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Home My WebLink AboutBLD2000-00481 Flood Certificate FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 En NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 V" 151 1. --f--- VE I ELEVATION CERTIFICATE IIm• •Kant: Read the Instructions on • es 1 -7. ��J iYIG — 4 a'tt I \ SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: IL`OING OWNER'S NAME 1 Policy Number '/Gf,AL ' 55-Z,6� UILDING 586'b1,4 0, ,(Icy¢ ipg Apt,Unit,Suds,and/or Bldg. No.)OR P.O. ROUTE AND BOX NO. Company N*IC Number TATE DE OO,eT G(IP G OW 0/A.S ilin/6 7 /1/4/ G j PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Desaiption,etc.) A 5Sc'S i 2' - S2,e p . AD. Bz/ - Z4- e9/2- BUILDING USE(e.g.,Residential, Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) ,T285-lO V LATITUDElLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: l.}�GPS(Type): Ldt/.v7r0,/J1 /Alliat." ( ##°-Stir-#*.#*' or ##.* #IP) i„ MAD 1927 (J NAD 1983 Li USGS Quad Map Li Other SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Bi. NFIP COMMUNITY NAME&COMMUNITY NUMBER 82.COUNTY NAME B3.STATE�I j � �ice-a SON/ 0�tS A 777A / 1 84.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL 88.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBERDATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) �300 6 0� O /9�z ,Jaz-- /9 /966z A A/a- B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. I FIS Profile X FIRM U Community Determined U Other(Describe): B11. Indicate the elevation datum used for the BFE in B9:4j NGVD 1929 I j NAVD 1988 L. Other(Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area(OPA)? U Yes g No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: jConstruction Drawings* I 'Building Under Construction* I 'Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. 02. 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 building, provide a sketch or photograph.) C3. Elevations—Zones A1-A30,AE,AH, A(with BFE),VE, V1-V30, V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, 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 appropriate,to document the datum conversion. Datum /'9Z9 Conve on/Comments B Gi/ 6L•0✓. /07./,7 Elevation reference mark usek q/D?i —✓ Go Does the elevation reference mark used appear o _ - / No • a)Top of bottom floor(including basement or enclosure) 27 . 0 ft.(m) R ., • b)Top of next higher floor _ft-(m) a �+ ` 1 C) Bottom of lowest horizontal structural member(V zones only) —ft(m) ,^, Of w' �16 / d)Attached garage (top of slab) ft.(m) E ,, �vb �'p`r0 • e) Lowest elevation of machinery and/or equipment w 19 0: 1,i"� 2 serviang the building _ft.(m) / / A",,!.= i/ ' • f) Lowest adjacent grade(LAG) ft.(m) t> D g) Highest adjacent grade (HAG) _ft.(m) c �titi �•`�,r,. n 7` h) No. of permanent openings (flood vents)within 1 ft. above adjacent grade / 1<J�A i) Total area of all permanent openings(flood vents)in C3h sq. in. (sq. cm) 0* ��Z IS OLMtfl SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATIO ----- This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C 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. CERTIFIER'S NAME /G A G ✓ ,4A/05RsQA/ LICENSE NUMBER TITLE COMPANY NAME 276�� !�/ZO./vZ7- /Zt Ait/s� r� T/G G 44,4A/ 6- / l/t/Eh2//k1 ADDRESS P O. 5O x /37k CAOT/�� STATE 4 ZIP CODEg � SIGNATU - e- pLEPHONE �J t3�Zoaa FEMA Form -31,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPURTANr: inMOMi i CopymeCORwpunwn0Unm nniuunit 11 rwnIRRi1A(iCfltp•nyL s: BUILDING EET Including Apt.,Unit, uits,and/or Bldg.No.)OR P O.ROUTE AND BOX NO. Polley Number r , SO PO/A r 1249 CITY_ P492 7— Z UOGOL(J sTA 1407 �� fe36;_" Company NAIC Number 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. COMMENTS � ,✓ , Ql� 1_1 Check 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 El through E3. if the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. El. 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 building,provide a sketch or photograph.) E2.The top of the bottom floor(including basement or enclosure)of the building is I i I ft.(m) I I Iin.(cm) I I above or Li 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 elevated in accordance with the community's floodplain management ordinance?Li Yes Li No Lj 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. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS 11 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),and G of this Elevation Certificate. Complete the applicable item(s)and sign below. The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer,or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. I J A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. I 1 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. I I New Construction I I Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building is: _ft.(m)Datum: G9. BFE or(in Zone AO)depth of flooding at the building site is: _ft.(m)Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS L Check here if attachments FEMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS