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Home My WebLink AboutEvaluation Report all DocuSigr7En'velope ID:56639563-962C-4417-SA3E-79609B9706AA U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date:November 30,2022 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. I 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: Hargrave/Coastal Palms Construction A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number: 10327 Muller Road City State ZIP Cade Fort Pierce Florida 34945 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lot 1 Muller Road Ranches A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential A5. Latitude/Longitude: Lat.27.388555 Long.-80.430276 Horizontal Datum: [] NAD 1927 ❑x 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 I AS. 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 N/A 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 132.County Name B3. State St.Lucie County-120285 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 CO170 J 02-16-2012 02-16-2012 AE 18.0 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9: ❑FIS Profile ❑x FIRM ❑Community Determined []other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ]NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)?•❑Yes ❑X No Designation Date: (] CBRS ❑ OPA FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 1 of 6 .DocuSign Envelope ID:56639563-962C-4417-8A3E-79609B9706AA ELEVATION CERTIFICATE OMB No. 1 Expiration Date:ate: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: 10327 Muller Road City State ZIP Code Company NAIC Number Fort Pierce Florida 34945 SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1, Building elevations are based on: ❑ Construction Drawings* ❑x 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: FCE 4804 1999 Vertical Datum:NAVD'88 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,crawispace,or enclosure floor) 20.3 ❑x feet ❑ meters b) Top of the next higher floor N/A ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑ feet ❑meters d) Attached garage(top of slab) 19.8 ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 5.(Describe type of equipment and location in Comments) 19 ❑ feet ❑ meters f) Lowest adjacent(finished)grade next to building(LAG) 19.3 ❑X feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 19.4 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support . 19.5 ❑ feet ❑ meters 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. I certify that the information 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. Were latitude and longitude in Section A provided by a licensed land surveyor? [Dyes ❑No ❑Check here if attachments. Certifier's Name License Number ;,;;; James A.Cesiro Jr. PSM5543 y ti� '�'_w'' , Title s; President 0 k Company Name ` PSM 5543 0 Pr"Atlantic Land Designs of the Treasure Coast Inc. `. Address STATE OF PO Box 1421 ALD5543@gmail.com o /r4 FRF,'ntOR IVT b%�/ City State Ddcusigned'by:,-=' ZIP Code h 'l /1 r\ Jensen Beach Florida 34958 ,�t>lwttSr�,tSlYb'`'','^ ~ A1338D8A59FD4C1... es D to Telephone Ext. SignatureJ Slro I b '°dg^s 08-04-2021 (772)398-4290 ` e Mar Copy all pag of this El ation Ce ficate an all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(indbdiQg ty of equip ent an cation,per C2(e),if applicable) .pbRevision-08-04-2021 -reflect building under construction-form boards in place, **No pictures were taken of the form boards** FEMA Form 086-M3(12/19) Replaces all previous editions. Form Page 2 of 6 - r 4D=Sign Envelope ID:56639563-962C-4417-8A3E-79609B9706AA OMB No. 1660-0008 ELEVATION CERTIFICATE 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: 10327 Muller Road City State ZIP Code Company NAIC Number . Fort Pierce Florida 34945 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 El—E5.If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A,B,and C.For Items El—E4,use natural grade,if available.Check the measurement used.In Puerto Rico only, enter meters. E1. 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, crawlspace,or enclosure)is ❑feet ❑meters ❑above or ❑below the-HAG. b) Top of bottom floor(including basement, crawispace,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6 9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 1-2 of Instructions), the next higher floor(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or ❑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? ❑ Yes ❑ No ❑ 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 the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 3 of 6