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<br />U.s, DEPARTMENT OF HOMELAND SECURITY <br />Federal Emergency Management Agency <br /> <br />ELEVATION CERTIFICATE <br /> <br />OMB No. 1660-000B <br />E)(cires Februarv 28.2009 <br /> <br />Nalionar Flood Insurance Program Important Read the InstructIons on pages 1-B. Olo383 <br /> SECTION,. - PR.OPERTY INFORMATION J'J1ri~sUrli~,90~nv tlse: <br />A1. Building Owner's Name Bu. +\e,.f\.eld POliCY, N\.idit)e( <br />A2. BUlkli5 Slre..\ Mdress (including Apt, Unll. Suite, and/or Bldg. No,) or P.O. Route and Box No. ,:qoMp;itili:t.m~, N"Un&er <br /> O~\ b*'s.tree+ "-.'-,.- -' <br /> <br />A3. <br /> <br />ClIy Ze. ""I ("VI \ 1\ OS Sta\.. FL <br /> <br />Properly OescripNon (lol and alock Number$, Tax Parcel Number. Legal Description, ate,) <br />Lcl ~ \L. \<10 CI OrZe ih (hillS <br /> <br />BuHding Use (e.g., Residential. Non-ReSidanll81, Addition, Accessory, etc.) r -esi den h 01...1 <br />Lalltucl8lL<lng;tude: Lat N A Long. f\J I~ HorIzon'al Datum: 0 NAD 1927 <br />Allaen at Jeasl2 photographs 01 the building if the Certfflcale is being used to obtain flood insurance, <br />&lIdlng Diagram Nurnber-'-- <br />Fora building with II crawl apace or enclosu..(s) , provide: <br />a) Square footage of aawt space or enclosure(s} ~ sq It <br />b) No. of permmenlllood openIngs in the c~ space or <br />enclosure(s) walls within 1,0 toot above adjacent g,sd9 ~ . <br />c) Tolal net area 01 flood openings in AS. b ~ sq in <br /> <br />ZIP Code 3:bLj ~ <br /> <br />A4 <br />A5. <br />A6. <br />A7. <br />AB. <br /> <br />o NAD 1983 <br /> <br />A9. <br /> <br />For it buIlding with an attactled garage, provide: N ~ <br />a) Square footage of attached garage 5q rt <br />b) No. of permanenl flood openings In the altacl1ed ,garage <br />waUa wlthill 1.0 foot above adjacent grade N Pi <br />e) Total net area of flood openings in A9.b N F\ sq in <br /> <br />SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br /> <br /> <br /> <br />Of I'eta <br /> <br />89. Base Flood Elevation(s) (Zone <br />AO, use base flOOd depth) <br />e,Y' <br /> <br />B10. Indicale the SOUl"Cll of the Base FlOOd Elevation (BFE) data or base flood depth en~~red In Item B9. <br />OFIS Profile ~FIRM DCommunilYDetennlned OOlher(besCftbe) <br />811. Indicate elevation datum used for BFE In llem B9: ti7 NOVD 1929 ONAVO 1988 DOIhltr (Describe) <br />812. Is Iha bUlk!ing located In a Coastal BalTler Resources System (CBRS) area or Otherwise Protected Area IOPA)i <br />Oeslgnalion Date N A 0 CBRS 0 O~A <br /> <br />DYes gj No <br /> <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY RJ;QUIRED) <br /> <br />C1. Building elevations are based on: 0 Construction DrSlMrlgS. .RJ Building Under Construction. 0 Finished Construction <br />.A new Eleva\ion Cenilicata will be requited when construction of the building is complela. <br />C2. Elevations - Zones A 1-A30, AE, AH, A (with BFE). VE, V1-V30. V (with BFE). AR, ARIA. ARlAE. ARIA 1-A30, ARlAH, ARJAO. Complete Items C2.a'g <br />bt'llow aCcoo-ding to Ihe building diagmm specified in Item A7. <br />8enchmarklJljlized local VerticalDatum NGlvO tG(?'1 <br />Conversion/Comments N A <br /> <br />a) <br />b) <br />c) <br />dj <br />e) <br /> <br />Top 01 boUom "oar ('nclUding basement, crawl space, or enclosure floor) <br />Top 01 thB nextlligher "oor <br />Bollom of Ihe lowest horizontal slructural member (V Zones only) <br />Attached garage (lop or slab) <br />lowesl el8vatiorl or machinery or equipment servlcilg the building <br />(Describe type of equipmenlln Comments I <br />lowest adjacent (linlshed) grade (LAG) <br />Highest adjacent (finished) grade (HAG) <br /> <br />Check the mltSSUrement used. <br /> <br />es .'2..0 ae~ <br />N'" , Dreet <br />NA. Ofeal <br />N A .---.0 feet <br />N ~ .-0 feel <br /> <br />QS .~feet <br />e '3 .~et <br /> <br />o meters (Puerto Rico only) <br />o meters (Puerto Rico only) <br />o meters (Pu~o Rico only) <br />o meters (Puerto Rico Orlly) <br />o meters (Puerto Rico onlvl <br /> <br />o meters (Puerto Rico only) <br />o melelS (Puerto Rico only) <br /> <br />f) <br />9) <br /> <br />SECTION D - SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION <br /> <br />This 08rtlllcation Is to be signed and saaled by a land surveyor. engineer, or architect authorized by law to certify elevation <br />Information. I certify thaI the Information on this e&rl/Dcate "'/>>W~tmts my besf elfotts to /ntBrpl'8t the dam availab/B. <br />I understand that any fa/sa siatemMt may be punishable by fine or imprisonment under 18 U. S. COde. Seat/on 1001. <br /> <br />o Chec* here if commerlls arlt prOli/ded on back of farm. <br /> <br />~>.CI~'~ <br />.nf:. -:;.. ~ -Q- ""At <br />(: ..r"..~ .f....:. .::.1::.:,,,,, <br />f~;:cr~A T;J I-:b A ~1l.J <br /> <br />fJt.\TF. f.f~:~E: <br /> <br /> <br />P L'S if '2>. g::FjJ <br />9 - a q -' 0<0 _ <br /> <br />FEMA Form 81-31, February 2006 <br /> <br />See reverse side for continuation. <br /> <br />Replaces all previous editions <br />