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HomeMy WebLinkAboutElevation CertificateO.M.B.
'ELEVATION CERTIFICATE ExprresMay31, 7993
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
provide elevation information necessary 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 the following pages.
SECTION A PROPERTY INFORMATION FOR IN COMPANY USE
:J
BUILDING OWNER'S NAME POLICY NUMBER
MR. & MRS. CRESSMAN
STREET ADDRESS (Including Apt., Unit, Suite and,or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
10851 SOUTH OCEAN DRIVE LOT 160
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
WINDMILL VILLAGE BY THE SEA LOT 160
STATE ZIP CODE-'
CITY
JENSEN BEACH FL 34952
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
PrnviriP the following from the proper FIRM (See Instructions):
1. COP.11.1'UNITY NUMBER
2. PANEL NUMBER 3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
(in AO Zones, use depth)
120285
0313 F
8/19/91
A—E
8.0
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): - NGVD '29 - 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 site, indicate
the community's BFE: - feet NGVD (or other FIRM datum —see Section B, 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
2(a). FIRM Z'on'esAl-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation
'C
of [L.Zfeet NGVD (or other FIRM datum —see Section B, Item 7).
(b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of I .' 'feet 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 ' feet above rl or
below ' (check one) the highest grade adjacent to the building.
—71
(d). FIRM Zone P.O. The floor used as the reference level from the selected diagram is ' - feet above' or below n (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? 11 Yes _ No 'I Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: X NGVD'29 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 B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion
eouation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ri YesNo (See Instructions on Page 4)
5. The reference level elevation is based on: I ! actual construction 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 will 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 the building is: i ' ' I ISI .! feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official 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
floor" as defined by the ordinance is: I I I ► I_ I ,I`! feet NGVD (or other F!RM datum —see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 90
REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE "rUh GUN I INUAI IUN
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or.architect who is authorized by stale or local law to certify elevation
information when the elevation information for Zones Al—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 iss'61 ed 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 still be entered.
I certify that [lie information in Sections B and C on 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.
CERTIFIEn S NAVE
r-ART,F R . STAP.KEY
LICENSE NUMBER (or AHIx Seal)
.
#4d 59
TITLE COMPANY NAME
PROFESSIONAL LAND 'SUY,VEYOF -NCCURIG'r:T LAND SURVEYING, INC • -
ADDRESS CITY
rrnrTAnT
STATE emir
FT,. 34997
LuUO 5.�. 1.J J. ..�
M1
(DATE
PHONE
SIGNATURE . ' !©
. �
(40 / 286-76.Q 4
rance agenUcompany, and 3) building owner.
Copies should be made of this Certificate for: 1) community official, 2) ins i
COMMENTS:
t
WITH ON PILES,
ON SLAB BASEMENT PIERS, OR COLUMNS
A v A A_ v
ZONES ZONES ZONES ZONES ZONES
REFERENCE
LEVEL RCEEFEREN
REFERENCE II BASEI LEVEL
LEVEL FLOOD
ELEVATION
0f
BA
OD
BASE • •�-•'"'• ADJACENT :;,ii • REFERENCE'S ELeyAT10N
FLOOD GRADE �.•jj LEVEL
ELEVATION REFERENCE ADJACENT. -
GRADE
LEVEL
j ���,. :::i.:,::;•.,'r ..':i :�' ::.,•'• ADJACENT i.
GRADE
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 of the reference level
floor.
Elevations for all V Zones should be measured at the bottom of the lowest
horizontal structural member.
0
r
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