HomeMy WebLinkAboutElevation CertificateU.S. DEPARTMENT OF ÈOMELAND SECURITY
Federal Emergency Management Agency
Na{ional Flood lnsurance Program
ELEVATION CERTIFICATE
lmpodant: Follow the lnstructlons on pages 1*9
Copy all pages of this Elevation CertilÌcate and afl attachments for (1)community offìoial, (2) insurance agent/company, and (3) building owner
OMB No. 1660-0008
Expiratlon Detel Novembor 30' 2018
FOR INSURANCE COMPANY USESECTION A - PROPERTY INFORMATION
cy
ÑETN tJ?A1 mgNaOwner's
UA
Company NAIC Number:and/or Bldg, No.) or P,o, Route andApt,, Unlt
State ztP
CD
42. Buildlng Slreet Address
Box No,
Num
,4,J
Description (Lot and43.Property r, Tax Parcel Nurnber, Legal Description,etc.)
z 4 4-A-)
A6. Attach at least 2 photographs of the buildlng if the Certlflcate is being used to obtain ilood insurance
A7. Building Diagram Numþer C Z - el
b) Number of permanent flood openlngs in the crawlspace or enclosure(s) within '1 '0 foot above adjacent grade
c) Total n€t area of llood openings in A8'b '.----_- sQ in
d) Engineered flood openings? [ yes f] ruo , t'
49. For a bullding with an attached garage:
a) Square footage of attached garage sQ ft
b) Number of permanent llood openi'þs ln the attached garag€ within 1'0 fool above adJacent grade
sq ft
sq rn
fiuno reas3q, /l I ll?7
Addition,B Use Non-Residenllal,Residential,A4.uilding (e.s'o
LongLat.Latitu de/Longitude:A5 Datum: I NAD 1927
c)T flood openings ln A9.b
AB. For a building wiih a crarrylspacç qr enolosure(s):
a) Square footage of crawlspace or enclosure(s)
flYes n No
B - FLOOD INSURANCE RArE MAP (FIRM)INFORMATION
83. S{ate
ECÒ
82,
-t
Name
,Q-
munity Nurnber
BB. Flood
Zone(s)
A'l
89. Base Flood Elevalion(s)
(Zone AO, use Base Flóod DePth)
6, lo\"9'
87. FIRM Panel
Effectlve/
Revísed Date.
86. FIRM lndex
Date
B4
gI
B
B
B ls the buildlng located in a Coastal Barrier Resources Syslem (CBRS)
Designation Date:- n CBRS n OPA
es:$evo
Y"" Ñ,
flood lnentered ao,ItemordatabaseElevatlonoddepthBaseFloFE)(B
Other/Sourc€nedDeterm nCommunityISFtrn
SBB Other/VDNA929 Source:trnItemlnuseddatumBFEforelevatloncatelndi1
ProtectedOtherwlse Areaorarea (oP úA)?
FEMA Form 0S6-0-33 (7i15)Replaces all previous edilíons'Form Page 1 of 6
information from $ectlon A.R RANCE COMPANY USE
MPORTANT:ln those s the co rr06
(includ ing Apt.,Unit,Suite,and/or Bldg No.)or P .o.Route and Box No.Policy Number:
Building Street Add ress
ztP
CitY EI
cïo N c B U¡LD IN G ELEVATION INFO RMATIO N (su RVEY REQU RED)
SE
C1. Building elevations are based on Drawings*Building Under Construclionr fl finisned Construction
*A new Elevation Certificate will be when construction of the bulldlng is complete'
V1 V30, V (with BFE),AR, AR/4,ARyAE, AR/41-430, AR/AH, AFyAo'
diagram sPeclllod ln ltst rr 47. llr Puarto Rico only, ontor meters.
Vertlcal Datum:Et btqz, La+ NG va 21
for the elevations in items a) through h) below'
ffltovo t
Datum usbd for bu
929 NAVD 1988 Other/Source:
ilding elevations must be the same as that used for the BFE'
Check the measurement used
a) Top of bottom floor (including basement' crawlspace' or enclosure lloor)101"5 feet ! meters
b) ToP of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (toP of slab)
")('8y,îîrîi3:"ii:liìff#Î,i?.i'Ê::l''"îÎltï'Ï1Îålg.Ji"buirding
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
I feet I meters
I feet flmelers
I feet f] meters
,KF
n
feet I meters
feet I meters
feet fl meters
h )Lowest adjacent grade
structural suPPoft
at lowest elevation of deck or stairs,ncluding feet n meters
SECTION D SU RVEYOR,E N GIN EE R,OR ARCHITECT CE RT¡FICATION
to certifu elevation information
t underdtand that anY false
tr Check here tf attachme nts
Name License Number
I fre*
Address 3 e e-z0 I
79^tx MZExt.77-Signature
ownerbuildingand(3)nsu rance nlcompanymcomofficial,agefor(2)ments unityattachall(and
type ofCom location, Per C2(e),if applicable)
OMB No.
Expiration
1660-0008
Date: November 30,201E
ELEVATION CERTIFICATE
FEMA Form 086'0-33 (7/15)Replaces all Previous edilions Form Page 2 of 6