HomeMy WebLinkAbout34-2116-014-0200FINAL ELEVATION CERTIFICATE
This ce silicate shall be submitted for compliance of 11c3-3f to DER,'vl Flood Plain Management Program to rcmove FINAL CONTLET10N
HOLD
This certificate will not be accented if all items are not completed
PROPERTY INFORMATION
(The following information to be provided by contractor, property owner or agent.)
Folio n 3o - - Z6 I 0 -~d D (NOT ACCEPTED WITHOUT*
THOUT FOLIO
PROCESS n ~1,5_32
New Construction Addition, Reconstruction or combi ation
9141 ga 2_3
. ernlit is -
I ecr,:r~ that the above information rep resents my best effort to interpret the data re ui:ed. I unde stand that any re; < undertake t prior to
ootam a ce uficate of completion or occupancy will be at the PER -i HOLDER'S RISK. The County wiJ7 review the elevation data
sub,-=td. Deficiencies detected by such review shall be corrected by the pemnit holder immediately and prior :o -;J her progressive •«o:s
being PtnniCed to proceed. : aiiu-- to submit the elevation survey or certificate or failure to make said cor."°. ctiors rt uired hereby shall be
cause to issue a stop work order for the project.
Date: 4
i- (,prat)
Phcre > ci ,
(srgmature)
ELEVAm_OZ`I CERT i F.'.. T r-
Tais c :-,f;cate is not -valid if any items are altered or not comple?ed. ~
Su'- C-21
CCiazun~ ty T_,. c~ f~? x Panel j Date of r n iR?_ Zer_e i 5a r iecc
~iG635` 0C> 6 ?j NCVT
Using FEMA's Elevation C:.rtiflcate irstrictions; indicate diagr
arn round on Pages 5 and 6 that best describes the subject building's refererce
level '
LOWEST FLOCK EL Ezi T ± ON . , (Too Reference level) t
; T : N . G . V . D . .
LOWEST ADJACENT GRADE ELEVATION ~4-
l T < N . G. V. D. .
C11U.,GE OR STORAGE, FLOOR ELEVATION
.ELEVATION OF HIGHEST CROWN OF. ROAD (Francine P*oo,y).. `o
N . G . V . D .
A/C-COMPRESSOR (Provide top elevation of supporting structure). , . 6,1S
FT., N.G. V. D.
1 herby certify that the infors^atlon on this cc tif1cate is arse and correct to the best of my knowledge and beiief
Date C~ tl~r~fl - !pfl II'Ir~sal 'PiI~ r u;. , r J -
C
ifi
'
N
'
'
'
`
-
~
ert
er
s
it
ame: dw:v~E
G_
1 s
iSG
v~
;Z 1
Phone ~ is Lam, Zi II
(p:17C)
(
L.....
Signature <
-
I
I
Carltlcste~ >g= PL•S
This form has been approved by The Federal Emergency' Management Agency (FE\1A) and mil be used for mood
insurance purposes-
Rev. May 31, 1995rELEWERT.195