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BOARD OF COUNTY
COMMISSIONERS
PUBLIC WORKS
CODE COMPLIANCE
DIVISION
In accordance with participation in the NFIP/CRS program, all elevation certificates are required to be reviewed for correctness and
completion prior to acceptance by the community. This completed form shall be attached to all elevation certificates maintained on Ole
and provided with requested copies of elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to
acceptance by the community.
The attached elevation certificated Is complete and corecL SCANNED
X Minor corrections have been made in the below marked sections by the authorized Community Official. BY
St. Lucie Co a
SECTION A- PROPERTY INFORMATION For.InsuranceCompany Use:
Al. Building Ovmefs Name - Pdtcy Number
Earl Ta for
A2. Building Street Address (Including Apt., Unit, suite, and/or Bldg. No.) at P.O. Route and am No. Company NAIC Number
A4. Building Use (mg.. Residential, Non-ResEdenllal, Addition, Accessary, etc.) Residential
A5. Laetuded.or dude: Lai. Lang. Horizontal Datum: ❑ NAD 1927 ® NAD 1983
As. Attach at least 2 photographs of the building If the Certinculo to being used to obtain good Insurance.
AT Budding Diagram Numbrfl_
Ali. Far a budding wish a cmW space or endasure(s), provide: AS. For a building with an attached garage, provide:
a) Square footage of crawlspacear endosure(s) NIA sq it a) Square footage of attached garage 374 sq it
b) No. of permanent gaud openings in lho crawl space ar b) No. of permanent flood openings in the attached garage
enclasum(s) wags within 1.0 foot above adjacent grade NIA wells within 1.0 foot above adjacent grade N/A
a) Total net arso of flood openings in A8.b N/A sq in c) Total net area of (food openings in A9.b N/A in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
04. Map/Panel Number
05. Suffix
Be. FIRM Index
B7. FIRM Panel
08. Flood
as. Base Flood Elevations) (Zone
Date
Effective/Revised Dale
Zones)
AO, use base no deplls)
1
12111CO281
G
6-30-99
H
17,0
B10. Indicate the source of the Base Flood Elevation (BFE) data at base Road depth entered In Item B9.
❑FIS Profile ®FIRM ❑ Community Determined ❑ Other (oescdbo)
911. Indicate elevation datum used far FIFE in Item 89:®NGVD 1929 ❑NAVD 1988 ❑ other (Describe)
B 12. Is the building located Ina Coastal BarderResources System (CBRS) area or Otherwise Protected Area (OPA)? El Yes ® No
Designaean bate ❑ CBRS ❑ OPA
COMMENTS: B12 filled out.
Community Official: X.
Date of Review: (,_ /
All elevation certifrcales shag be maintained by the community and copies with the attached memo made available upo request.
IOSEPH E. SMITH. District No. 1 • DOUG COWARD. District No. 2 • PAULA A. LEWIS. District No. 3 • CHARLES GRANDE. District No. 4 • CHRIS CRAFT. District No. 5
County Administrator - Douglas M. Anderson
2300 Virginia Avenue • Fr. Pierce, FL 04982
Permitting and Zoning: (772) 462-1553 FAX (772) 462-1705
Contractor Licensing: (772) 462-1672 • Code Enforcement (772) 462-1571 • Inspections: (772) 462-2165
Fax: (772) 462-1148
www.co.sr-lucle.fl.us