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Home My WebLink AboutELEVATION CERTIFICATE 4-12-18zq U.S. DEPARTMENT OF HOMELAN6 iziLCURITY arjANNED ` " OMB No. 1660-0008 Federal Emergency Management Agency �� Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATI'6ICATE Important: Follow the instructions on pages 1-9. Coov all naaes of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. C15855 v SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: CHARLES BELLEFLEUR A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 133 NETTLES BOULEVARD City State ZIP Code JENSEN BEACH FL 34957 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 133, SECTION II, OUTDOOR RESORTS OF AMERICA AT NETTLES ISLAND, according to the Plat thereof, as recorded in Plat Book 16, Page 1, 1A throw h 1J A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°17'10.99"N Long. 80°13'34.87"W Horizontal Datum: ❑NAD 1927 ENAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 660 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 3 c) Total net area of flood openings in A8.b 2052 sq in d) Engineered flood openings? ❑Yes ENo 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 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes ENo SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State 120285 ST LUCIE CNTY UNICORP ST LUCIE Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number J Date Effective/ AE (Zone AO, use Base Revised Date Flood Depth) 12111CO311 2/16/2012 2/16/2012 (6) (10) NAVD88 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑FIS Profile EFIRM ❑Community Determined ❑Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 ENAVD 1988 ❑Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes ENo Designation Date: ❑CBRS ❑OPA FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 1 of 6 GI =VATInN C_FRTIFIC:OTF OMB No. 1660-0008 Expiration Date: November 30, 2018 C15855 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: 133 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH FL 34957 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑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 AT In Puerto Rico only, enter meters. Benchmark Utilized: A-05 RMZ=.93 Vertical Datum: NAVD 88 Indicate elevation datum used for the elevations in items a) through h) below. ❑NGVD 1929 NNAVD 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) 4.92 ®feet ❑meters b) Top of the next higher 7.38 ®feet ❑meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ®feet ❑meters d) Attached garage (top of slab) N/A ®feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 6.42 ®feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 4.70 ®feet ❑meters g) Highest adjacent (finished) grade next to building (HAG) 4.80 ®feet ❑meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A ®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. best to interpret the data available. I understand that any false I certify that the information on this Certificate represents my efforts 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? NYes [:]No ®Check here if attachments. Certifier's Name License Number 'AJ o Kenneth J. Osborne 6415 t% F I c ae o o No.6415 F Title Registered Professional Surveyor r F 9 A � Company Name COMPASS o n Ix N Address 6250 N Military Trail #102 s, STATE OF e, ° �� g Z o R s ID f. ` City State ZIP Code West Palm Beach FL 33407 s u A Signature Date Telephone 12 3/29/2018 561)640-4800 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) C2:E= AC EQUIP LAT AN DLONG PROVIDED BY GOOGLE EARTH FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Nage z of b RI FVATInM C.FRTIFICATF OMB No. 1660-0008 Exairation Date: November 30, 2018 C15855 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: 133 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH FL 34957 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, crawlspace, 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 BFE) Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. community -issued or 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 (7/15) Replaces all previous editions. Form Page 3 of 6 CI C%IATIf%Kl f_<=QTIGIf_AT= OMB No. 1660-0008 Expiration Date: November 30, 2018 C15855 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: 133 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH FL 34957 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. G3. ❑ The following information (items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑New Construction []Substantial Improvement G8. Elevation of as -built lowest floor (including basement) ❑feet []meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: ❑feet ❑meters Datum G10. Community's design flood elevation: ❑feet ❑meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑Check here if attachments FEMA Form 086-0-33 (7/15) Replaces all previous eaitions. rul i ll raac -* V BUILDING PHOTOGRAPHS OMB No.1660-0008 CI C%/ATlf%kl t%=0TIGI(_AT1= r:nntinllatinn Pane Exeiration Date: November 30, 2018 VV5—..1I 5%05V ..r.... C15855 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: 133 NETTLES BOULEVARD City State ZIP Code Company NAIC Number JENSEN BEACH FL 34957 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. , i 7ffi I I: af� . Photo One Caption SIDE VIEW `f� B r F AA. gcWJ� I F Photo Two Caption REAR VIEW FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6