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HomeMy WebLinkAboutBLD2001-00709 Flood Certificate C I 1J ED F -RAL EMERGENCY MANAGEMENT A CY V ---- O.M.B. No. 3067-OQ77 TIONAL FLOOD INSURANCE PROG Expires July 31, 2002 I r 5 200i ELEVATION CERTIFICATE 1 Important Read the Instructions on pages 1 -7. • �.:1• ,,J+ „r,f SECTION A-PROPERTY OWNER INFORMATION For'I earitsd►Cotttpetty!iiiec' ' •P'o6tc7l�t1IMhi1� - Z.e.r=F �- AC3C5`(— C. cDr_o i2c) SSi „ , i:::. SU'1LDING STREET ADDRESS(Including Apt,Unit,Suite,and/or 31dg.No.)OR P.O. ROUTE AND BOX NO. Cssetpawy Ai.JC 1 , A-T U.S. Nw-( I0I +- \r`l:L-r .[e.OD 2a/No = . . CiTY STATE ZIP CODE (*.;?,V Ic... GEis.)6_ \.,‘/A 98 374, PROPERTY DESCRIPTION(Lot and Stock Numbers,Tax Piecel Number, Legei Description, etc.) L o T I c F THE iNioai2,t ; C3AR-T L-1 SH 02'r Pc-AT BUILDING USE(e.g., Residential, Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) 2ESio Exari i\i-- LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE [__I GPS(Type): ( fee-U -tW .eit' or IV fix) U NAD 1927 Li NAD 1863 U USGS Quad Map i_,j Cthor, SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION 81. NFIP COMMUNITY NAME&COMMUNITY NUMBER B .COUNTY NAME 93.STATE ITA►.,E.L. 835 o F I C.ZS ..S EFEER.SOr./ \A/A j B4 MAP AND PANEL 95. SUFFIX 3e. FIRM INDEX B7. FIRM PANEL 138. FLOOD 88. BASE FLOOD ELEVATiON(S) NUMBER DATE EFFECTiVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) j 53ooc.9 0835 S 7- ( 9 --S2. A/o,,E. A �.. 9O. OD FT. 810. Indicate the source cf the Base Flood Elevation(BFE)data or base flood depth entered in B9. I J FIS Profile Lf FIRM II Community Determined (Xj Other(Descnbe): SEE CoAA n-c Cni i s R,6r Z 811. Indicate the elevation datum used for the BFE in 89. X NGVD 1929 L. NAVD 1988 Lj Other(Describe) 812. Is the budding located in a Coastal Barney Resources System(CBRS)area or Otherwise Protected Area(OPA)? ( j Yes (Xj No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl Building elevations are based on: LjConstruction Drawings' LJBuilding Under Construction' LfFinished Construction •A new Elevation Certificate will be re^'.I+r _ when construction of the budding is complete. C2. Building Diagram Number (Sc.• ,d building diagram most similar to the building for which this certlflc ate Is being compietr.. • see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations-Zones Al-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 budding diagram specified in item C2. State the datum used. if the datum is different from the datum used for the BFE In Section o, 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 t cal 9 Conversion/Comments Elevation reference mark used (a-IS t S.c.r.. U5C-+6 Does the elevation reference mark used appear on the FiRM? 1_1 Yes j){j No a)Top of bottom floor(including basement or enclosure) ft-(m) ' NAN'\V` -,..1/4i//.61,71////:; 2 b)Top d next htghec floor ft.(m) °' • . N c: _ Xt.:r .Of'owest 1-or-'.Arni strut rnl m,_mt)er(V mr;ect �niy; ft(rr- 4 0O 0.,oN se L:. .:),z-u cited _',: r- -e(4.A:rx slab) `t(m is- •/ S4. 9 , ❑ e) Lowest elevation of machinery and/or equipment f i� U Z 1� '- servicing the building —ft(m) E 1 :` % ), .% 7 f) Lowest adjacent grade(LAG) 9( .2.7 ft.(rsy II' x ' ''p w ` ❑ g)Highest adjacent grade(HAG) 9 7 .90 ft.if?' �'� ��Ij, a ray 0 h)No. of permanent openings(flood vents)within 1 R above adjacent grade •• fib ` . 