HomeMy WebLinkAbout34-2116-000-0040, dupeit, 4-4 FINAL ELEVATION CERTIFICATE
This certificate shall be submitted for compliance of 1lc3-3f to DERM Flood Plain Management Program to remove FINAL COMPLETIO`
OLD
This certificate will not be accepted if all items are not completed
PROPERTY INFORMATION
(The following information to be provided by contractor, property owner or agent.)
-,I/(P - -
Folio # 30
40 (NOT ACCEPTED wrrHOUT FOLIO) /~/n
Address PROCESS d 3 Permit ~O-660,Al
11"' New Construction Addition, Reconstruction or combination
I certify that the above information represents my best effort to inteTrct the data required. I understand that any work undertaken prior to
obtain a certificate of completion or occupancy will be at the PERMIT HOLDER'S RISK. The County will review the elevation data
submitted. Deficiencies detected by such review shall be corrected by the permit holder immediately and prior to further progressive work
being permitted to proceed. Failure to submit the elevation survey or certificate or failure to make said corrections required hereby shall be
cause to issue a stop work order for the project.
Name:
Phone #
(print)
Date:
(signature)
ELEVATION CERTIFICATE
This certificate is not valid if any items are alter or n9qt co pleted j q _-5A f >0401 2 Of Q 7/.' /ql
Subdivision Name r~G/ 1/ 114- ~~SkOi 1 Lot Blk PB PG
Community #
-Suffix
Panel #
Date of FIRM
FIRM Zone
Base Flood
120635
Y4 Ft. NG"vi,
Using FEMA's Elevation Certificate instructions, indicate diagram found on Pages 5 and 6 that best describes the subject building's reference
level
LOWEST FLOOR ELEVATION (Top Reference level) FT. N . G . V . D .
r
LOWEST ADJACENT GRADE ELEVATION 17, &0 / FT. N.G.V.D.
GARAGE OR STORAGE FLOOR ELEVATION q241 FT. N.G.V.D.
ELEVATION OF HIGHEST CROWN OF ROAD (Fronting Pro rty) FT. N . G . V . D .
5,41 CJ`s
A/C COMPRESSOR (Provide top elevation of supporting structure) • • 9.66
I hereby certify that the informationn on this certificate is true and correct tp tl:e best of my knowledge and belief.
Date ✓ 7 - %r
Certifier's Naive
Phone (Print)
Certifier's Signaturef
Certificate # : _L'; - ,
FT. N.G.V.D.
This form has been approved by The Federal Emergency Management Agency (FEMA) and may be used for flood insurance purposes-
Rev. May 31, 1995/ELEVCERT.195