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Home My WebLink About0804-0166 ELEVATION CERTIFICATE 7-23-07�- U.S. DWk EPARTM*nFELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency OMB o. to 08 y National Flood Insurance Program Expires February 28.2009 g Important: Read the instructions on pages 1-8. Al. Buiidina Owners Pin —SECTION A - PROPERTY INFORMATION A7. A8. Address (Ind join Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No- R\\.G A -_ __ ! 0 W Building Use (e.g., Residential, Non -Residential, Addition, Accessory, eta) Latitude/Lon gitude: Let P't Long. Attach at least 2 photographs of the building if the Certificate Is being used'to obtain flood insurance. Building Diagram Number_]_ For a building with a crawl space, or endosure(s), provide: a) Square footage of crawl space or enclosure(s) A fl A9. For a building with an attached garage; provide: b) No. of permanent flood openings in the crawl space or -� _ a) Square footage of attached garage enclosures) walls within 1.0 foot above adjacent grade ,�� ,,,b) No. of permanent flood openings in the attached garageft c) Total net area of flood openings in A8.b walls within 14 foot above adjacent grade l.i/,k. - � sq in c) Total net area of flood openings in A9.b 'q In SECTION B - FLOOD INSURAntc: stele RA An l.__I r10 rrorile N FIRM El ;., - --- -• ••r"• �,lac,vu I,, Imm 0W. Cofilniunity,Deterrhined .[]Other (Describe) Indicate elevation datum used for 8FE in Item B9: C`NGVD 1929 ❑ OtherNAVO Des ❑Other (Describe) Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes [�No Designation Date CBRS rl OPA - - Q11V11 %.erunCase will be required when construction of the build ni g sulmp� ing hoer construction' jJ Finished Construction Elevations -Zones Al-A30, AE, AH, A (with SFE), VE, V1430, V (with BFE), AR, ARIA, ARME, AR/AlA30, AR/AH. AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. 'Benchmark Utilized[�41L j Conversion/Comments Vertical Datum_f.,, fa \ 1 _ t, # _ r bC-1'E E E l-EV . Check the measurement used. a) Top of'IDottearfloor (including basement, crawl space, or enGosure floor b) Top of the next higher floor ) --� ��et meters (Puerto Rico onl Bottom of the lowest horizontal structural member (V Zones only) —�❑ feet ❑ meters (Puerto Rico on t) Attached 9ara9e•(top of slab) feet* ❑ meters (Puerto Rico onl P1 :) Lowest elevation of machinery or equipment servicing the building —0 fleet ❑ meters (Puerto Rico only J U L 2 3 2007 (Describe type of equipment in Comments) --[] feet ❑ meters' (Puerto Rico onty Lowest adjacent (finished) grade (LAG) ry PUBLIC WORKS Highest adjacent (finished) grade (HAG) �1J het ❑ meters (Puerto Rico only) ST. LUCIE COUNTY, FL i SECTION b__ I. o, , yea oy a land surveyor, engineer, or architect authorized by law to cer.. ! certify that the infwnaiion on this Cer&#Cate represents my efforts interpret y l data cart 7d that any false statement may be punishable by fine orimprisonment under 18 U.S. Code, Section here if Comments are provided on back of form. 81-31, February 2006 -1- See reverse side for continuation. U. meters (Puerto Rico only) ICATION y elevation We. 1001. PLACE E E °Its E >S SIGNAT O ATE HERE 9- et 1192�_ Replaces all previous editions IMPORTANT: In these spaces, copy the corriesponding. information from Section A. For.1murance Com Building Street Address (including Apt• Unit, Suite, and/or Bldg. No.) or P.Q. Route and Box Use Umber' No. tY� Po}ic�r;N City r: tGN t t1.7F�bb 1 S I a 4 State ZIP Code Gbirr8igllKi!{ ttbelr° ; . 'J s <;;., .SECTION D - SUR% Copy both sides of this Elevation Certificate for (1) SECTION E - SUILDING ELEVATION For Zones AO and A (without BFE). Complete Items E and C. For Items E1-E4., use natural grade, if availabl El. Provide elevation information for the following an grade (HAG) and the lowest adjacent grade (L CC a) Top of bottom floor (including basement, crawl b) Top of bottom floor (including basement, crawl E2. For Building Diagrams 6-8 with permanent flood i (elevation C2.b in the diagrams) of the building is E3. Attached garage (top of slab) is Ea. Top of platform of machinery and/or equipment st ES. Zone AO only. If no flood depth number is avallal ordinance? ❑ Yes ❑ No ❑ Unknown. TM SECTION F - PR The property owner or owner's authorized epn r or Zone AO must sign here. The statements in Property Owner's or Owner's Authorized Reore Signature Comments r ne +ocai 0Mcial who is authonzed.by law or ordinance tc and G of this Elevation Certificate. Complete the applica G1. 0 The information in Section C was taken from 01 is authorized by law to certify elevation Intorma G2. ❑ A community official completed Section E for a G3• ❑ The following information (Hems G4.-GO.) is pn G4. Permit Date G7. This permit has been issued for. [] New Construo Ga. Elevation of as-buift lowest floor (including basement) G9.8FE or (in Zone AO) depth Of flooding at the building.- . Offiaal's Nang Comments IGINEER, OR ARCHITECT CERTIFICATION (CONTII official, (2) insurance agent/company, and (3)'building owner. TION FOR ZONE AO AND ZONE A here if •E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A. B. Check the measurement used'.- In Puerto Rico only, enter meters. • 1. check the appropriate boxes to show whether the elevation is above or below the highest adjacent space, or enclosure) is ❑ feet ❑ meters ❑ above or El 'below the HAG. ;pace, or enclosure) is ` ❑ feat ❑ meters ❑ above or ❑ below the LAG. 3enings provided in Secii¢n�A items 8 and/or 9 (see a e 8 of Instruction), the next higher floor ❑ feet U meters ❑ above or below the HAG. ] feet ❑meters [] above or. ❑ below the HAG: vicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. e, is the top of the bottom floor elevated in accordance with the community's floodplain management local official must certify this information in. Section G: F OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION who completes Sections A, B. and E for Zone -A (without a FEMA4ssued or community -issued BFE) A, B, and E are correct to the best ofmy IMOWedge. s Name state ZIP Code uaze Telephone G - COMMUNITY INFORMATION (OPTIONAL) iminister the community's floodplain management ordinance can complete Sections A, S, C (or E), item($) and sign below. Check the measurement used in Items G8. and Gg. r documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who 1. (Indicate the source and date of the elevation data in the Comments area below.) ilding located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. tad for community floodplain management purposes. ❑ Substantial Improvement e building: ❑feet ❑ meters (PR) Datum ❑ feet ❑ meters (PR) Datum Jeiephone FEMA Form 81-21 Fahn��.a. onn