4' 0 i)Total area daft permanent openings(flood vents)in C3h sq. in. (sq. cm) deli,,,//,iw. SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This cal tif,clitiun is to be signed and sealed by a land surveyor, engineer, or architect authorized by taw to certify elevation information. I certify that the Information In Sections A, Q and C on this certificate represents my best efforts to Interpret the data available. I understand that any false statement maybe punishable by fine or imprisonment under 16 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER A .1OL-p C. \(9oD WA Z 39t t TiTLE COMPANY NAME pf�E`z. w00D S j.VI tnct. 11,,c. ADDRESS 2 i ES 01 S c.c.v E.�t' RO. CITY t�ort_�" t oc.�Ng6K j,ATE�A ZIP CODE g8 3G8 IMPORTANT: In these spaces,copy the sponding infcwmation fromSection A ::Fein �aiiytlow l .: BUILDING STREET ADDRESS(Including Apt., Unit,Suite, andlor Bklg No.)OR P.O.ROUTE AND BOX N P 15tyNumber: .i4 : O. S. W.w'( lot -.- �11 t..o woo D 2c s oak A ' GITY STATE ZIP CODE Corm* - .,•• 'iE ;i Q ► C..tC-n.l E.- lea V 8 37` ) '.r,, , . 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 • U SEp US c. -+- S et. IA. L-tS 19 `t:. N,svo t7Z9 Ec-e✓ /03. Z3 A► T 6 c. Ei) MAO Si-iOw5 ELEVAr,o/vS fAk E A-T Sir E. B u r t..0 n N is ?t,..,A N s ERE- IV O T A V A r L.A A L..E.. A 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 CeRA'kate is Intended for use es supporting information fora LOMA or LOMR-F, Section C must be completed. E l. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed- see pages 5 and 7. If no diagram accurately represents the building. provide a sketch or photograph.) E22_ The top of the bottom floor(Including basement or enclosure)of the building is j I ,( ft(m)1 I jin.(cm) Li 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?L1 Yes Lj No Li Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owners 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. / A,e..Nc o . Wcx�0 c. a (� -4 c . PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE Z t SS D i 5 G o✓s,t.'" P..o . Po2T IOW Aisi.Av p ka)A . ,83G8 SIGNATURE W DATE TELEPHONE //- S- 200 / 3C:.0- 385- S968 COMMENTS Lj Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law Of 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. G1. L. 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 Cor-•tints area below.) iI A comrnu"t' °Metal=rnr.,eted Section E for a buiki n. located in Zone A t:vitnout a FEMA-4s:ue- ^r Cec miinit7-i:. Jell r -'=j o: Zone AC. G3. I j The following information(items G4-G9)Is provided for community floodplain management purposes. 54. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED 07. This permit has been issued for. Li New Construction (_I Substantial Improvement G8. Elevation of as-built lowest floor(includingbasement)of the buildingis: —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 ,. ,. • Ali N r .D E C PA W E 0 cn DEPT.OFJCOMMUNITY DEVELOPMENT N Q Gs R: + 4* ..4 Q© y 10 AMH SR fk„0 l , l0. i,N 00 . 5L� < z • O O r' 7) 23 x m o _ 1 tC N Cn AROA \\ OCO x to v s�,f °SFo `° �7 x CO rn ro C, v `�03 CA Si?.� = r— lD R7 O N C.J = Cri Lo U1 N cm r m X x ...,,, ,,,____.\ >. '0 to r- . X • m tD -i cn W CD 1-21 cn a , it r fa ) 0 z 0 (A • i11 IA) co 0 P 4) 0, N . rn 0 m � P1 > 0. II G.` C. ,i) CA • o In EAST LINE . SECTION 14 _i______/::k 1