38 SEAGRAPE CIR _
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�L.EVATiON CERT'lF1CA'TE ����
RECERAI.QMERQENCY MANAtLEiM1ENT At�ENCY ��"�'11•��
� NATIONAl. FLA00 lN8U:3ANCE PROQRJIM
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�� O�CTlON C �UILDIN�ilLIIV�TION pitORYATION �,,:
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u+�sN.a�d�m,�s�w+�ot W.11J.0 aa trovo ta eaw�e�+-.�e s.�on a�n�1.
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a TM�hvadon o�tM�ow.a�.ao knn+�dt:ay adjacent ro�+e buM�np is;LLl_Ll?1.l$I t..:tV6vo(or olAer Ft�+i e�s.o -
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SECTION D C:.1�tl�llli�TY lNFORlNATION
1.ff�t o��nip►olbdai t�onsl�!or w�►k�p�n4�I�stions s�do�s tf�Q+�+�l�e�e+o�Ifwii 4�eiaA�4�e110A i:.;�1�t
b�not iM'fo�w�se ibor"as dMk+�d in�oo�a�x�'s�aodp4ln�n�aq�e�o�o�,��Iwa�ion d Iht biiei�lt"bw�`st"�;�
• bo�'as dMlrKd b�r�or�d4~ano�4: �L1._L�J.0 te�t i�iGVD(a otl+K FlRrd dsc�un-�s��S�tion B.1t�n+�.
�.Wh of ZM�but o�eonsbuetion a suDstanli�l keprovaen�nt
FI�fA fotm i1�11.MAR!7 �fMC�S/ttl KtEV10lRt EOrt10lZS SfE�fYESSE SOE iOR t�tilNUAl10N -
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. SECYION� CER'nFICAYI�N
. This CGrtiflcatbn is tc bo algn�d by a tand surveya,enpineer,or architect w�o is authorized by stata or local law to csrtify elevation
inhxmation wAan Ihe elevation informadon!or 2ones At-A30,AE,AH.A(with BFE),V1-V30,VE,and V(with 8FE)is roquired.
rommu�ity oMicials whd are autho�ized by bcallaw or ordinancs to provida�loodplain manapem�nt into►mation,may a(so stgn ths
CenificaGon. tn thv case of Zones/10 and A(without a FEMA or communiry issued BFEj,a bulid�g 016ciat,a ptoperty owner,or an
owner'a hprosanta��ve may at�o dfln the certificatlon.
Refsrana lsvel diapramt 6,7 and B•Disdngulshinq Features�tf the uNOer Is unable to certify to breakawsy/non-breakaway wa�.
�ncbsure slz�,Ia�Bon ot ien+ldnp equlpman�area use,wan apentngs,or unnnished area Featurs(s),then G.st the Festur�(s)not
tndudod h the Cemficaqon under Comments betow. 7hQ dlaflram number,Section C,Item t,must sdll b�entered. i
!cKdly that the Infamabon in Sectlorts B and C on thJs cerNdcata re�resants my besr ellorts to lnterprst fho�h�av��7sb�s.
t trndentand that arty t�dss state�nent may be punishable by f,ne or imprr'sonment undsr f 8 U.S.Cods,SrctlOn 100f,'
1U��t1�.�a,�.J E. �S'�,•JIC;�rS r`�'b�. S7zv
CEATtf�ER3 NAME l►CENSE NlJMBfA(a Axlc S�aq �
-J� N r,c,�Ac�� �Ati1W��NR 1�Le.
T1T�E COASPANY NAAIE ��N��S��! �f
1 ' � zn La�� �' �2 � 3`�'
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�13-99� - 2�so
i�ONATtME DATi MONE �
Copte=should be tnade o(thls Certlflcste for:1)comm�ntt�r efneiil,2y Insurence agenvcomp�ny,and 3)bulldln9 own�: �`��
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�7r�rA.�c �Od� �.1�.�IAki� y £�•O �
COMDNENTS: -
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o`�i� wrtN oN�ats, k
su� �ttvnrt rma�at eotu�ws
A V A • V —
ZOHti 20hl3 lONEf 20N[S 20NES�
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Th�daflnms sbove illustrate ths poinls at whkh tha elevatlon�should be mQUUred ln A Zones and V 2ones.
E�Eiont lor aq�A Zone=should b�measu►�d�t the top ol th�nlerond�I�wl tloor.
ENvO ( sq,..Y Zon�a shoub be msuurod at the bottom of the towsst horizontal atructural member, ,
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l'1 � l 6 � � �Z ELEVATION CERTIFICATE O.M.B. No. 3067-0077
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F E D E R A L E M E R C a E NCY MA N A C a E M E N T A G E N C Y �p��e s J u l y 3 1, 1 9 9 9
� � NATIONAL FLOOD INSURANCE PROCRAM
. . ATTENTION:Use of this certificate does not provide a waivar ot the flood insurance purchase requirement.This form is used only to pro-
vide elevation intormation 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 ot Map Amendment or Revision(LOMA or LOMR).You are not
required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner ot this form.
inatructiona tor completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION Foa iNSUw�,NCe connPnrvv use
BUIl01NG OWNER'S NAME POLICY NUMBEFi
STREET ADDRESS(Inciuding Apt,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPAtvY NAIC NuMeER
3 8 �E.�, 0� � �c\�
OTHER DESCRIP710 (LOt and Block Numbers,etc.)
