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<br />U.S, DEPARTMENT OF HOMELAND SECURITY <br />Federal Emergency Management Agency <br />National Flood Insurance Pl"Qgram <br /> <br />ELEVATION CERTfFICA TE <br /> <br /> <br />lIse: <br /> <br />A1. <br /> <br />Building Owner's Name Bu.-Hey.f\-e.ld <br /> <br />B"lklj~ Str....' I'.ddress (including ~I., Unll. Suite, amI/or Bldg. No,) or P.O. Route and Box No. <br />~()~ \ b*' tree+- <br /> <br />City Le h,/ r-h \ \ \ '5. Sta1,. FL <br /> <br />Property Description (lor and Block Numbers, Tax Parcel Number, Legal Description, etc.) <br />L,,'! ~ \L. \<10 Li otZe >h rnills <br /> <br />Bunding Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) f -esi de n h 0\..1 <br />Lalltudell<lng;tude: Lal N A Long. N 1-,\ Horizontal Datum: 0 NAD 1927 <br />Allaen at Jes912 photographs of the building if the Certfflcate is being used to obtain flood insurance. <br />Buidlng Diagram Number--L- <br />For a bu1ldlng with a crawlspace or encJosure(s) , provide: <br />al Square footage of a-awl space or enclosure(s) ~ sq It <br />b) No. of permanent "oed openings in the crawt space or <br />enclosure(s) walls within 1,0 foot above adjaCMI grad8 ~ . <br />c) Total net area of flood openings in A8 b ~ sq in <br /> <br />Important; Read the Instructions on pages 1-8. <br />SECTION A. - PROPERTV INFORMATION <br /> <br />A2. <br /> <br />rijp~Y;NArc, fifuTJ&er <br /> <br />A3, <br /> <br />ZIP Code 3:6Ll ~ <br /> <br />M. <br />AS, <br />AG. <br />A7. <br />A8. <br /> <br />o NAD 1983 <br /> <br />A9. <br /> <br />For I! building with an attached garage. provide: N ~ <br />$) Square footage of attached garage sq rt <br />b) No. of permanent flood openings In !he attached ,garage <br />waUs wlthill 1.0 foot above adjacent grade N Po <br />c) Total net area of flood openings in A9.b N Pt sq in <br /> <br />SECTION B - FLOOD INSURANCE RATE MAP (F)RM) INFORMATION <br /> <br /> <br />0(" " cI a <br /> <br /> <br />89. 8ase Flood E/oevation(s) (Zone <br />AO. usa base flood depth I <br />e,y' . <br /> <br />810. Indicate me SOIKce of the Base Flood Elevation (BFE) dale or base flood depth en~~red In /lem B9. <br />DFIS Profile ~FIRM o Communi IV Detennlned OOlher(Oeacrlbe) <br />811. Indicate elevation datum used for BFE In Item 89: ~ NGVD 1929 ONAVO 1988 o Other (Desctibe) <br />B 12. Is Ih8 building located In a Coastal BDlTler Resources System (CBRS) area or Otherwls1il Protected Area (OPA)? <br />Deslgnation Date N A 0 CBRS 0 O~A <br /> <br />DVes <br /> <br />g] No <br /> <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br /> <br />C1, Building elevations are based on: 0 Conslruction OravWngs. Rl BUildIng Under Construction- 0 Finished Construction <br />.A new Elevation Certificate will be requiAKl when construction of the building Is camplel.. <br />C2. Elevations - Zones A1-A30, AE. AI-I, A (wItIl BFE). VE. V1-V30, V (with BFE), AR, ARIA. ARlAE. ARIA 1-A30, ARlAH, AAJAO. Complete Ilems C2.a-g <br />bt'llow according to Ihe building diagmm specified in Item A7. <br />Benchmark Utilized , 0 cO;. ( Vertical Datum Nt=; V 0 t G\ '29 <br />ConversiOn/Comments N A <br /> <br />Top ot tx.Itom "oor (InclUding ba5ement. craWl space, or enclosure floor) <br />Top of ths n6)(j higher noor <br />Bollom of the lowest horizontal structural mem ber (V Zones only) <br />Attached garage (top or slab) <br />lowest el8vaUon 0' machInery or equipment servfcklg the building <br />(DesCribe lype of equipmenlln Comments) <br />lowest adJacenl (finiShed) grade (LAG) <br />Highest adjacenl (finished) grade (HAG) <br /> <br />a) <br />b) <br />cJ <br />d) <br />e) <br /> <br />Ch8ck the measurement used. <br /> <br />e s .'2.0 B";eet <br />N -A, 0 Fellt <br />N A. 0 feet <br />N 1\ .--.0 feel <br />N ~ .-0 feet <br /> <br />~o .~feet <br />e ~ ..8.....@1'eet <br /> <br />o meters (Puerto Rico only) <br />o meters (Puerto Rico only) <br />o meters (Pu8fto Rico only) <br />o meters (Puerto Rico only) <br />o meters (Puerto Rico only) <br /> <br />o meten; (Puerto Rico only) <br />o malers (Puerto Rico only) <br /> <br />f) <br />g) <br /> <br />SECTION 0 - SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION <br /> <br />This oertlftcalioo Is 10 be signed and sealed by II land 8urveyor, engineer. or architect authorized by law to certify elevation <br />Informallon. I certify thet the Information on this CertiRc:at6 f9~"ntl1 my best 9Ifoti$1r3 Intflrpret the date avaifab/e. <br />I undersland that any false slalffmenl may be punlshabJe by fine or imprisonment under 16 U.s. Code. Section 1001. <br /> <br />o Check here if comments are prtl'./fded on back of farm. <br /> <br />~x-~c~~~; . <br />~F..._[..., ,.-E.L.. <br />SIGNATUFd':. Ar'IG <br />[.lATE f'if=f~E~ <br /> <br /> <br />FEMA Form 81-31, February 2006 <br /> <br />P L '3, 'fJ ?:FF:F5 <br />C~ _ a q - 0<0 <br /> <br />See reverse side for continuetlon. <br /> <br />Replaces all previous editions <br />