35 JUNIPER WAYu.s.a���ra��ro�NC�re�os�c�s��rr El.�VAT1iJN t���2TIFiCATE �
�E���n�. �n��ns��cv r��aa�i�r�r �r�cY
4'ertrf>rrvJ �lo<xJlnsurcrrac� Pt-ugt�rm �Cit�1"�Ait'1�` ��8, t� �T�it �t18r�fU�l`�flt1'S W1 �lA�@8 '�--�.
SEC7tt?N A-PRC1PERi'Y 1NF�RMATit?N
A9. Building t�utirnets Name IAWREN�F �. J£7NhfS{iN �N� �[5� CC)UV1.�Y 1�1-7�529
A2. 8ui�fing 5treet Ad�iress (inGuding Apt., U��t, Su�te, andlw Sldg, �t�:} c+r P_t�: Route�and B� No.
�5 JL7N6P�t2 tNAY � �
�_�.�� GitY GLFA#21tVATER �, ���.�.�_� StBte �'[.�� ZIp�COde 3�767 �_.__
oN18 �io. � sso-or}�t�8
�xpir�tian C1ate: Juiy �1, 209�
�OR INStlF2ANC� COMPANY USE
� A3, Pfoperty flescription (l� and Btock Num�rs, Tau� Parcel Number, Ls9�i Oes�nption, e#C.y „""°..°�°� _,..rt.�._ _._...
PARCEI 10 - {T�i-29-15-�46�i6-�-tNO$t} i�1CJ7 �OR CONSTRUCTtONF NC?T �`t1R OEStC�I
. A4. �tui�iing Use (e.g.. Residential, Nas-t2esident��i, Addrtion, Ar.cessory, etc.j �2�81[� i��.,,:fi�
R5_ l3tifucfalt:ongitade: Lat. ��'t�'�i t" Long. -�t'49'32_7° t#ttrixontaE Datt�t►: Q NA01927 X NAO 1983
A6. Aftach a4 least 2 pl�wtographa oi'the building � the Certif�cate is h�tng used to obtain fl�d ii�surance:
A7. Buiidin� [3i�ram� t�iumtrer � �
A8. �or a b�ikiing w�h a c�awlspa� ar encbsure(e): A9. Fat a building vvith an attachsd �arage:
a) Square faotaga oi cravvi�pac�e cr enck�sum{s) �l s4 fi a) Square f�tage of ariactaed garage tt� sq ft
k+j EVumber ot permaneM fltaod opertings in the craw�space b} Number of permanertf � open'a+gs in ihe aHached garaga
ar endes�u�e{s} within 1.81ooi atwve adjacent grade �A within 1,0 iaot above adjacent gradg i�/g
c) Tata! net arva of Rood Qt'�rtings i� AB.b �/ sq °sn c) Totai ne# area � flaa�i c�aninga in AB.b [� sq in
d} Engineered fbad op�nings? Q Yes X No d} Engirr�eered flood aper�ings? C� Yes X Na
SEC'fiON B- FLCat7![? iN3ilRANCE RATE MAP (�lRM� IIVFORMATIU�i
— — _.... � � �.w._�m�,
81. NFtP Gommun�ty Name & Community Nurreber B�. County Name
�i� c�� c��wa��- �z�os� ��r���.�.a�
B3. �atate
���t2lOA
,.�. __.�
84 Map!(Panei Number 65 Sutfix 88. FtRM lndex Qate 87. FI€�M P�nei BS. Fi�c! B9. ea� Ftood �tevation(s} (zone
9�tfl3�-(it�s�i C"s t}9Nb31�!}03 EffB4�'%Y81Rev�� [}at8 ZOn��B} AS?, uaB ksas �flOOd deplh)
Btf�� Indicate the saurce a# the Base Flos�d Eleva6an {BFE) data ar base flood depth entere�i in item 89: _._._ _._ _ _.__,,._
��IS Pmfrle X FiEtlIA [� Community t�tetm�ed ❑ Enher/S4urce:
Bt 1. indicate elevation datum used fior BFE in item 89: Q NC,'VD 1929 X NAVO 1985 Cj OtherlSourca;
9i2. is the buikfing l�ated in a Cosstat 8�r�ier Resources System �GBRS} area or t�ihenaise Rrat+�efeii Area (OPR)? CI Y� X hto
r�es�nat�on oate: C� ca�s CI «mA
��C"Y'tC?�t C-- 8U{I.DiFiG EIEYATIt7N iNFQtiMATtt3N (SUltY�Y itE4UfRECtj
Gi. Suitdi�rg eisv�#iona are based on: (� Conatruction �garirags' Ci Buikfing Under �sns�ructyan' X Fir�ist4ed Gonstructie>n
rA new Elevation Ce�#if�cats wiit be rsquined wh�n c�nstructiaa di ttre buikli�r� is compiete.
