HomeMy WebLinkAbout34-2117-002-1143FILIAL ELEVATION CERTIFICATE
This certificate shall be submiuod for compliance of 11c3-3f to DERM Flood Plain Maaagement Program to remove FINAL, COMPLETION
HOLD
71ds cert{fcate will not be accepted {/'all items are not completed
PROPERTY INFORMATION
(The following information to be provided by contractor, property owner or agent.)
Folio # 3 0 (NOT ACCEPTED WITIiOUT FOLIOln
.
Address /.S707 N V/ A-7* - A19. PROCESS I. 1AP-1mit ff:q &,7--)
V 'New Construction Addition, Reconstruction or combination
I certify that the above information represents my best effort to,'intcrpr~ct 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 immcdiatdy and prior to further progressive work
being permitted to proceed. Failure to submit the elevation survey or certificate or failure to make said conrctions'required hereby shall be
cause to issue t stop woric order fixghe project-
Name.-
Phone
lQs~' 11 I
(sigrutturo)
ELEVATION CERTIFICATE
This certificate is not valid if. any Items are altered or not completed. .
Subdivision Name VE14F,t(4a ,d am Lot $ Blk S PB4+ PG
Community I
Suffix
Panel
Dateof
FIRM
, Zone
FI
M
Base Flood
120635
0090
;
7-17-
R
/
N/A Ft. NGVD
Using FEMA's Elevation Certificate instructions, indicate diagram found on Pages 5 and 6 that best desenbcs the subject building's micronec
Level
LOWEST FLOOR ELEVATION (Top Refercrtoe Tavel)
q .q 3
FT.
N . G . V . D .
LOWEST ADJACENT GRADE ELEVATION
8,7
FT.
N.G.V.D.
GARAGE OR STORAGE FLOOR ELEVATION
MIA
FT.
N.G.V.D.
ELEVATION OF HIGHEST CROWN OF ROAD (Fronting Property)
8. (o 0
FT.
N . G . V . D .
A/C COMPRESSOR (Provide top elevation of supporting structure)
9.5 3
FT.
N . G . V . D .
I hereby certify that the information on this ccrtiftcate is true and correct to the best of my knowledge and belief.
Date : 1®- ZG° 1 9 Cutifier's Name : Q obri y4L-
Phone or: (30T) Z 3 T-1 S75-0
Certifier's Signature
PLS
Certifteate / 4171
This form has been approved by The Federal Emergency Management Agency (FEMA) and may be used for flood insurance Purlose$-
Rev. May 18, 1995tELEVCERT.195
MAP RMVI SC-®: t~A1ZCP 2, 1994-