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Home My WebLink AboutElevation Certificate lit.', FEMA NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE .} . AND INSTRUCTIONS U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CEIRTIFICA TE OMS No. 1660-0008 Exoires Februarv 28. 2009 M. A5. A6. A7. A8. Important: Read the instrul:;tions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Policy Number A1. A2. Company NAIC Number ZIP Code r;s "'"512- A3. 'tl\ '\ V\. '<'\~~...... Horizontal Datum: 0 NAD 1927 0 NAD 1983 sq ft A9. For a building with an attached garage, provide: a) Square footage of attached garage sq ft b) No. of permanent flood openings in the attached garage ~ walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b sq In c) SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION I B3. State ff\tl . B9. Base Flood Elevatlon(s) (Zone AO, use base flood depth) B8. Flood Zone(s) B11. B12. 000 Indicate the source of the Base Floo~l~n (BF ) data or base floo dept entered in Item B9. o F,IS Profile D FIRM ~ommunity .E..et?,"ed D Othor (Describe) Indicate elevation datum used for BFE In Item B9: l!rNGVD 1929 0 NAVD 1988 0 Other (Describe) Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date . 0 CBRS DOPA B10. o Yes ..".-- [H"No SECTION C - BUILDING ELEVATION INFO,BMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings. uilding Under Construction. 0 Finished Construction . A new Elevation Certificate will be required when construction of the building is I:omplete. C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE). AI~, ARIA, ARlAE, ARlA1-A30, AR/AH, ARlAO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized _Vertical Datum Conversion/Comments 1:" a) b) c) "*d) e) Top of bottom floor (including ,basement, crawl space, or enclosure floor) Top of the next higher floor Bottom of the lowest horlzontar structural member (V Zones only) Attached g~rage (tpp of slab) Lowest elevation of machinery or equipment servicing the building (Describe fype of equipment in Comments) Lowest adjacent (finished) grade (LAG) Highest adjacent (finished) grade (HAG) Check the measurement used. '\ \ \ .i~et D meters (Puerto Rico only) ._D feet 0 meters (Puerto Rico only) ._D feet 0 meters (Puerto Rico only) '\ '0 .L~eet 0 meters (Puerto Rico only) ._0 feet 0 meters (Puerto Rico only) f) g) D feet o feet o meters (Puerto Rico only) o meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, CIR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architel:t authorized by law to certify elevation information. I certify that the information on this Certificate represents my best effolts to interpret the data available. I un~tand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. g" Check here if comments are provided on back of form. ~:rl..P~(~,E ~ L1i;ense Number \~-z.:.~q c... O~) ~, ~ · latetc'\"\ ZIP cOdeC:;~~1Z. TelePhoni ~ . ~S 1.\1..\"1" 't.S'D ...... .~~~ ~~;p~t HEHiE FEMA Form 81-31, February 2006 See reverse side fl)r continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Addrc;.;lncluding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. \~"'1~)C> "-'L ~...",,-....t.."' oS": City State "" For Insurance Company Use: Policy Number ZIP Code ~~". S CTION D . SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Company NAIC Number Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. to,O 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 E1-E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1-E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. E 1. 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 __' _ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is __' _ 0 feet 0 meters 0 above or 0 below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectl~\ Items 8 and/or 9 (see ~e 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . _ 0 feet U meters 0 above or U below the HAG. E3. Attached garage (top of slab) is _' _ 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is __' _ 0 feet 0 meters 0 above or 0 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? 0 Yes 0 No 0 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, B, and E are correct to t/; e best of my knowledge. Property Owner's or Owner's Authorized Representative's Name State ZIP Code Address City Signature Date Telephone Comments o Check here if attachments SECTION G . COMMUNITY INFCJRMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's noodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9. G1. 0 The information in Section C was taken from other documentation that has heen 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. 