C2. Elevations - Zanes A1 A30, R�, AN, A(with BFE�. V�, V1 V3t). Y(with BFE), AR, AFtlA, Jtf2fAE� ARIAt-A3b, AWAH, AR/ACt. Gampiete Ete+ns G2.a-h
beEow accord'sng to the buitding cliagram speci#ied in tte�t kl. tn A�bo Rico onty. ertter meters.
Bencirmark Utiii�ed: ��� Verticai I�atum: �Nt� f,889
indicate �leva#icsn datum u�ed ior the elewations in it�ns a� th�au�h h) beldw: Cl F�VC3 1929 � NAVO 1988 Cl t;3thert5aurce:
Datum used for buikding elev�dons must be the same as lhat used fa the BFE.
Ghack the measur�tr+ent �useci.
a} 7op of boKom tk�ar {induding bas�ment, crawlspaaa. or enr.i�ure �aor) �,� X fest Cl meters
b) T�rp ai tAe ne�ct higher flaor �,� Xi� teet Ci meters
c} Bottotn ot the lawest horizantat structura! rr�smber {V Zones onht) �-A� X ieet [] msters
dj Attached garage (top af siab) � j.� X faet C� meters
e) l.awest elevation of macF�inery or equipmen# servicing Ehe bui#ding �.� X feet [,� meter$
(I�escribe fYPe of equi�nent and location in Comrrran#s}
fy �rrwest adjacent {fm�hed} grade next to buitding {CAG� �>� X teet C� me#ers
5) Higtsest ad�acent (fineshed) grade �xt to buiidfng (ttA�} ±�,$ 7C i�±t C� me�rs
h) lou�est �dyscen# grade a# lowe�t e�avation of deck or stairs. ir�cl�iing sdrur�u�ai suPP� �1,� X fi�et C� meters
S�CTION O- SURVE1lC3R, ENGINEER, 4R ARCNlTEC"f CEittlflGATIC3P+t
----
This certifieatiun is to be s�ned and sealed by a land susveyor, engmee�, ar arc�it�t authorized by taw ta ce�#ify etavatian
infocmatic>r�. t ceRify tfiaf the intormation on this Gerttfrcata �presants my best eh�rts fo interg�ret the data avsFlable.
t understanc! that any latse ststerrrent �nay 4e punishabJ� by fir�e tN tm�'rsortmertt uru�ir 98 Ct. S. Code. Sectfon 7(l01.
(� Gh�ck here i# comments �re provided on Dadc of fioim. Were latitude and Eongitudp in 5ection A provlded by a
fio m
p ChecEc her� i# $ttachmersts. i€cense€i land sutveyar7 #� Yea Ci Na
Certifier's Name L�L�4Nt7 F. OySAf2D
TittB� f�" E. S.___._._
Address
�orm C186-0-33 {�/12)
Licer�se Number 3�59
Company t+iame FLA �URVEY3 CCJEtF�:
�.. ;�a�a c�y r��.�s st�ce �i. zr� coae �
t3ate 08128J2014 iel�phone 23��i8�°t60t?
See revers� side for tx�n�lnueCion.
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Rej�taces all pr�vi�s editions.
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IMPC�RTAAiT; (n the�e
infc�rrr3ation from �ec�on A,
�ui�ling Street Address {including A�rt., Unit, Suite, andtor Bldg, fVa.) or P'.O. Rtrute and 8ax Na.
