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Home My WebLink About0804-0166 ELEVATION CERTIFICATE16 ° Iow "Na `- NANNEDQV ! ` U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIf=1CATEt uCle Co ►FMB No.1660-0008 Federal Emergency Management Agency Expires February 28.2009 National Flood Insurance Program Important: Read the instructions on pages .1-8. A2. SECTION A - Unit, Suite, and/or Bldg. No.) or P INFORMATION Route and Box No. Aa. Building Use (e.g., Residential, Non -Residential, Addition, Accessory,. etc.) Fr °LS t 1Jl.t`1-1r t - A5. Latitude/Longitude: Lat ?_1.44$I_ S d Long. - UL 14 Horizontal Datum: ❑ NAD 1927 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used'to obtain flood insurance. A7. Building Diagram Number_ A8. For a building with a crawl space. or endosure(s), provide: Ag. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) LJL sq ft a) Square footage of attached garage b) No. of permanent flood openings in the crawl space or Nosq ft ) endosure(s) walls within 1.0 foot above adjacent grade �� b . of Permanent flood openings in the attached garage C) Total net area of flood openings in A8.b walls within 1.0 foot above adjacent grade I. & -A, 4A_ sq in c) Total net area of flood openings in A9.b -La /A,_ • sq in B11. B12. SECTION B - FLOOD INSURANCE RATE MOP 16:10 ut uuenoiueTinuj Indicate elevation datum used for BFE in Item B9: `C�NGVD 1929 u vu'c' �u��nael Is the building located in a Coastal Barrier Resources System (CBRS) as or Otherwise Protected Are1988 Other a (Describe) ❑Yes y�No Designation Date CBRS OPq 5ECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: • lJ Construction Drawings' ❑ Building Under Construction' Finished Construction A new Elevation Certificate will be required when construction of the building is complete. 02. Elevations —Zones AlA30, AE, AH, A (with BFE) below according to thee , VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/AlA30, AR/AH, AR/AO. Complete Items C2.a-9 building diagram speafied in item A7. Benchmark Utilized h Conversion/Comments P%UhVertical Datum . ► C. 1.1, _ . E _ T1 Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) El Top of the next higher floor meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) `❑feet ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machine or —❑ feet ❑ meters (Puerto Rico only) (Describe equipment machinery equipment servicing the building _Q. feet ❑ meters'(Puerto Rico only) type of a ui mart in Comments) Y) 0 Lowest adjacent (finished) grade (LAG) 9) Highest adjacent (finished) grade (FLOG) �Lf i�t ❑ meters (Puerto Rico only) _ .�[-Meet ❑, meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized b law to certify information. I certify that the information on this Cerocate represents my best efforts to interpret the data ova�eevation J understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Certifi :i's Name ;PLA�CE E E License Numb JdUE Title �' r V L'cT YS tl.A �5�_ SIGN,4T , t Company Name LATE HERE " Address City State' ZIP Co a �JA4 .4 SS7 Signature Date - '9 - 14 - O 1b A- I4 O Telephone FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPO'gNr. I' n City C � 'b.9 i .wCeil• •.�.... W•s�^�t�^. .�•"". fj t Tr4g: i�ci3 -�`4 o°' <,. J the Icoffftpo::1 g' information from Section A. ="�,,anr Bidg. No.) or P.O. Route and Box No. Fc Pc State ZIP Code f t ,tcTION D - SURVEYOR, ENGINEER, OR'ARCHITECT CE(CQNTII Comm Copy both sides of this Elevation Certificate for (1 j co RTIFICATION munity official, (2) insurance agent/company, and (3) building owner. enrts .Insurance Company use: Ovate, SECTION E -BUILDING ELEVATION INFORMATfON (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE ❑ Check here if attachme For Zones AO and A (without BFE), complete Items E7-ES if the Certificate is intended to supportA (WITHOUT BFE) and C. For Items E1-E4, use natural grade, if available. Check the measurement used: in Puerto Rico only, enter meters. a LOMA or LOMR-F request, complete Sections A, B, El. 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, crawl space, or enclosure) is ❑ b) Top of bottom floor (including basement, cxawl space, or enclosure) is feet meters ❑above or E2. For Building Diagrams 6-8 with permanent flood openings provided in Secti A Items 8 and/or 9 (see a' e 8 of In ❑ below the HAG. ❑ that ❑'meters❑above or ❑ below the LAG. (elevation C2.b in the diagrams) of the building is _ E3. Attached Instructions), the next higher floor garage (top of slab) is ❑feet meters ❑ above orbelow the HAG. E4. Top of platform of machinery and/or p ❑ feet ❑ meters [] above or. ❑ below the HAG. is ES. Zone AO only: If no flood depth n ber'is availaservicing ise tobuilding bottom floc ❑ feet ❑meters ❑ above or ❑ below the HAG. ordinance? r elevated in accordance with the community's floodplain management Yes ❑ No ❑ Unknown. The local official must certify this information in, Section G; SECTION F - PR The property owner or owner's authorized repn orZone AO must sign here, me statements in ProPertY Owner's or Owners Authorized Repre Address vmcra, wno is authorized by law or ordinanc and G of this Elevation Certificate. Complete the app G1, ❑ The information in Section C was taken fror is authorized by law to certify elevation info, G2. ❑ A Community official completed Section E fc G3. ❑ The following information (Items G4,-09.) is G4. Permit Number GS. Date P G7. This permit has been issued for. ❑ New G8. Elevation of as=buift lowest floor (including b; G9. BFE or (in Zone AO) depth of flooding at the Local Officia—PS" are Community Name Signature :k Comments f OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION Who completes Sections A. B, and E for Zone'A (without a FEMA-issued or commun*Iss A, 8, and E are correct to the best of my knowledge. ued BFE) s Marne Date G - COMMueoTV rues State Telephone Code able item(s) and sign below Chedr the measugreme�t °u an k items I w anld G9.e�ons A, B. C (or E), other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who ration. (Indicate the source and date of the elevation data in the Comments area below.) a building located in Zone A (without a FEMA-issued or communfty-issued BFE) or Zone AO. 1170vided for community floodplain management purposes. mit Issued. G6. Date Certificate Of Compli�ce*cc�upancy ssued *on ❑ Substantial Improvement 1 of the building: ❑ feet ❑ site: meters (PR) Datum ❑ feet ❑ meters (PR) Datum + e+epnone FEMA Form 81-37, February 2006