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<br />U.s. DEPARTMENT OF HOMELAND SECURITY <br />Federal Emergency Management Agency <br /> <br />ELEVATION. CERTIFICATE <br /> <br />OMB No. 1660-0008 <br />El(cires Februarv 28.2009 <br /> <br />NBlionaf Flood '~'anC8 Program Important; Read the Instructions on pages 1-8. ~3R3 <br /> SECTION A - PR.OPERTY INFORMATION 1'll.dn&\li~~:90~nv [.I$S; <br />A1. Buhding Owner's Name Bu.-t\er-A~ld PiIIicy. Nlaiit)e( <br /> .:'..:.'.:'. '.. . <br />A2. BiJlldi58lree\ Mdress (including ^pI., Unit. Suite. and/or Bldg. No.) or P.O. Route and Box No. ~~ri:ip;iri)j;NArc li1mi&ilr <br /> ()~, b-t""'.c:::.tree+ '.. '. ..' <br /> ". .~.. . <br /> <br />A3, <br /> <br />Clly Ze "''I ("hI 1\5 State FL <br /> <br />Properly Description (Lot and Brock Numbers, Tax Parcel Number. Legal Description, etc.) <br />Lef1 ~ \L. \ q 0 C I 0 f' 2e In r n i \\ S <br /> <br />Building Use (e.g., Residential, Non-ResidenllaJ. Addition, Accessory, etc.) f -ec,i de Y1 ti 0..1 <br />La1ilucl8lL<lngitude; Lal N A Long. N 1.3" Horizontal Datum: 0 NAD 1927 <br />Allach at least:2 photographs of the building If the Cer1ll1cate is being used to obtain flood inSUlance. <br />Buldlng Diagram Numbar--L-.. <br />For a bulldJng with a crawlspace or enclosure(s). provide: <br />a) Square footage of aawt spac:e or enclosure(s) ~ sq It <br />b) No. of permanent nood openIngs in the crawt :space or <br />enclosure(s) walls within 1,0 foot above adjacMI grad8 ~ . <br />c) Tolal net area of tIood openings in ASb ~ sq in <br /> <br />ZIP Code 3351..\?- <br /> <br />A4 <br />AS, <br />AG. <br />A7. <br />AB. <br /> <br />o NAD 1983 <br /> <br />A9. <br /> <br />For I! building with an attached garage. provide: N t\- <br />8) Square footage ofattadled garage sq It <br />b) No. of permanent flood openings In Ihe attac.hed.llsnoge <br />waDs within 1.0 foot above adjacent grade N P- <br />c) Total n9t area of flood openings in A9.b N P\ sq in <br /> <br />SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br /> <br />B2. County NlIme <br />p~ C <br /> <br />B7. FIRM Panel <br />EffedivelRevised Dale <br />ra- 11- q I <br />810. Indicate Ihe source of tile a- Flood Elevation (BFE) data or base flood depth en~~red In Item B9. <br />OFIS Profile ~FIRM DCommunilYDetennlned o OIher(DesCJIbe) <br />811. Indicate elevation datum used (or BFE In lIem B9: ~ NGVD 1929 ONAVO 1988 o Other (Describe) <br />B 12. Is .hlll building located In a Coaslal Barrier Resources Syalem (CBRS) ar~ 01' Otherwise Protected Area (OPAl? <br />DesIgnation Date N A 0 CBRS DO!;'A <br /> <br /> <br /> <br />Of ,'cia <br /> <br />89. Bsse Flood E/levafion(s) (Zone <br />AO, use base flood depth) <br />e,4' <br /> <br />DYes <br /> <br />gJNo <br /> <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br /> <br />C1, Building elevations are based on: 0 Construction Dra~ngs' .RI Building Under Conslruction- 0 Finished Constructloll <br />.A new Elevation Certifiesle will be requil8d when construction of the building Is complefe. <br />C2. Elevations - Zones A1-A30, AE. AJ-l, A (with 8FE), VE. V1-V30, V (With BFE). AR, ARIA. ARlAE. ARiA 1-A30. ARlAH, AA./AO. Complete Items C2.a-g <br />bEllow according to the building diagram SPecilled in Item A7. <br />BenChmarkUtjlized \ Oc.o.. \ VerlicalOa\um NGov 0 1C\?9 <br />ConversionlC<lmments N A <br /> <br />e) <br />b) <br />cJ <br />d) <br />eJ <br /> <br />Top 01 lx>Uom "oor (including ballSment, crawl space, or enclOSlJre ffoor) <br />Top of the next higher floor <br />Bottom of the lowest horizontal slructural member (V Zones only) <br />Attached garage (lop of Slab) <br />Lowest elevation or machInery or equipment serv/mg the building <br />(DesCribe type of equipment In Comments) <br />Lowest adjacent (finIshed) grade (LAG) <br />Highest adjaceol (finished) grade (HAG) <br /> <br />Check the maasurement used. <br /> <br />€I S .'2.0 B"reot 0 metelll (Puerto Rico only) <br />N -A. 0 feet 0 metelll (Puerto Rico only) <br />f\J A .=0 feet 0 mete"' (Pu~o Rico only) <br />N A .--1] feet 0 meters (Puerto Rico only) <br />N /)r .-0 feel 0 melers (Puerto Rico only) <br /> <br />~ '0 -~feet 0 meters (Puerto Rico only) <br />e ~ .~et 0 melen; (Puerto Rico only) <br /> <br />f) <br />g) <br /> <br />SECTION 0 - SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION <br /> <br />This aertiftcatioo Is to be signed and sealf1d by a land SU"'GYor, engineer. or architect authorized by law to c8l1ify elevation <br />Information, I certify that the Information on Ihis Certificate "'!>>W5tmfl1 my best 9Iforts to Int9rpret the data available. r- _____ <br />' understand that any false slatement may ba punishable by fine or imprisonment under 1 B U. S. Code. Sect/on 1001. <br /> <br />o Checl< here if commenls are PrClll/ded on back of fCTm. <br /> <br /> <br />{J:~TF. r"iFi-{E <br /> <br />FEMA Form 81-31, February 2006 <br /> <br />I PL 'S 4l6~F:Fj <br />I 9 - 9. q - 0(0 <br /> <br />See reverse side for continuation. <br /> <br />Replaces all previous editions <br />