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See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
5912 SEAGRAPE DRIVE
City FORT PIERCE State FL ZIP Code Company NAIC Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
FRONT VIEW TAKEN ON 3/09/07
SCANNED
By
St. Lucie
County
REAR VIEW TAKEN ON 3/9/07