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Home My WebLink AboutElevation Certificate ~ ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM '\TTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only 10 A Jrovide elevation information nece.ssary to ensure compliance with applicable community floodplain management ordinances, to _determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). . Instructions for completing this form can be found on lhe following pages. ~- O.M.8. No 3067.0077 E)(pir~s May 3/, /993 STREET AOORESS (Including ApI.. Umt. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX ~ . Lid- 23 7~. ~ h ~~,,_ ~.e.~~ \ ~~, \ OTHER ~ESCRIPTION (Lot and Block Numb1rs, etc.) \ . P (() ~ '+ \ t:I-\- \ \ 3<:> - \ \ S - "Z.. \ CITY fJ~,cr<7- ~~. ~:. SECTION 8 FLOOD'INSURANCE RATE MAP (FIRM) INFORMATION ~~ t'\E: La . 'N.....l. I FOR INSURANCE COMPANY USE , POLICY NUMBER \ COMPANY NAJC NUMBER SECTION A PROPERTY INFORMATION BUILDING OWNER'S NAME VV\~ C.()J&S~uck "~. ZIP CODE CSc:.~?? Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMSER 2. PANEL NUMBER J. SUFFIX 4. DATE OF FIRM INDEX 5. FIRM ZONE '1-1o~~'2- 00'2-- c.. \ \- \9- q1 ~E: S..SASE FLOOD ELEVATION (In AD Zones. us. d.Plh) ~o~.o 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ~ NGVD '29 LJ Other (describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM, and the community has established a BFE for this building sile, indicate the community's BFE: I . .~ Oi~:.~ feet NGVD (or other FIRM datum-see Section 8. Item 7). SECTION C, BUILDING ELEVATION INFORMATION · 1. Using the Elevation Certificate Instructions. indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level \ . . e(a). FIRM Zone~ A 1 :A30, AE, AH, and A (with SFE). The top of the reference level floor from the selected diagram is at an elevation of :' I .:.- feet NGVD (or other FIRM datum-see Section 8, Item 7). (b). FIRM Zones V1. V30, VE. and V (with BFE). The bottom ot .the lowest horizontal structural member of the reference level from the selected diagram. is at an elevation of' I I I I I.U teet NGVD (or other FIRM datum-see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I i I.U feet above 0 or below:-..: (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The'f1oor used as the reference level from theselected diagram is! I I.U feet above 0 or below 0 (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No 0 Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: 0 NGVD '29 0 Other (describe under Comments on Page 2). (NOTE: if the elevation datum used in measuring the elevations is different than that used on the FIRM [see Section 8, item 1], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on P?ge 2.) 4. Elevation reference mark used appears on FIRM: 0 Yes 0 No (See Instructions on Page 4) 5. The reference level elevation Is based on: ~ actual construction 0 construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor In place, in which , case this certificate wifl only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to Ihe building is:: I I I I I, U feet NGVD (or other FIRM datum-see Section 8. Item 7). . SECTION D COMMUNITY INFORMATION If the community oHlcial responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest a floor" as defined by the ordinance is: I I I I U.U teet NGVD (or other FIRM datum-see Section S, Item 7). W. Date of the start of. construction or substantial improvement . FEMA Form 81-31, MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION ..J . ~ SECTION E CERTIFICATION A This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to car1lfy elevation . information when the elevation information for Zones A1-A30, AE, AH, A (with BFE),V1-V30,VE. and V (with BFE) is required. .Community officials who are authorized by local law or ordinance to provide floodplain management Information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official. a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6. 7 and 8 . Distinguishing Features-If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment. area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must stili be entered. I certify that the information in Sections B and Con this certificate represents my best efforts ,to interpret the data available. I understand. that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. ' CERTIFIER'S NA~ 1\ ~ . LICENSE NUM8ER (or Affix SeaJ) t<\Of\Ctll! ~. .~4~~Q~ \ ~ \ e.L3 TITLE W ~ ~~~ COMPANY NAME \let \ \~ ~1!!\41 ~Cl CO. ~ ~ ADDRESS ~ \- CPr ." , _ \ ...J STATE \ lo.~.~. r~~ I\"<<',} -se:. Y t'RR.;';'- ~ \..a '-..,~,\ ~'J\.~ ~ \ 'Z... ) \..\~ 1 - -z..'S 1 0 SIGNATURE ~~~_ .r;.:!-3-?'9 'PHONE Copies should be made of. this Certificate for: 1) community official, 2) Insurance agent'company, and 3) building owner. . ,'. ~'..,. :' ZIP e COMMENTS: N 0 -r"t. '. +~ ~-(.. ~ <:;~ La vu~-\-- ~ \ 00 .. O\..Uc..\\\nc... \~ ~ ~ \e.\J~~\') ~ \) V\ F)~..... \s ...... \f:\~v . (1 ()V\~~\Jc...\.\(:)N .C\lt>. \ c.......+ ~\~ O.c-~\oc-L ~\o.q ~ ~~~cO j ~~ ~ \ ~ c....\- ON SUB WITH BASEMENT ON ~1LE5, ~IERS. OR COLUMNS A ZONES .v ZONES A lr ZONES , F '- ^- "'] , ",', l,l, ~''''''.'''''l'~~l :;.;.::::ir':::~',~;~X~::; l''',~ 'IoIWoCEHr :,:: ":".l... CREFERENCEI ORAoe ~," .~ lZYe~ \,~.. , . 1jI;rt~~.. "i'/'''''\'\{ ,..~;{q)!-;~';n".~' BAS E "-000 EUVATION '-'-' ~ A V ZONES ,ZONES 1fr 'RE:~~~E~ ~ IREFERENCE! I I ~~ ~!Y!~. :--.. ~ I --\.' .........::% ,\ JE IRFJEIENC!II<l).JN;EHT ~EVE1. ORAoe . F1.000 ElEVATION The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top at the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. ~ Page 2