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IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Cpmpany Use: <br /> Building Street Address(including Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Policy Number <br /> �SO 6/G /.I�C.OivD " <br /> City State ZIP Code Company NAIC Number <br /> OR��vo �,v SS3 3/ <br /> SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED) <br /> Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. <br /> Comments <br /> Signature Date <br /> ❑ Check here if attachments <br /> SECTION E -BUILDING ELEVATI�N INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) <br /> For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,compiete Sections A,B, <br /> and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. <br /> E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent <br /> grade(HAG)and the lowest adjacent grade(LAG). <br /> a)Top of bottom floor(inGuding basement,crawispace,or enclosure)is _ ❑feet ❑met�rs L�above or ❑below the HAG. <br /> b)Top of bottom floor(including basement,crawispace,or enclosure)is _ t�et ❑meters ❑above or ❑below the LAG. <br /> E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectiq�Items 8 and/or 9(see a es 8-9 of Instructions),the next higher floor <br /> (elevation C2.b in the diagrams)of the buiiding is _Q feet LJ meters ❑above or �below the HAG. <br /> E3. Attached garage(top of slab)is �feet Q meters �above or � below the HAG. <br /> E4. Top of platform of machinery and/or equipment servicing the building is _�feet ❑meters �above or �below the HAG. <br /> E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's fioodplain management <br /> ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this information in Section G. <br /> SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE) CERTIFICATION <br /> The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or communiry-issued BFE) <br /> or Zone AO must sign here. The statements in Sections A,8,and E are correct to fhe best of my knowledge. <br /> Property Owner's or OwnePs Authorized Representative's Name <br /> Address City State ZIP Code <br /> Signature Date Telephone <br /> Comments <br /> ❑Check here if attachments <br /> SECTION G-COMMUNITY INFORMATION (OPTIONAL) <br /> The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), <br /> and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Chedc the measurement used in Items GS and G9. <br /> G1. � The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who <br /> IS aUthOi IZ6�Fiy IavY t0 CE�iIf�%81EVdtiC�i iflTOiti'i8ti0f1. (iiiviC8i8 ii�@ SQL'iCE 8i�.'�i uai�Oi.f12 8�2V5�10^�uia ir,the Carnme^:3 8�23�IOVJ.� <br /> G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. <br /> G3. ❑ The following information(Items G4-G9)is provided for community floodplain management purposes. <br /> G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued <br /> G7. This permit has been issued for: �New Construction �Substantial Improvement <br /> G8. Elevation of as-built lowest floor(including basement)of the building ._afeet ❑meters(PR) Datum <br /> G9. BFE or(in Zone AO)depth of flooding at the building site �feet ❑meters(PR) Datum <br /> G10. Community's design flood elevation ._�feet ❑meters(PR) Datum <br /> Local Official's Name Title <br /> Community Name Telephone <br /> Signature Date <br /> Comments <br /> ❑Check here if attachments <br />