 tt,iTo LA,.tK City State ZIP Code Company NAIC Number Bo. V-.,/,aa 8 34 8 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and-(3)building owner. Comment... T2.r•t+ (VIAar4s At o.,.a (Ke 005e••s4At...4 5 0-.1;1• 14A 13E,Ea1/4.7 l)E Ti2.s O' ( (>0.c.E5 4 S6T) 1- v$Po "T8+H"t ' (,12..a• St-rt4E 'iv LI4,,ir !P'o4.6 E.t.d. l5.99 Es-16.cbws4E0> RY t?t.. , a` � �µ '2.M• Z(.) LocA—a xi 132+Niv t cu- Si nature i / L J o Date / g C. Caa• ll ( o Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑ above or ❑ below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ._❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ._❑feet ❑meters ❑above or below the HAG. E3. Attached garage(top of slab)is ❑feet❑meters ❑above or ❑ below the HAG. • E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,8,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), nd G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. Cl. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2_ ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. 03. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit.issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for. ❑ New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum • Local Official's Name Title Community Name Telephone . • Signature Date_ - - ' Comments • • ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions