HomeMy WebLinkAbout1399 Stirling Rd FEDERAL EMERGENCY UTANAGEM W AGENCY O.M.B.W.30S94)W
�) NATIONAL FLOOD INSURANCE PROGRAM Expires July 31.2X2
L� ELEVATION CERTIFICATE
important: Read the instructions on PlIiges 1 -7.
SECTION A-PROPERTY OWNER INFORMATION fra EiP !j1�`) i•`''i'' "
,.......... :.....
BUILDING OWNER'S NAME � .:
a:Ia:u:itf:�;x ylllii itciEE i'iiii i..............
neiudi A U ,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. ........
SUITING STREET ADDRESS(1 ng pt,
CITY l 01 SATE ZIP CODE
04
PROP OESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,eta.)
BUILDING J(SE(e.g.,Iltesidertial.Non-residentlai,Addition.Accessory.etc. Use Comments section N necessary.)
Bo t L,8/ ig(LI "A-u
LATrrUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM. SOURCE (_J GPS(Type)
( -0#1-se.s>r or ax (J NAD ISZ7 iJ NAD t g63 L„)USGS Ouad Map iJ O tnr.`.-_-_
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
TP CO UNrrY NAME b COMMUNITY NUMBER 82 C LINTY NAME 83.STATE
(Q ZO 0 t )A- V 6 A
B4.MAP AND PANEL B5.SUFFIX 66.FIRM INDEX B7.FIRM PANEL Bfl.FLOOD B9.US FLOOD EL A )
NUMBER DATE EFFECTIVE/REVISED DATE ZQNE S) (Zone A,tna dapel of ftoedMq)
•Z-0 L O ACc,�{{
B10. Indicate the source of a ase Flood Elevation(BFE)date or base flood depth entered In 89.
LJ FIS Profile IRM (J Community Determined LJ Other(Describe):
B11.indicate the eI dog datum used for the SFE in B9:0-0GVD 1229 u NAVD 1988 (J Other(Describe):
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? (J Yea No
IOAJ
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: "Construction Drawings* LJBuilding Under Construction' WFinished CoftdnXdotr
•A new Elevation Certificate will be required when construction of the budding is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed-aee
pages 6 and 7. 1f no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/Al-A30,AR/AH,AR/AO
Complete items C3a-4 below according to the building diagram specified in item C2.State the datum used.If the dsturtl is dffferant from
the datum used for the BFE in Section B, convert the datum to that used forthe BFE.Show field rmeosurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion.
Datum ConversiWComments
Ele tion reference mark used Does the elevation reference mark
�u�sedd poor on the FIRM? LJ Yea�NO
Top of bottom floor(including basement or enclosure) --7Ij
0 b)-Top of next higher floor —R.(m) q
0 c)!Bottom of lowest horizontal structural member(V zones only) ,._.fL(m)
0 d)Attached garage(top of slab) IWO
0 e)Lowest elevation of machinery and/or equipment ft ft.(m) fr5.�1 ���
servicing the building i
0 f)Lowest adjacent grade(LAG) Z ft. a-•21 Z
0 g)Highest adjacent grade(HAG)
(3 h)No. of permanent openings(flood vents)within 1 ft.above adjacent grade _
0 i)Total area of all permanent openings(flood vents)In C3h sq.in.(sq.cm)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by taw to certify elevstioh Information•
i certify that the information in Sections A, B, and C on this certhIcate represents my best efforts to interpret the data avaelabls.
l understand that anv false staternentmay be punishable by fine or im ' onment under 18 U.S. Code, Section 1001.
-71
CERTiF1ER'S NAME ID¢4-NJ ?i LICENSE NUMBER -a-SL
TITLE /��— COMPANY NAME UN l V E2StA- SUMUffV1 QI,f-►
ADDRESS -- ..A/ TZ CITY 2Zy A-7TD AL STATE T%[ ZIP CODE �53Q�Z.le
SIGNATURE DATE _Zj-d`Z TELEPHONE
S EDITIONS
FEMA Form 81-3 ,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOU
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