347 GULFVIEW BLVD S ELEVATION CERTIFICATE O M B. No. 3067-0077
FEDERAL EMERGENCY MANAGEMENT AGENCY Expires)uly 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
��oper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).You are not
ed to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form.
Inatructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POIICY NUMBER
STREET ADORESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
l. L � S
OTHER DESCRIPTION{Lot and Block Numbers,etc.)
LO"T'� �8 G� LLD�I D W�t�tE SK�NNE2 S�3 D� ��S�o�
CITY STATE ZIP CODE
c�c�R wk-r��e r..-�R��,� �
SE'�TION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the following from th��.3r�p�r FI�iM (See Instruct��n�):
_.,�..._....,_�.._m.,.,.�.,�m_.m-..,
1.COMMUNITY NUMBER + y� -� a�NE!NI,r�3�.� :t.SUFF�;: 4.G,4TE Of,f:`;":i iNDE:: + �.tIFM°vN� o �ti`' =:�` J : -`JA ;^N �
� � °' � �n 4� Z: „ ..c dv�thj �
I 25 09(� m_ ?oo-m7 �� �u�. �8 ���6�.��, �� � `.�_.___._.__�.1
7. Indicate the elevation da?ur��i �y,�em uset;c�n!he�iRt,A �ot�Bas�Flooa Elevatior,�(�F�}: ��NG'v'd'2� '_ Ot��er j���:criL�on b�c!<)
8. For Zones A or V,where ne �.°F�is provided on the FIRM, and the community has established a SFE far this building site, indicate
the community's BFt:._ __.. .v_:.�._:reet t�t�'V��o► 7;�ier FiFtl�datum—seE :��ciion �, item 7;
— , .�. .._.�..�—� ��C�'14Ai C Bl}dLDING ELEVAi{�N II��s,3RAAAT€uN
1. Using the Elevation Certifica?� instructions, indicate the diagr�m number from th�dia�r�ms�rr+.�r:s�or,�ages 5�n��tii�t"est
�nbes the subject bv��i��s nference l�vsi__.,� .
IRM ZOrteS A1-A3n, r�,s-, :?�-` 1�e1 A(wii[h �rr-�,. i he tnp cf the r�fer�nce le+���ri;a;±'t��;P ti5 ��;�t�8d r?icr$�'3;i� i� :-;�;�,�!:/��,i':i�
of� ' ' � � �.��feet��IU��'� (or c�ther FI�M daturts--see Section B, Item 7).
(b). FIRM Zones V1-V30, V�.,.:�a V(with BFE). The bottom of the lowest horizontal stsucturaf ��n�ber of th�r?fer�nce!�_�:�e�f;urr�
the selected diagram, is?t an eievation of' ' ' ' .''.��feet NGVD (or other FIRM datum—see Sectien B, Item 7;.
(c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is ' .—feet above __ or
below L' (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is � ' !._:feet above - or below� (check
one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference
level) elevated in accordance with the community's floodplain management ordinance? '�� Yes � No J Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:� NGVD'29 � Other(describe
under Comments on Page 2). (NOTE: Il the e/evation datum used in measuring the elevations is different than that used on
the F1RM (see Section 8, ltem 7J, then convert the elevations to the datum system used on the F1RM and show the conve,rsion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: � Yes �No (See Instructions on Page 4)
5. The reference level elevation is based on: i� actual construction ❑ construction drawings
(NOTE: Use of construction drawings is on/y valid if the building does not yet have the reference level�loor in place, in whicf�
case fhis certificate will only be valid for the building during the course of construction. A post-construction Elevafion Certificate
will be required once construction is comp/ete.)
6.The elevation of the lowest grade immediately adjacent to the building is:� I � ' '$'.'4� feet NGVD (or other FIRM�iati,m-see
Section B, Item 7).
� SECTION D COMMUNITY INFORMATION
�ie community official res�o�s�ble for verifying building elevations specifies that the reference level indicated in �erti�n�:, �tem 1
;ot the"lowest floor"as d�sinec� in the community's floodplain management ord�nance,the elevation o�ii��bud�+^a's"��'�vest
floor"as defined by the ordinance is .� 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�equired. �
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 officiai, a property owner, or an
owner's representative may aiso sign the certification.
Reference levei 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, wail 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, must still be entered.
I certify fhat the information in Sections 8 and C on this certificate represents my best eNorts to rnterpret the data availab/e.
1 understand th,at any false statement may be punishable by fine or imprrsonment under 18 U.S. Code, Section 1001.
C�RTIFIER'S NAME UCENSE NUMBER�or Affix Seal)
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TITLE COMPANY NAME
L���D(�__REC�1� TC�2�'� S�RvEYug--�Ih�P��_-�(�m���Fi4iR /•vC,
:1DORESS i,ITY 'STATE Z�p
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SIG�IATURE DATE PHO E
. p,,-►.�� x ,Y,.,,,.r, � �___.�..—._t�,1_2�1�9 f-a..�� ���-�4 S 2
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"::opies shoutd be made o�ihis Gertificate for: 1)com:�unify af9icial, 2j insurance agent/company,and 3)building owner.
�t��AMENTS: ----------------------.__ ____---------------__----
------------>--�---- — –---- -- – -- -- �
ON WITM ON PILES,
SlAB BASEMENT PIERS,OH COLUMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
aEFE?E�+C`c aEFEAENCE
c/F` aA�E LEVEL RE:ERENCE
I �ICOG IEvEL
ELEVATION
1
B�SE BASE
� ADJACENT qEFERENCE F�OpO
F���� GR�pE :EVEL ELEV�7�ON
EtEV�T�Drv REFEAENCE �D�a.CEnT
lEvEl GRnOE
..-'.ADJACENT-.
���� . . . .`.�.:�-. GRADE �.
I
� 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 floor. �
i
! Elevatiors for all V Zones should be measured at the bottom of the lowest horizonta! structurat member. �
�
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