�5Jt�N��'�€'ik+1A1LY ��.� _._.�.�......_ �..,
c�ry cl�ar�nra��� ..� �_�.� �.,�, �—_._ � __ Sta�e i=��Rto� �[P cade �37�i
�t3R INSl1RANCE CC�MPAN`! US�
Paticy Nurnber. �..�
Gc►mpanp NA1G Narrt4aer;
S��T�tiN D— SURV�YOR, EMGINEEfi, C!R AR�HtT'�C't GEi3Ti�lC�liiQN (GCINTINU�O)
CopY hc#h sides of this Elevation Cert€C�cats far (tj commun�ty af�ciat. i2) insurance ageratfeompany, and (3j bu�tding ownsr.
Gomments CaF'S GC}Li-.
DET�RF111EdATi0�1 �RC
USEO IS �'sPS. i`H�R�
��a oar� o� �r��.;r�
signacure
! f
v�ilEF�� 7AK� fR{3�1 �"s�XiGL� E1�i2TH. pUt?i �Ci� G�}NS"T�U�TtC3N, �T �A�t t3ESItaN. F�4C}D ZQN�
PEt7q� #N.�rtt3Ni s.1 �� DATA1t+lAS PR�t'F�R��} �t�R 1=Lt�l7 tNSURAMGE F7URPOS�S C?N4�Y,T'ti� ECtUi�'AAFN'"1'
4:�' �i'�'dQTEl�f it#Sj P1.t#5 t3iZ iMtit+Et#S Pi2��iSIC}N.1T�N14�1a!�`�t3 tRi G2{@} IS Ti-l� Gt?(�{CRETE AIf2 GUNL1CCit�Nlt'tt.�
o�r�ar�o��
NC}T RE4UtFtE1i) FGiR Zt3NE AC) ANf� Z+QtdE A
Fo� Zone� �l�? and A(v�Eh�tat �FE}, compF�ce (tems �t—E5. !f the Certifieate i� int��ci�d tt� suppart a L+�MA �f LCIRAR-F request� cawnple�t$ �ection� Az �t,
and G. For Items E1—Ed, use naturat grade. itavaelsbl�. Gheck the measurement used. tn Rue�ta Rico onty, enter,�neters.
Ei, Rrovida et�v�tiar� ininrmatinn %�r thg iollowing arid ct�eck ihe appropr+ate troxes tc� sh+�w wMethes the ete+ra#icsn ;� abnva at beiow #he h�,i�t�est adjac�nt
grade (t;l#G) and tha lowest ad�acent �rad� {tA�}.
a} Top of 6ottan fk�or (inc#uding taasemertk, cr�wispace. nr enciosutej is [� f�rt C7 mets�rs Q a�aue or [:� betow the N,4G.
bj Tt� of bat�am flosfr {inctuding basement, crawispace, or encMasure} i� __. �,�,.��.... Q feei [� meters 1� abave ar � l�elow the LAG.
E2. Far Buik3ing IJia�rams 6-9 wiih perma�nf flood o�tenings provide�i in Sec#inn A Etems S andl�r 9(se� p�ss 8—� of instructionsj. ths next higher Etop�
(etevation G2.b i� the diagrams} af the buikfing i� CI fe�t [.J mefers Q abou� ar Q t�eslow #he NAG.
E3. fttt$Ched �ai#ge (ttrA of sl8bj i� � . �I feei Cj mek��s � ahove nr (� tre[�w the NAG.
�4� iop af piaE�orm flf macf�ine�ty aadtor equiptnent�senr'scir�g ttte buildi�ng is �.� �❑ fee# �] metecs ��} above or [� betdw�the N�4�.
E5. Zor�e AO anty: if na flood de}Mh rsurnlr�r is avaitable. is the Yop of the bcrttom floor ete�rated in accordance with th� evfnmuniity"s flo�d{siair� managsment
acdinanceF [] Yss CJ NQ [� �1r�known. 7he loca! o�ficial must csyttify t#?is in#armation in Sec#ion G:
�ECT�ON F-- PFt4P�FtTY QWNER �UR tiWNER'� I�EPIZESENTAT1YEj CERTiFICAT10Pt
The prope�ty vwn�r ar awner`s authar�xed representa#iue whc� ca�pt�te� 8ections A, �, and E fur Zan� A{wRhaui a�EtulA-issued or commun�ty-issu�d 8��j
or Zane RA must s�n hec+�. The stat�tttenf$ irt Sec�ians R, B, a+td E a�� cvrrect ta�the bssC.oi my kn�wtedge.
