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IMPORTANT: In these spaces, copy the corre.pondlng InformatIon from Section A. BuildIng S~I Add/'9SS (includr~ ~l., Unit. Suite, and/or Bldg. No.lor P.O. Roule and Box No. ~O?:ll ~ ;)T. City Y h, \ \ -s. Slate k ZIP Code , SECTION D . SURVEYOR, ENGINEER, OR ARCHITECT CERTlFICAnON (CONTINUED) ;F.pri.~"c.Gompan\l Usa; . - ;.' _~~liIkI~ Copy both side. of thl$ Elevation Certlflcste for (1) (XImmunlly omelet, (2) in$UflII'IC9 agent/company. and (3) bUilding ownef. Comments CaCl;:: shot 01"\ \-or of' -Pootey Signature ~ ~ Dete q , d9.- () 0 Check h if attachmenls SECTION E . BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONe A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1-E5. If tile Certl~te Is ir\lencled to support s' LOMA or LOMR.F request, complete Seclionfi A. B, and C. For Il8ms E1-E4, use nalural grade, if available. Check Che measurement used. In Puerto Rico only, enter meters. E1. Provide elevation infonnation for the following and check the appropriate boxes to ilhow whether the elevation Is above or below the highest adja<:en t grade (HAG) and Ihe lowest adjacent grade (LAG). a) Top of botlom floor (including basement, mJWl apace, or enclosure) is _' _ 0 !'eet 0 m'stel'll 0 above or B below the HAG, b) Top of botlom 1I00r (indudlng ba8ernent. aawr space, or enclosure) Is_. _ 0 feet 0 meters 0 above or be.low the LAG. E2. For Buildlng Diagrams 6-8 with permanent flood openIngs provided In SecliQn..A Items 8 ~d1or 9 (see Q!!pc 8 of Instructions,. the next higher 1Ioor (eltntallon C2.bin thedlsOtams) of the bllildlng is _._0 feet U malers U above or U below lhe HAG, E3. AUached garage (lop of slab) is _. _ 0 feet 0 ~ers 0 above or 0 below the HAG, E4. Top of platform of machinery and/or !Kjuipment servicing lhe buildJng 18 _' _ 0 ffil 0 meters 0 sbove or 0 below (he HAG. E5. Zone AO only: If no flood depth numberls available. 18 !he lop of the bottom tocr elevated in accoroan<:e with the commun"'lallootlplaln management ordinance? 0 Yes 0 No 0 Unknown. The local official mUst certify Ihls/nformallol'lln Sectfon G. . ~/ SECTION F. PROPERTY OWNER (OR OWNER'S REPRESENTA.TIVE) CERTIFlCATlON The properly owner Dr owners authOOzed represdntative who completes Sections A. B. an,cI E for Zone A {without a FEMA-flQued or (;(Immunity-issued EIFE) or Zone "'0 musl sign here. The 5fslfml6l1rs in Sections A, B, and E.", COl7Bc:t to lhe best of my knowledge. Property Owner's or Owner's Authorized Represenlative's Name Address City ~ Stale ZIP Code Signa\u"e Date Telephone Cmnments SECTION G . COMMUNITY INFORMAnON (OPTIONAL) The local official who Is authoriz:etl by law or ordlnsl1Cle to admlnisler \he community'8 floodplain management ordinance can complete Sections A, B, C (or E), and G of lt1ls Ele~alion ~rtiflcate. Complete the applicable item(s) and sign balow. Check the measurement used in Items G8. and G9, G1. 0 The informetlon In Saction C was laken from other documentaUcn that has been signed and llealed by a licensed SlJrveyor, engineer, or arcf1ilect who is authorized by law to oortify elevation inlormation. (lndlcete lhe source and dale of the elevation data in thll Comments ares below.) G2. 0 A community official completed Section E fi:JI a buildIng located In Zone A (wilhout a FEMA-issued or community-issued BFEI 01' ZOne AO. G3. 0 The following Information (Items G4.-G9.) Is provide<:! for community IIOQdplaln management purposes, G4. Permil Number G5. Dale Permit Issue~ G6. Date Cer1iftcale Of CompllenceJOccupancy IssLled o Check here If attachmeR~~ G7. This permit ha& been issued for. 0 New Consfructlon 0 Stlbstanfiallmprovemenl GB. Elevation of as-builllowe&t floor {Including be.sement) of tile building: G9. BFE or (in Zone AO) dept/l or lloodil)g at the buDdIng sIte: o feet 0 mel8rs (PR) . Datum o feel 0 meters (PR) Datum Local Official's Nama Tille "Telephone Communlly Name Signature Date Corrmeni~ o Check here IT attachmenls FEMA Form 61-3\ i February 2006 Replaces alf previous editions