0 A community official completed Section E for a bullding located in Zone A (without a FEMA-issued or community-Issued BFE) or Zone AO. G3. 0 The followilJg information (Items G4.-G9.) is provided for community floodplain management purposes. I G4. Permit Numbe~ .' I G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: 0 N~w Construction 0 Substantial 1m Jrovement G8. Elevation of as-built lowest floor (including basement) of the building: _ _ G9. BFE or (in Zone AO) depth of flooding at the building site: o feet 0 meters (PR) o feet 0 meters (PR) Datum Datum Local Official's Name Title Community Name Telephone Signature Date Comments o Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions APR-03-2008 08:12 U,S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Managlllment Agency Nationsl Flood Insurance Program Important: Read the instructions on pages 1-8. P.02 OMS No. 1660-0008 ecoires Februarv 28. 2bo9 SECTION A - PROPERTY INFORMATION Fer Insurance Company Use:! A1. B~~ld.,,~ () ...,,~ I~ t JUlI~~ .s ---. ":t.. (5 ~."k. H--Wl~ PoIfY Number I ?~ e f'AQ.€.9 FoQ: -. : 1\2. Building Street Address (includIng Apt.. Unit, Suite. and/or Bldg. No.) or P.O. Route and Box No. Corrpany NAlC Number : _.1 '7730 Co lit.. A,,<..ro,^~ :So E'.. , I City _ \... Stale . , YI~ I o It, L,...""e:, M N A3. PropertyDescrlpii~"(Lot and Block Numbers, Tax Parcel Number; Legal Description. etc.) ---1:0, r ..:2.. ...S~ 'J'~ I>J ~e.1Z ~ ~ ::"J ~ ._~':(.<:,-: 1../. ~. NI'IC,-s'!I. ht.. ZIP Code ~531-z. M. Building Uu (e.g., Residential. Non-Residential, Addition. Iccesscry, etc.) i2 f1 S ,0;."""",,, "- AS. LalllUdellongltude: Lat. Long. Horizontal Datum: 0 NAD 1927 0 NAD 1983 A6. Attach at least 2 pholographs of the bu~dlng If the Certificate is being used 10 obtain nood insurance. A7. Building Diagram Number_ A8. For a building wllh a crawl8Pace or enclO$ure{s). provide: fl.S. For a building wilh an attached garage. provide: a) Square footage of crawl space or enelosure(s) sq ft a) Square footage of 8ueehed garage sq h b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings In the attached garage enclosure(s) walls within 1.0 toot above adjacenl grade _ walls within 1.0 foot above adjacenl grade : c) Total net area of toad openings in M.b sq in c) Total net area of flood openings in A9.b sq in SEcnON B - FLOOD INSURANCE RATE MAP (ARM) INFORMAnON 81 NFIP Community Name & Community Number ::I~ 10 n. t../t-w, E' ""2.(1) L{ 3 "'Z.. 82., County Name ..s eu T 83. State PIN 64.. Map/Panel Number 85. Suffix 86. FIRM Index 87. FIRM Panel 88. Flood 89. Base FIcocI Elevalion(s) (Zone I~ Date EffectivelReo.Ased Dele Zane(s) AO. use base llood depth) OO~"2.. 1111,\ h, 1\1,~ /97 AE:.. 90~. '1 610 Indicate the source of the Base FlOOd Elevation (aFE) data or base nood depth entered In Ilem 89. o FIS Profile 0 FIRM ~Community Determined 0 Other (Describe) B11. IndlCste elevation d3lllm used for BFE in Item 89: ~ NGVO 1929 0 NAVD 1988 0 Other (Describe) 812 Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date " 0 CBRS DOPA o Vet ''"::8 No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1 Building elevallons are based on: 0 Construction Drawings. 0 Building Under ConslnJction" ~ Flnlahed Cqnstruetion "A new Elevation Certificate will be requited when construcdon of the building is complete. C2. Elevations -Zones A1.A30. AS. AH, A (with BFE). VE. V1-V30, V (with BFE). AR. ARIA, ARiAE, AR/A1.A30. ARIAH. ARJAO. Complete ken1l; C2.a~g below according to the building diagram speo'fled In Item A7. Benchmark Uti~zed Vertical Datum '" &V D 1"1 z.c, Ccnvsl"&ion/CommenlS a) b) c) d) e) Top of bottom ROO/' (including basement. crawl space, or endC$lJl'e floor) Top of the next higher floor Bonom of the lowest horizontal SlYudural member (\I Zones only) Attached garag8 (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe ~e of equipment in Comments) Lowesl adjacent (finIshed) grade (LAG) Highest adjacent (r,"i~hed) grade (HAG) Check the menurement used. 7 II. '5' ~ reet 0 meters (Puerto Rico only) ~- q 7-1 . S I]] feel 0 meters (Puerto Rico only) ....._0 feet 0 meters (Puel1o Rico only) '=I Oq ,..1..1&1 feet 0 meters (pUerto Rico only) o feet 0 meter& (Puerto Rico only) f) g) <=io~ .~teet ~'O .~~ feet o meters (Pu.eno Rico only) o meters (P~ Rico only) SECTION 0 - SURVEYOR, ENGINEER. OR ARCHITECT CERTIFICATION Thi, certification Is to be signed and sealed by a land surveyor, engineer. or architect authorlzed by law to c$1Jfy elevation information. I c8l1lly that the information on rhis Certificate represents my best efforts to interprer the dara available, I understand rhar any false statement may be punishable by fine or imprisonmenr under 16 U.S. Code. SecrJon 100t. IZ] Check here if comments are provided on back of fO/'m. ~r's Name, C oJ I'!., r.rtr' 1--1. Tlde'-l '" , ~ IV C ::.. It- ...4.. .J..;; <<- Address __. jtQI..",?1,,') r/!t'..../-J..; SlgnalJJre_ . ,'. 