F*roperty Ch�vner's ar Owne�'s Authorized Representatiive's Narrr�
._._� _______. �. __ M.....� _ � _ _
Address
Signaturs
Comments
Gity
Date
State
Tai�hone
ZIF' £ode
,C�he�4c hei� �f atia�hments:
SECT[41V G --+COMMEINITY INFi��iMATIt}N (C}PTiCt�ALj
7he locai off�al who is authorized by laav or 4rdinar�ce #o acz�nnini�ter ihe c.amrnunity's fleyodplain mana�ment o�tlinance can c�rnptete Sectirans R, B, C(vr E}, and G
aE thls �Eevatio� Ge�tiF�ate. Ca�nplete the a�pfica6te item{s) and si�n kelorv. Check the measurem�nt used in itea�s G8�10. Ir� Puerica Ri�co aniy, enter met�€s.
G1. (� The in#ormation in SecEion C was taker� fram s�ther doce�mentallon that has been signed and seaSed by a lic�ns�sd surveyor, engineer, or arcbileat wha
Fs authorized k�y law to ae�ki#y elevation infarmati�. (indicate the sAUrce and date of the eievat�an data in tise Ccymments ar�a hetow:)
G2 � A enr�r�m�r�ity oti�clal comp�eted S�:cEivn E for a buiid�r�g [ocaEed tn Zone A{+�rithout a P�MA-issued or G�mrrsuni#y-rsst�ed B�E) �r Zon� AQ_
G3. �] 'fFre fatkrw�ng 's�fatmaNcrn {iiems G4-Gt0) is p�ovided tor comrnu��+ floodplain m�r►ayem�nt purposes_
.�'i4. P�rrmit Nutnbet � G5. 4ate Pennit issued
fJate Gettiftcate 4f Cr�mpiiBtnCe/CkCUpancy
�7. "Chis �rmtt has been issuad for: C3 Ptew {:onstructior� 1� Subsiantial Impravement
G8. Eleva#ian of as-buikk ivwest flo�r (inc�ing baseme€�t� of th� buildi�g: C� fe�#
G9. SFE or (irt Zons ACi} G�pth of flooding af the buiEding sitc: ��e�
G1t}. �ornmunit}r's desigr� florsd etevatton:
�.acat Utfi'i�i��s Eiame�
Communi#y Name
Sign�ture
�omments
[] feet
irite
Tetephtxre
C1ate.� ___..
p meters 4atum
p meters Uatum _�
Q meters Datum
Gheck here i( aitachments.
�EMA Form Q86-0-33 (7t12) htepl�ces a#1 preuious �ditior��.
EIEVATlfJM CERTt�ICATE, a��� � Buil+dirt� Phot+�gr�tphs
S�e InskruGtior�s fOr i#ern A�.
IMPt)RTAPIT. In thes+e spaaes, cc�py the �orrespvndtng in%rmat€on from Seation A.
� _ � � �e �_ _� _ �.�.w. e� ... _ �� _�.m. .. � _�_._
Bui€ding 5treet Addre�s (inctading Apt.. Unii, Sud�, 8ndfor Bidg No.) or P.O, R�ut� �nri B�x No
35 JUNiPER WAY
City Cl�k.�RWAiER
Stata �Lt��tt43A ZIRCode �3�67
FOR {NSURANGE COk1PRNY 1I5�
PoEicY Num�ser:
G�mpany NAIG
IP using the Eisvation Certific�te to �tb#air� #�tFiF� flood insu�artiee, affix a# least � buNic�i�tg ph�#ctgrapi�s belaKr according to the instrvctiorss
tor lt�rr� A6_ idenkiiy ali phctitographs with date taken, °Frant V�ew" and "'Rear uiew'"; and, if required, "Ri�ht Side V'sew" and "E.e(t �ide
View.° When appticabie, photcsgraphs must show the €aurrdatian wifh representative example� crf the flovd opsnings or vents, as
indicaf�d ir� Seciian A�. If suk�m`rFfing rns�re pho�ograp�s then wiii �it an tfiis pa�e, use �ite Cantin�uatic�n Page.
��� �ROltIT VIEV1t OSl28f2tt1�
FEMA Farm 088-0-33 {7t12) Replaces ali previaus ediGons.