�ldQ. C� �1N,�- -�
CITY STA E �, ZIP CODE
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SECTION 8 FLOOD INSURANCE RATE MAP(F1RM)INFORMATION
Provide the following trom the proper FIRM(See Instructions):
1.COMMUNITY NUMBER 2.PANEI NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE fLOOD ELEVATION
(in AO 2ones,use deptti)
12so9� Do► � �u rq 19g� �� IC�
7.Indicate the elevation datum system used on the FIRM for Base Floo Elevations(BFE): �NGVD'29 ❑Other(describe on back)
8.For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site,indicate
the community's BFE:�J.—l__�_iJ.0 teet NGVD(or other FIRM datum—see Section B,Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1.Using the Elevation Certificate Instructions,indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level �7
2(a).FIRM Zones A1-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation
oF_..i__''•.�.1�.lL 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 reterence level from
the selected diagram,is at an elevation of I l l I I I.0 feet NGVD(or other FIRM datum—see Section B,Item 7).
(c). FIRM Zone A(without BFE). The floor used as the reterence level from the selected diagram is � �.J feet above� or
below� (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 Ll�.�feet above� or below](check
one)the highest grade adjacent to the building. If no tlood depth number is available,is the building's lowest floor(reference
level)elevated in accordance with the communiry's floodplain management ordinance? � Yes ❑ No � 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: If the efevation datum used in measuring the elevations is dif/erent than that used on
ihe F/RM (see Section B, Item 7J,then convert the elevations to the datum system used on the F/RM and show the conversion
equat;on 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:�ctual construction ❑ construcUon drawings
(NOTE: Use o!construction drawings is only valid if the building does not yet have the refe�ence level Iloor in place,in which
case this certificate will only be valid lor the building during the course ol construciion. A post-construction Elevation Certificate
will be requi�ed once construction is complete.)
6.The elevation of the lowest grade immediately adjacent to the building is:�L.� feet NGVD(or other FIRM datum-see
Section B,Item 7).
SECTION D COMMUNITY INFORMATION
1.If the community official responsible for veritying building elevations specifies that the reference level indicated in Section C,Item 1
is not the'lowest floor"as detined in the community's floodplain management ordinance,the elevation of the building's"lowest
floor'as defined by the ordinance is: �1J.0 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 REPt.ACE5Al1 PREVIOUS EDtTIONS SEE REVfRSE SIDE FOR COrli1NUATION
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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 otficials who are authorized by local law or ordinance to provide floodplain management information,may also sign the
ceriification. 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 levei diagrams 6,7 and 8-Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size,tocation of servicing equipment,area use,wall openings,or unfinished area Feature(s),then list the Feature(s)not
included in the certitication under Comments below. The diagram number,Section C,Item 1,must still be entered.
1 certify that the information in Sections 8 and C on this ceriificate represents my best eHorts to interpret the data available.
1 understand that any lalse statement may be punishable by fine or imprisonment under f 8 U.S. Code,Section 1001.
I��c�-�a�\ E 5�1��5 � b� �7Zc�
CERTIFIER'S NAME UCENSE NUMBER(or AHix Seal)
�;�l� /� �r�1r-1c.�—' QyV,Eri Gd�tV �N����ir�� Es�Ta,l N�E.l=S 1�Le
TIT�E,�, , �,� COMPANY NAME �
���`�'. �� ''� ' L►4�5 �� tc� L�r�� � L � 3` (o��
�?��',ADOAES 't . ��
STATE 21P
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�IGNdT E ;• DATE PHONE
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���'�o��s sfi�rl�rf���;inade ot this Certificate ior:1)community official,2)insurance agenUcompany,and 3)building owner.
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COfiNI�i1Et�°fi'�� ����'A '�- �oc� tl� Rk1o:�
' �a 1-��- t-��w��� �IEVw�to✓� l0• I
y,�H ON PILES,
�H VIERS,OR COlU61NS
SlAB BASEMEHT
A � A A V
ZONES 20NES ZONES ZONES ZONES
AE�EAE�+CE qEFEAEHCE
l�SE �E�� tEYEI
aEiEati+CE - i��
tEvfl
ELEV�nCh
� �'- �ix. t�M � �'j' , .
( h:+ �.: '>'� 6ASE
_ :;':'r.';`i`.'. " REFEREVCE f1000
B+�SE '��%��- AOJ�CENT�:: EIEVATqN
i1000 .`��� � GRADE tEvK
[tE'/�T�Oa RECEpEr+CE �O.u�CEtii
lEvEl G�uOE
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::: �::��.:��:..' "•''!'..':';. �:•�Y�i.:•�'';'J"+::�•'
;.�1:.. }°Li.L::;,•:�i. .e:, '�
,�.�,.1.. .;:i:, �i.�.'.•,wA.:'::!AOJACENT�;:
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7he 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 tevel floar.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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