'Y..r(fof-'''"?y!., ; '......". '-.....""'" .s "J A-.vSIJ ,.J Company Name \ ... 'J ,.\ ....1 W ,,,..J'.J(.'1 II'. 1 Ci~.... , Stafe Tr:.,.:', ..;,E; rr..,Q.!. ~~ I Date cl 1/ 'r I ~ g License Number ~: :'~ J~ ,;, L1-Z 'o~ p...~ :..; .;:;. .":' ~tl. PPr ';-',.--- ZIP Code c <' ~.". ., N.t-J W'JJ "- Telephone "t~Z- L,uJi_ 2r.-7:.J ,,~ FEMA Form 81-31. Feoruary 2006 See reverse side ftlr continuation. Replaces all previous ed!tions APR-03-2008 08:12 P.03 IMPORTANT: In these spaces, copy the corresponding Infonnatlon from Section A. For Insurance Company Use: Building Street Address (ine\.:JCIing Apt., Unit, Suite, andlor Bldg. No.) or P.O, Route and Box No. PoIi~ Number ._.,_-1- 7 L~_J_IJ ~r- r:...,.(,JJ oJ>.,-L ,~ :'::l c:, City State ZIP Code Company NAle Number ! r/t.\ '..J.i;~.. ' . 1./1 N 5~ 57c... ~.. p.-1J..C_ SECTION 0 - SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATlON (CONTINUED) Copy both sides of this Eleva~on Certificate for (1) comrnunily official, (2) insurance agent/company. and (3) buidtng owner. Comments. ,". ,'" .'\! ." '~',,~. ~ I r , .....____.-.__..~~~~:?J~:.l~......._:..~i;"t:.'._..,........~,.:::.,...:.).!..-".....,t..::..:.::.~::-:~~..<.l. J..;.~" 01'" ,,. I~I It1 ~~~Jo'V"'I ,~ "'J~ r- ~ I'.....~..J ,,~ J.r I .J \ ~ .r~ ,.l .:. 'r, ~;'(', ~ .J ,...,..,,' 'to.le.. C~.r r=- c fV1 f+ .~: ~~. ~ t'I.'" ~ .,'; Signature. _.-- ..' _' ..... Date "e..I I i .1',;-;7 -p'.,' '-;--. " 1I ,,(} & 0 Check here i' attachments SECTION E - BUILDING ELEVATION INFORMATlON (SURVEY NOT REaUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE; For Zones AO and A (withoc./t BFE), complete Items E1.E5. If the Certificate is intended to support a LOMA or LOMR-F requesi, complete Sections A, B, and C. For Items E1.E4, use natural grade. if available. Check the measurement used. In Puerto Rico only, enter rnetenl. E' , 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 l,_t adjacent grade (IJl.G). a) Top of bottom t100r (Indudlng basemen!. crawl space, or enclosure) is _' _ 0 feet 0 meters 0 above or 0 below the HAG. b) Top of bottom rloor {lnduding basement, crawl space, or enclosure) is _' _ 0 feet 0 meters 0 above or 0 below the LAG. For Building Diagrams 6-8 wilh permanent flood openings provided in Sec:tiW Items 8 ~'or 9 (see ~e B ~ Instructions), the next higher floor (elevation C2.b In Ihe diagrams) of !he building is _' _ 0 feet U melAn U above or U below the HAG. Attached garage (top of slab) is _' ___ 0 feet 0 meters 0 above or 0 below the HAG. Top of platform 01 machinery andlor equipment senticing the building is _' _ 0 feet 0 mete", 0 above or 0 below the HAG. Zone AO only' If no flQod depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No D Unknown. The local official must certify this Information tn SectIon G, E2. E3. E4. ES. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTA nVE) CERllRCA liON The property owner or ownerr'!! 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. S, and E are correct to the best of my knowledge. Property Owner's or O'M'ler's Authorized Repr.entatlve's Name Address City State ZIP Code Signature Date Telephone Comments o Check here if attacHments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local offlclal who III authOl'tzed by law or ordlnaneelo administer the community's floodplain management ordlnflnce can complete Sections A. B. C (or E), and G of this Elevation Cenlfic:ate. Complete the applicable ilem(s) and sign below, Check the measurement used in Items G8. and G9. G 1. 0 The information in Section C was taken from other documentation ltIat hB6 been signed and sealed by a ~censed surveyor, engineer, or architect who is aultlorized by law to certify elevation information. (Indicate the source and date d lhe elevation data in the Comments area below.) G2. 0 A community official completed Section E fa a building located in Zone A (without a FEMA-issued or commUnity.i66ued BFEI or Zone AO. G3 0 The following In (ormation (Items G4.-G9.) is provided'or 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: 0 New Construction 0 Substentiallmprollemenl GB. Elevation of as-built loweat floor (including basement) of the building: G9. BF!: or (In lone AO) depth of flooding at the bu~ding site: o feet 0 meter1> (PR) o feet 0 meters (PR) Datum Datum Local Official's Name Tille Community Name Telephone Signature Date Comments FEMA Form 81-31, February 2006 o Check h~re if at!ac~ments Replaces all pre.lious ~Itions TOTAL P.03