61 MIDWAY ISLAND .,;� _ , . . � � _
. . . . 1!/�'�� .No 3067 77
ELEVATION CERTIFIC fMiy3�,�3
FEDERAL EMERQENCY MANAQEME C�UL � 8 � ,
�� . ' NATIONAL FLOOD INSURANCE PR � cniy to
ATTENTiON:Use ot this certHicate does not provide a waiver oi the flood insurance pu hase r �
provide etevatbn iMormati�on necessary to ensure compliance with applicable commun M or LOMR):
n
determine the proper insuranoe premium rate,and/or to supPcrt a request for a Letter M
InstnicNons for compl�tin�thls lonn c�n b� found on
SECTION A PROPERTIf INFORMATION Fo�i"g�a�cE co���rr� {'.'
, Poucr Hu�p ;�.
su�onac;omreas� E,�l D U tL��4
�'-r/oNls i oM � - : ,,
coMwurv wuc Nu�R ��
STREET ADDRES3(k�udn0 Apt.•UNt.Suit�anNor Bidp.Number)OR P.O.ROUTE�NO BOX NUMBERr� . �.�'���
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o�+�fi DESCRtPTION Mt and Block Nixnbers.�IC.) ' `��-'
L.Q7 2;(o C� I �T 3 c IS4t1-tJD �STA7Es c�� CL.��t�cc.�R TE2 F'L 3�63a ' � __ y
STATE 21P CODE '� :
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- SECTION B FLOOD INSURANCE RATE MAP(FlR�INFORMATION �y:
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Provide the followinp from the proper FIRM(See Instructions): h�`� ��:
t.CaAAAAUf�TV MA�ABER 2.PANEL NUAABER 3.SUFFI% 4.OATE OF fIRM INDEX 5.FIF�t ZONE a..�ZaW.uN d�f�) � "
��.5p q b o 0 0 '7 D B�i�S/Y2 A-� :-� 1I. v�� � : `.
7.Ind��e the elevallon daWm system ussd o�the FI RM for Base Flood ElevaN�e�is�hed a BFE for��(��,.��C
S.F o r Z o n e s A o r V�w h e re n o B F E i s p r o v i d e d o n t h e F I R M,a n d t t►e o o m m u i ry
the oommunity'a BFE:L�1�L1-1.0 feet NGVD(or other FIRM datum-see Sectbn B,ftem 7), `
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, : SECTION C BUILO1N�i ELEVATION INFORMATION . ' , � ;- � ;
S 1.lb�p the Elevation Ce��e I�ons.i�te the diagram number from the diagrams found on Papea 5 and 6 that best
descxi�ss the subJeCt builditq's referenCe level.L_ . r ,
2(a).FIRM Zones A1-A30,AE,AH,and A(wiM BFE). The top of the reference Ievei floor from the selected diayram is at an etevabon
of�•�feet NdVD(or other FIRM datum-see Section B,Item�.
(b).FIRM Zonss V1-V30,VE,and V(with BFE). The bottom of the lowest horizontal stn�ctural men�ber of the reM�e�os Isvel hom
(� � ths�eCted diapram�is at an elevaUon of l�L��.�-�teet NaVD(or other FIRM datum-see SecNon 8,Item 7I• � �`
���.�p�����t gFE), The floor used as the reference level hom the selected diagram is w.U feet ahove❑ or.
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bstow❑ (chedc one) the hfghest grade adjaceM to the building. y '
(�.FlRM Zone AO. The floor used as the reference level irom the selected diagram is l._i.�J.L�ieet above❑ or be�ow 0(chedc
pne�ths Mqf�est qrade adjacern W the buildinp. If no flood depth��s�mber is available,is the buildin�'s lowest floor(reference
Iwet)elevsted in aocardance with the community's iloodplain management ordinance7 ❑ Yes ❑ No (� Unknown , ,,
� 3,�r�caM the elevatlon datum system used ln determining the above reference level elevations:❑ NGVD'29 � Other(c.ascxibe
ur�Commsnts pn Paps 2). (NOTE: N the eleveNon detum used Jn measuring the elevallona!s dlNerent than that ussd on
ths FlqM �sss Sectron g,ltem 7J,then oonveri the elevallons to the datum system used on the F/RM and show the aa�v+erslon
` puatlon unO�sr�om►►►ents on Pepe 2.) � � � � � .�. . �-, �
� 4.�v�on referenoe mark uaed appears on FIRM: ❑ Yes ❑No (See Instructions on Paqe 4 �'
i��`i�� �"'*= r �
ction drawi s ' � ����� �&� . 4
5.Th�refe�enoe level eisvation is based on: �actual oonstruction ❑ constru ng �� �,
re/ere Je oor in eoe,ln whktR�
(IMpTE; Uas of oonshuctlon drawlrtQs�s oMy valld if the building does not yet have the P�
� ��IS os�a�e wlll pniy be valJd/or the bulldlnp during the course o/construcflon. A post r�s�r��o►f�'EkvaUonpC�te
w�be ro4ulred axae conat►ucEbn!s complete.) �
a,Ths sl�vatfon cf th�bwest�rade fmmediately adjacent to the building is:�.U feet G�bh''�;,F(RM`deitifi�1;31b��,
8ac�ion B,Item 7�. '" Ci7�l C7F CL�A�'vV�OT�R "
SECTION D COAiiN1UNITY INFORMATION � ,
-� �.It ths oommunky omda�rsaponsiWe tor ve�iN�nq buiki�n0 elevatlons specffies thet the reterence level indicnted In Sectton C,Item t
i��t q�s 9ovwst Moor'aa d�finsd in ths community'a Hoodplain maneqement ordinance,the elevatbn of the bulldinp's"lowest
}��s dsllnsd by ths or�nanoe is: �_L_l_I_�•L.l feet NQVD(or oth��RM datum-see Sectfon B,12em�.
2.D�ot ths start of constructlon or substandal improvement � •
/(�AAiOl�lltl-�1�MA�lO REPLACESALLPREVIOUSEDITIONS SEEREVERSE3IDEFORCONTINUATION
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