HomeMy WebLinkAbout34-2109-004-0040FINAL F,LE VATION CEWrIFICATE
Z'ris ;c-ir tr- s!t t 1. ~c milmittr im :~+mliia►n:~ nl l~r_:•~i'ta 4iCE:TJI lid taite l0iarn~getnexet ~'Ctrp;rttrn to rrinove l~AiX1,'L`t~TJtf$ Ei`ION
HOLD
Ibis cedUkale Ivfll not be accen mall heats are not completed
PROPERTY INFOPHATION.
= T--R~__== ho Ibllowing 1100 ma.tion to be provided by contactor, property owner or agent.)
OllO 3 0 - ,;'•'rJ a- %/'i~... = Y 1~ L?„'_"' (Nat' ACCet!f 4 WTI7i0UT f OLtO#) .
Address 2 1Yo Al. Al PROCESS a:
Ho,v Co"Struciion Addition, Reconstruction or aombbuttlon
I certify that the above infotrrtation represents eny best effort to hntetprct the dnttt required. I understand dint any work undortaki6n prior to
obtain a octtlGc-tte of eorttpletloet nr oceupapey will be at the PERMIT FIOLD$R'S PJSK. Tho,Cottrtty will re-41" tho elovidan data
submitted. Detlolencies detected by such review shall be corrrctod by the permit holder immediately and prior to further prograndwa work
boing Irarrr iked to proeoed. Failure to submit the elevation survey or cettitloate or failure to make said corrections required hereby shall be
caut'a to issues a stop work order for Ilia project.
Name:
Date:
({trier() .
Phone b
. (aigiiaturc)
r=>= =__-------_---===~,v ELEVATION CERTIFTCATV
This certifkale is not valld if arty iLeins are altered or not contpfettd. •
Subdivision Naute
Lot Blk PB PG
community #
Suf f ix
Parlel
Uate of FIRM
FIRM Zones
Base Flood.
120635
0080
3 - - ~ ¢
~K t i
MIA Ft. NGvl)
Usistg FEMA's Elevation Certificate botruc(ions, indicate diagram found on Pagcs 5 and 6 Qtat best describes the subject building's refere•nrn
level I
LOWEST FLOOR ELEVATION _ _ . , ('t'op Reference level)' P. Zo FT. N. G. V . D.
LOWEST ADJACENT GRADE ELEVATION 1,04 F'T. N.G.V.D.
GARAGE OR STORAGE FLOOR ELEVATION °u/A FT. N : G . V . t) .
ELEVATION OF HIGHEST CROWN OF ROAD (Fronting Property) /Q. 3 Z FT. N . G . V ..D .
A/C COMPRESSOR (f't•otide top elevaUotr of support)ug structure) Z. FT. N . G . V . D .
I hereby certify that the itnforrttation on this certificate iA true and correct eo tite best or my knowledgo and belief.
Date
Cerlifter's Name:. cx/// Zz ES l/~- e' .eie
Phone 30f;-- Z i? ~e {Fran[)
Certitier's Signature
Cettii'tcate# . 12260
PLS
This form has been approved by 't'he Uc4cml Emergency Management Agaticy (FEMA) and may be used for flood insurance Furpoxcs-•
rte-, May 18, 095111-UEVCERT-195
TO 3Jttd
6066-699-906 bZ:80 L66T/60/60