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40 SEAGRAPE CIR � :^L ,� � � �. I�R� ' ��l ELEVATION CERTIFICATE o.rn.a. No. sob�-oorr FEDERAL EMERCENCY MANAGEMENT AGENCY Expires July 31, 1999 � � � NATIONAL FLOOD INSURANCE PROGRAM ATfENTION:Use of this certificate does not provide a waivar of 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 tor a Letter of 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 of this form. Instructiona for completing this torm can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSUFiANCE COMPANY USE BUILOING OWNER'S NAME POIICY NUMBER STREET AODRESS(Including Apt,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER �(� 5 E�4 {'�a ��rc�L OTHER DESCRIP I (lot and Block Numbers,etc.) �3id�, � �.�.►;� �l� - C�a STATE ZIP CODE ��,,��,�p�� r-�� SECTION B FLOOD INSURANCE RATE MAP(FlRM)INFORMATION Provide the fotlowing from the proper FIRM(See Instructions): /.COMMUNITY NUMBER 2.PANE�NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM 20NE 6.BASE FLO00 EIEVATION (in AO Zones,use deplh) I ZSO� (o C�01 `� �v� • l5�11 �� JO 7.Indicate the elevation datum system used on the FIRM for Base Flood Etevations(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:��—��.0 feet NGVD(or other FIRM datum—see Section B,Item 7), SECTION C BUILDING ELEVATION�NFORMATION 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 Z— . 2(a).FIRM Zones A7-�,A�3�0,AE,AH,and A(with BFE). The t�p of the reference Ieve1 floor from the selected diagram is at an elevation of�_�_�•�.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��,U teet 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 �.�feet above:_i or below� (check one) the highest grade adjacent to the bui�ding. (d).FIRM Zone AO. The floor used as the reterence level from the selected diagram is L�.�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(re(erence � i r' r levelj elevated in accordance with the community's floodplain management ordinance. � Y�e(s ;� No L: Unknown 3.Indicate the elevation datum system used in determining the above reference level elevations:l'�NGVD'29 � Other(describe under Comments on Page 2}. (NOTE: If the elevation datum used in measuring the elevations is diNerent than that used on the FlRM (see Section 8, Item 7J, then convert the elevations to the datum system used on the FlRM and show the conversion equation unde�Comments on Page 2.) �,/ 4.Elevation reference mark used appears on FIRM: ❑ Yes 1!�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 fhe building does not yet have the re%rence leve!floo�in place,in which case this ceRificate will only be valid for the building during the course of construction. A post-construction Elevation Certi/icate will be required once construction is complete.) 6.The elevation ot the lowest grade immediately adjacent to the building is:�Z•�i 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 re(erence level indicated in Section C,Item 1 is not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: �.�.0 feet NGVD(or other FIRM datum—see Section B,Item 7). 2.Date of the start ot constructian or substantial improvement • FEMA Form et-31,MAR 97 REPlACES ALL PREYIOUS EDITIONS SEE REVERSE SIDE FOR COtJTIMJATION . : . . _ �� SECTION E CER7IFICATION � This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation intormation 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 aiso sign the ce�tification. 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,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, must still be entered. 1 certify that the in/ormation in Sections B and C on this certi/icate represents my best efforts fo interpret the data available. !understand thaf any/alse statement may be punishable by line or imprisonment under i8 U.S. Code,Section i001. �� A�� \��+"-1 S �5� S7 Z c'� CERTIFIER'S NAME / LICENSE NUMBER(or ABix Seaq �� "° htNtEriGUN ( ot�1SJ C't1� FNc_it�E. � ,��,lf.�/ NI+A��"`4.� , ; � COMPANY NAME ��z `y��'°°� � l� ��v� ��-� 31� L.,�.��1 �' � l �L �s�l��9 ; ��iAp `� CITY STATE ZIP .. '� �i3- ��'�"Z€56� . :�� :FY�, OATE PHONE :� 'E G- � a�:P y m �p •.�'�'r°� � <7 �'�� . � ." ��CoPi�E shpei��1`f�7nade of this Certificate for:1)community official,2)insurance agenUcompany,and 3)building owner. � , ' � co'�i�i��i,iTSv�t . G�a�r�a � �=1�:..e �1��v��oYJ = � � v1a�� s�ak� C1,-Jw��OrJ - IU • � ON WRH ON CILES, Su8 BASEME►R PIERS,OR COLUMNS A V A A V 2pNES 20NES ZONES ZONES 20NES AEFEAENCE qEFERENCE tEVEI pE�EpEr.CE B�SE LEYEL �EvEt c�00a TE�EV�ny+ 1 � �...l,�a ..`+" �v F ��:; .::%�'� . .�: ' N�SE .,'.,'rr�''� ... �� REFEREVCE F1000 NSE - .AOJ�CENT.:'::;1', LEvEt EIEV�iKK� ��ppp GRAOE ' ,sA EIEv�•O'� qEFEAENCE �OJ�CEtiT lEVEI G�uOE . .,_n';Si°.+,;5?` � _ ;:�:..:..t::::':i•'•t'.;• -,•:,. :�)ti:,::}.:;;•-:•;;y!,-:i': �... .. . �°i•) �s:.`r;::�L'<:-.•::p.i; .fx�,:.,+.i,+{i:.:`: . .-�.��:� .:f;�i:�:��:::i�:i�::;J:�r� : '• : �..i:•.:.;. : •ij'AQNCENT::. ..,:; .,;.�.:::,:;:_,:::.::.,:_ .,-., .:'l�:+:��:':...... :....::'i:;�::: GMOE 7he diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Eleva6ons for all A Zones should be measured at the top ot the reference level iloor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2