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HomeMy WebLinkAbout34-2116-004-0010, dupe= ..AO FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE ,nportant: Read the Insi SECTION A - PROPERTY BUILDING ADDRESS (including Apt., Unit, Suite, and/or clM,A Bf-e CC (e.g., Residential, Non-resider Esr of /V7"114 C_ ms on pages 1 - 7. R INFORMATION ROUTE AND BOX NO. STATE FL ri lion, etc.) LASS D ments area, If necessary.) O.M.B. No. 387-0077 Expires December 31. 2005 .use. • : < ZIP CODE ✓~p5'f nvReLVF4 I AL UA I UM: SOURCE: LJ GPS (Type): ( - #+K' -Y or L NAD 1927 LJ NAD 1983 LJ USGS Quad Map L Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY w Iu1aro on ..r., 2 t~ ✓ - 41A11 t ed3Q;O, ' ' 163. STATE M/ A Aoll rDAOE NUMBER ~m rANt~ B8 . FLOOD 9BFLOOD EION(S) 12 D ZS C - Q©0O EFFTEVISED DATE ZS) use depth of Hooding) 17 9Z - 9f B10. Indicate the source of the Base Flood Elevatlon (BFE) data or base flood depth entered in B9. 1_J FIS Profile J?9 FIRM L Community Determined LJ Other (Describe): B11. Indicate the elevation datum used for the BFE In B9: 12!Q NGVD 1929 U NAVD 1988 U Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? I._J Yes No Designation Date: ,1 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: JJConstruction Drawings' LJBuilding Under Construction' ><Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number _ I (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, A;,/AO Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum &j Y D Conversion/Comments Elevation reference mark used Al- 4s~ S -Does the elevation reference mark used a ppear on the FIRM? U Yes No 13 a) Top of bottom floor (including basement or enclosure) S ft-(m) ❑ b) Top of next higher floor ft.(m) ❑ c) Bottom of lowest horizontal structure ember (V zon only) e4 ft-(m) ~l N ❑ d) Attached garage (top of slab) C" _ gyp, 9 ft.(m) S ❑ e) Lowest elevation of machinery and/or equipment 1 servicing the building (Describe in a Comments area.) 9 ft. (m) 13 0 Lowest adjacent (finished) grade (LAG) - ti ❑ g) Highest adjacent (finished) grade ,.zft.(m) z (HAG) '140 -C ft.(m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adja nt grade _ .t ❑ i) Total area of all permanent openings (flood vents) in C3.h , in. 0 sq. (sq. cm) 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. I certify that the information Ir Sections A, B, and C on this certificate represents my best efforts to Interpret the data available. I understand that an false statement may be punishable b fine orim Imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME 0ARY B. CASITEL LICENSE NUMBER Z 9 TITLE 04129 COMPANY NAME GARY B. CASTEL SURVEYING +A r t3 - FL cIr WUE 33 1-0 8 SIGNATURE DATE TELEPHONE - 9 -!2 - 03 3~f =t.r3 - 97Lo FEMA Form 81-31, JUL 0 OSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS J IMPORTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Including Apt., Unit, Suite,end/br Bldg. No:) OR P.O: ROUTE AND BOX NO. a r.~-i c•e•~t CITY STATE ZIP CODE SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner. COMMENTS 1_1 Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as'supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately'represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I ) I ft.(m) I I lin.(cm) [__j above or " below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is L--I_I ft.(m)1 I lin.(cm) above the highest adjacent grade. Complete Items C3.h and C3.I on front of form. E4. For 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? I_I Yes I-I No I-1 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. C (Items C3.h and C3.i only); and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS I-1 Check here if attachments 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. G1. I_I The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. I_I 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. i_j The following information (Items G4-G9) is provided for community floodplain management purposes. G7. This permit has been issued for. U New Constnxttion U Substantial Improvement G8. Elevation of as-buiR lowest floor (including basement) of the building is: _ fL(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site Is: _ fL(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS I I Check here if attachments FEMA Form 81-31, JUL 00 _ REPLACES ALL PREVIOUS EDITIONS