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Home My WebLink AboutElevation Certificate' a4 -U.S. DEPARTMENT OF HOMELS' .q_) SECURITY OMB No. 1660-0008 Feder,_al Emergency Management Agency Expiration Date: November 30, 2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Marvin D. Kelly A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 11600 Twin Creeks Drive City State ZIP Code Fort Pierce Florida 34945 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) I.D. No. 2333-234-0001-000-5 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential / Pre -Construction A5. Latitude/Longitude: Lat. 27°23'20.56649" Long.80°26'38.85650" Horizontal Datum: ❑ NAD 1927 Fx� NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1 B A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage 728.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State St. Lucie Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12111 CO164 J 02-16-2020 AE 18.6 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 69: ❑ FIS Profile Z FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6 J►: v ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 11600 Twin Creeks Drive City State ZIP Code Company NAIC Number Fort Pierce Florida 34945 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: x❑ Construction Drawings* ❑ Building Under Construction* ❑ Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. 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 C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: GPS RTK Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) ❑ feet ❑ meters b) Top of the next higher floor ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ meters d) Attached garage (top of slab) ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building ❑ feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) ❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) ❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. / understand that any false statement may be punishable by fine orimprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number Ted E. Phillips LS 5932 - Title Professional Surveyor and Mapper r_ . _ -- Company Name TEPHILLIPS, LLC _ -_` Sep.! ee6 Address 102 SW Parish Terrace ; - City State ZIP Code Port St. Lucie Florida 34984 Signature / Date Telephone Ext. (772) 359-7023 opy all pages of this Ele ertificate and all attachme s for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (inclu4odlype of equipment and location, per C2(e), if applicable) Pre -Construction FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 2 of 6