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HomeMy WebLinkAbout1200 Stirling Rd Ar- I .4•,, .r.rt�t•r.i pit.. L FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.e.No.3W-M NATIONAL FLOOD INSURANCE PROGRAM eorn July 31.2W ELEVATION CERTIFICATE Important. Read the instructions on pages 1 '7• .� ...... SECTION A-PROPERTY OWNER INFORMATION A BUILDING OWNER'S NAME IiRICENisnbet`". E :eEE •••Y.::::�::i:::X:.....:.:.:...:::.:: aT:::: BUt ING STREET ADDRESS(Including ,Unit.Suite,andfor Bldg.No.)OR P.O.ROUTE AND BOX N0. 01!!A!! `I ................ .. . p Q Lf lV G- ZIP CODE CITY fL f So o-A PR ERTY DESCRIPTION(Lot and Bioek Nur^tkrs,Tax Parcel Numt»r,Legal Oeseriptkrn,etc.) U L I L ! etc. Use Comments section If } �® BUILDING USE e.g.,ResidWIWI,Nor esidee>tisl,Addition.AecessaY, �) HORIZONTAL DATUM: SOURCE: (J GPS(Type}: LATtTUDE/LONGRUDE(OPTIONAL) NAD 1f?Z7 IJ NAD tg83 USGS C lued Mep u Other------ ( '. •-p• or SWAWW U SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B3.STATE 61.NFtP COMMUNITY NAME 8 COMMUNITY NUMBER BZ COUNTY N t z n n IRM PANELfla.FL000 ne AO,use depot d Ioedrq) B4.MAP AND PANEL B5.SUFFIX �•FIRM INDEX EFFECT FtvE/REVISED DATE ZONE(S) Q NUMBER f ZD 1 ICC3 :57 entered In B9. B10. Indicate the source of the Base Flood Elevation(BFE)•dda or base flood d Other ( ) u FIS Profile FIRM U CommunttY Determined NAVD 1Qgg LJ Other(Describe): B11. indicate the elevation datum used for the BFE in BQ: NGVD B or Otherwise Protected Area(OPA)4 JJ Yes Ll Na B12. is the building located in a Coastal Barrier Resources ys ( RS)sres Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY ...... REQUIRED) intshed Cornttudior► Building Under Construction' C1.Building elevations are based on: uConstrudion Drawings JJ ` •A new Elevation Certificate will be required when construction of the building is complete. G2 Building Diagram Number (Baled the building diagram most sirrftr to the building for which Oft Certificate Is being complrrted-see pages 6 and 7. ff no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations—Zones AI-A30,AE, AM,A(with BFE),VE,V1-V30,V(with BFE), ,AR ARIA,AR/AE,AR/A1,A30,AR/AH,ARIAO t ed, If the daturb Is Complete items C3a4 below according to the building diagram specified In BF�ow field meaatum surements essuurements datum conversion the datum used for the BFE in Section B, convert ttte datum t to document the datum cortverslon. calcutation. Use the space provided or the Comments area of Section D or Section G,as appropriate, Datum Conversion/Commentss r on the FIRM? LJ Yes No Elev •on reference mark used Does the elevation reference An mark used_> rPea Top of bottom floor(including basement or enclosure) ❑ b)•Top of next higher floor ---- ❑ C)-:Bottom of lowest horizontal structural member(V zones only) ®ft(m) ❑ d)Attached garage(top of stab) ❑ e)Lowest elevation of machinery and/or equipment R(m) E�- servicing the building IL(m) `O-� ❑ Lowest adjacent grade(LAG) ..•7< fL(m) ❑ g)Highest adjacent grade(HAG) ❑ h)No. of permanent openings(flood vents)within 1 It.above adjacent grade sq� ) cm Cli)Total area of all permanent openings(flood vents)in C3h SECTION D-SURVEYOR.ENGINEER,OR ARCHITECT CERTIFICATION elevation infonitation This certification is to be signed and sealed by a land surveyor, engineer, or Archited authorized by law to certify l certify that the information in Sections A, 8, and C an this Certificate represents my best efforts to interpret the data avar7abb. 001. i understand that any false statement a be nishable b fine orim •sonment urrduCENSE NUMBER Section CERTiFIER'S NAME D f�iV T!—��G f� COMPANY NAME t,/d l ilE2S�� �u�J&51y1V('A TITLE i 3 -Ar7— STATE T�L, ZIP CODE ADDRESS �t7Z N ,p�ZI�.FDTZ CITY 1be']V lL1TZ1 TELEPHONE (� O SIGNATURE FEMA Form 81-3 AUG 9g SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREI/iOU3 EDiT10N8 x _ NAM , 10,ANT - s` zn u. m join uin pop, e r.- xv r F < ON N R: -Z vat , ,w'