HomeMy WebLinkAboutE-ELEVATION CERTIFICATE - 1916 WALLENBERG DRIVE - SPRING CREEK (3)ELEVATION CERTIFICATE O.M 9. No 306700
FEDERAL EMERGENCY MANAGEMENT AGENCY EAprres May 31. 19
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
Provide elevation information necessary to ensure compliance with applicable community tioodptain management ordinances, to
determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).
Instructions for completing this form can be found on the following pages.
BUILDING OWNER'S NAME
Gr,e
STREET ADDRESS (Includin
M(P in/al')en
OTHER DESCRIPTION (tot:
L.of- it G alla,
CITY
SECTION A PROPERTY INFORMATION
API., Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND SOX NUMBER
Block
r•un INaururlCE COMPANY USE
POLICY NUMBER
COMPANY NAIC NUMBER
na
STATE
SECTIONS FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
ZIP ZIP CODE
I. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE CF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION
000102 r' � ¢ A SJl f l I P71 (n AO Zeros. M daidth)
Li �"'� So01. 1
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ® NGVD'29 OOther (describe on back)
8. For Zones A or V, where no BFE is provided an the FIRM, and the community has established a BFE for this building site, Indicate
the community's BFE: I I 1 1 L! feet NGVD (or other FIRM datum -see Section S. Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicall the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level
2(a). FIRM Zones At-A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram Is at an elevation
oil 1441 1T1 JJ feet NGVD (or other FIRM datum -see Section B. Item 7).
(b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation OIL I I I I I J feet NGVD (or other FIRM datum -see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LU.0 feet above 0 or
below 0 (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram Is L _J.L I feet above 0 or below (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? 0 Yes 0 No 0 Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: ® NGVD'29 0 Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
the FIRM (see Section 8, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: 0 Yes R No (See Instructions on Page 4)
5. The reference level elevation is based on: X actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid it the building does not yet have the reference level floor In place, In which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.)
6. The elevation of the lowest grade immediately adjacent to the building is: L E9_9_ZJ.6J; feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
is not the aowest floor' as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor' as defined by the ordinance is: 1 1 ' 1 I I L II feet NGVD (or other FIRM datum -see Section B, Item 7).
2. Date Of the Start nr rnnevnr,i.......-..�_.... ...
SECTION E CERTIFICATION
This certification, is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certtfy elevation
information wnen the elevation information for Zones A5—A30, AE, AH, A (whh 8FE),VI—V30,VE, and V (with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 . Distinguishing Features-11 the certifier is unable to certify to breakawa
enclosure size, location of servicing eguioment, area use, wall openings, or unfinished area Feature(s), then
included in the certification under Comments below. The diagram number, Section C, Item 1, must stiff beg,
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret.Ae j'dt available".
I understand that any false statement may be punishable by line or imprisonment under 18 U.S. Code, Sect IQp 0
*q' (�
CERTIFIER'S NAME
(or Affix Seal)
TITLE / COMPANY NAME ,AEFIIIIII II/EEEAN,
,4ssoc _
AGGRESS _ CITY STATE Zip
Copies shodYd be made of this Certificate for: 1) community official, 2) Insurance agenticompany, and 3) building owner.
COMMENTS:
ON WITH
ON PILES.
SLAB BASEMENT
PIERS. OR COLUMNS
A v A
A V
ZONES ZONES ZONES
ZONES ZONES
REFERENCE EASE
REFERENCE
LEVEL
REFERENCE
LErE� R4.e
LEVEL
ELEVAi
• n.:. :., d:.p.
BASF _ ryry
1
FLroe AWACENT :S: 'dl� RE/ERENT;E
REVAT" GRAOF M LEVEL
REFERENCE AG C +1.
B
R0000 0
ELEVANCN
LEVEL O�[�E -
E
1
W.
t....:_lii::'i6m{fp(`.i °^�"E .
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.