223 PALM ISLAND NW, LOT 58, UNIT 6C ELEVATION CERTIFICATE O.M.B. No. 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waivar of the flood insurance purchase requirement.This form is used only to pro-
vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine
the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).You are not
.equired to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form.
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING OWNER' NAME POLICY NUMBER
v�� o VEnn�E BEK�►�t
STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
ZZ L nl . M/.
OTHER DESCRIPTION(Lot and Block Numbers,etc.)
�-r 56 . u��T �� . �s���� EsrarEs o�. �c.�r��w�tTEK.
CITY STATE ZIP CODE
GLEA(ZW qT�1�., �.. 3¢�3-0
SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the foliowing from the proper FIRM (See Instructions):
1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION
(in AO Zones,use depth)
��,y�g� 0007 � e-i�-9�- �h � i2.�
7. Indicate the elevation datum system used on the FIRM for Base Fiood Elevations(BFE): I-I NGV ac
8. For Zones A or V,where no BFE is provided on the FIRM, and the community has established a �f r I 'd te d te
the community's BFE:I I I I I I.0 feet NGVD (or other FIRM datum—see Section B, Item 7)
SECTION C BUILDING ELEVATION INFORMATION MAY
1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams foun c�P ��NT SVCS
describes the subject building's reference level�1_ . C�TyQ�GLF�IRWATER
�a). FIRM Zones A1-A30,AE,AH,and A(with BFE). The top of the reference level floor from the s i a an e eva ion
of I I�.�feet NGVD(or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1-V30, VE, and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of�J.0 feet NGVD (or other FIRM datum—see Section B, Item 7).
(c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is W.U feet above❑ or
below❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The filoor used as the reference level from the selected diagram is ��.U feet above❑ or below❑(check
one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference
level)elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:�'fVGVD'29 ❑ Other(describe
under Comments on Page 2). (NOTE: If the elevafion datum used in measuring fhe elevations is different than that used on
the FIRM (see Section B, Item 7J, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: �Yes ❑ No (See Instructions on Page 4)
5.The reference level elevation is based on: �actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if ihe building does not yet have the reference level floor in p/ace, in which
case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate
will be required once construction is complete.)
6.The elevation of the lowest grade immediately adjacent to the building is:I I�.0 feet NGVD (or other FIRM datum-see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
�s not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest
�or"as defined by the ordinance is: � � � � � �.U feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement .
FEMA Form 81-31,MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones A1—A30,AE, AH, A(with BFE),V1—V30,VE, and V(with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the �
certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a building official, a property owner,or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8- Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, rpust still be entered.
1 certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data availab/e.
I understand that any false statement may be punishab/e by fine or imprisonment under 18 U.S. Code, Section i001.
CERTIFIER'S NAME LICENSE NUMBER(or AHix Seal)
L�RIZ L. E�A�S 2�3�
TITLE COMPANY NAME
��R�Eyo,� �v�,�s ��o �����y ,��� 1N� .
ADDRESS CITY STATE ZIP
2l9� M�1�J �r• UN(T' -�{� DU�1 ED 1�, .�.. 3 y �y e
SIGNATURE _D — DATE �ONE 73 `�8 Z�
Copies should be de of this Certificate for: 1)community official,2) insurance agent/company,and 3)building owner.
COMMENTS:
•
ON WITH ON PILES,
SLAB BASEMENT PIERS,OR COi.UMNS
A V A A V
" ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE BASE LEVEL REFERENCE
LEVEL FLOOD � LEVEL
ELEVATION
t
...,:.:�._,.:.....,�..,. .........:.:..:...........�::::.. .
BASE
BASE ���+�>�''1�:,��. �pOJACENT��:i� REFERENCE FLOOD .
FLOOD � EIEVATION
GRAOE LEVEL
ELEVATION REFERENCE ADJACENT
LEVEL GRADE
� m ���:'ADJACENT?.
.:�::�::,:...�.:::�::'.::.:':::;:�.:�,f1:;:::� GRADE �.
t'':�`;'.ti'.IT{/i��".i.`.i'.`.::?:'.:Y::�'..i:::;':)�lR1�:'�::.; ..
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level tloor. � � (� (� � (�] �
V ��, v
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural
. � � [1
Page 2 ;����E�,;���E`i�1_C)PMENT Si/�S
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