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U.S.DEPARTMENTOFHOMELANDSECURITY ELEVATIONCERTIFICATE onnBNo. �s6o-000a
<br /> Federal Emergency ManagementAgency Expires March 31,2012
<br /> National Rood Insurance Program important: Read the instructions on pages 1-9.
<br /> SECTION A- PROPERTY INFORMATION For Insurance Company Use:
<br /> A1. Building Owners Name Policy Number
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<br /> A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
<br /> O !G SL i!/
<br /> City DiP oNo
<br /> A3. Property Description(Lot and Biock Numbers,Tax Parcel Number,Legal Description,etc.)
<br /> �/D .vo. ZZ - //7-2.� - �/-�oa 2
<br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) �Ff'/D E'.vT/AG.
<br /> A5. LatitudelLongitude:Lat. �i"'/°,SS• S�/ � Long.93° 3`1.�3D ' Horizontal Datum: NAD 1927 NAD 1983
<br /> A6. Attach at least 2 photographs of the building if the Certificate is bein�used to obtain flood insurance. ❑ �
<br /> A7. Building Diagram Number 2
<br /> A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
<br /> a) Square footage of crawlspace or enclosure(s) �sq ft a) Square footage of attached garage N� sq ft
<br /> b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage
<br /> enclosure(s)within 1.0 foot above adjacent grade � within 1.0 foot above adjacent grade
<br /> c) Total net area of flood openings in A8.b /V/A_sq in c) Total net area of flood openings in A9.b N/� sq in
<br /> d) Engineered flood openings? �Yes �No d) Engineered flood openi�gs? �Ye� � �;c
<br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
<br /> 61. NFIP Community Name&Community Number 62.County Name 63.State
<br /> ORONO 270/78 E.t/�flEP�it1 MN
<br /> B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone
<br /> Date Effective/Revised Date Zone(s) A0,use base flood depth)
<br /> Z�aS.� C o,3 i2 E 9-2-Q y 9- -o X AE 93/
<br /> 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
<br /> ❑FIS Profile �FIRM Community Determined ❑Other(Describe)
<br /> B11. Indicate elevation datum used for BFE in Item B9: �NGVD 1929 ❑NAVD 1988 ❑Other(Describe)
<br /> 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? � Yes �No
<br /> Designation Date �CBRS �OPA
<br /> SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
<br /> C1. Buiiding elevations are based on: ❑Construction Drawings" ❑ Building Under Construction` ,�Finished Construction
<br /> *A new Elevation Certificate wili be required when construction of the building is complete.
<br /> C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h
<br /> below according to the building diagram specified in Item A7. Use the same datum as the BFE.
<br /> Benchmark Utilized LAf« M,�v,vEre,✓kA ,�,G.tAYf BAY D��t Vertica�Datum it/Gdd /9 2 9
<br /> ConversioNComments iV�1q
<br /> Check the measurement used.
<br /> a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 4`�'9 �feet ❑meters (Puerto Rico only)
<br /> b) Top of the next higher floor S / feet ❑�!meters (Puerto Rico only)
<br /> cj Bottom of tne lowest horizontal str�ctural member(V Zones only) itJ feet u meters (Puerto Rico only)
<br /> d) Attached garage(top of slab) N/.4 n feet ❑meters (Puerto Rico only)
<br /> e) Lowest elevation of machinery or equipment servicing the building �VT,/,� n feet �meters(Puerto Rico only)
<br /> (Describe type of equipment and location in Comments)
<br /> fl Lowest adjacent(finished)grade next to building(LAG) 9�� , � �'feet ❑meters (Puerto Rico only)
<br /> g) Highest adjacent(finished)grade next to building(HAG) 956 .3 �feet �meters (Puerto Rico only)
<br /> h) Lowest adjacent grade at lowest elevation of deck or stairs,including �5/ . O (�'feet �meters(Puerto Rico only)
<br /> structural support
<br /> SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
<br /> This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation _
<br /> information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. i���0• s����
<br /> I understand that any false statement may be punishable by fine or imprisonmenf under 18 U.S. Code, Section 1001.
<br /> � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a L/c.,tiQ, �27SS
<br /> licensed land surveyor? �Yes ❑No i� -ii-a 9
<br /> Certifier's Name License Number
<br /> GRv ER c��ssvci�,"��;
<br /> Title P.tE/'iD E,c/T Company Name GRONB C2 G ¢AJ'J'O C /A'?'ES , l.c/C_ 4 5 N W(LLOVb�"�
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<br /> Address City GOi!//(r" GAkE State M� ZIP Code
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<br /> Signature Date Telephone
<br /> J11`i�'� ii-i�- a9 9s2-�i7,� - 5✓i�i�
<br /> FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces a►I previous editions
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