Flood Control - Elevation Certificate - 1125 W Two Rivers Lane - Two Rivers Sub 03 - 4/24/2009
08/28/2008 14: 13 FAX 2083787758
MARKSLANDSURVEVING
III 0021005
U,S. OEPARTMENT OF HOMt=:LAND SE<.
Federal Emergency Management Agency
National Floo" InsuranC9 Program
ry
ELEVA liON CERTlFICA
OMB No. 1860.0008
Expires March 31, 2012
Important. Read the instructions on pages 1-9.
SECTION A -PROPERTY INFORMATION
A1. Buj~ese~r yJ, ~VJF~EST, JJ2.. A "_
A2. e~lIdlng Streer Addr\lS$ (inClud1n!l pl.. Unili'fuiw. Qnd/~H 8ldg. No~ P,O, Rout
-z. - I,' .() n
City Stilte I.
;,...-;. ~
A3. Prol)orTY- GSerlD on (Lot and 810ck Numbers. In ~~~~J'~ge~ Lag~ De,a~~n, Il~C,~ , O^ 1 f( "'0 .~
i DT2-4- ~L 2-0 'TWD v.-yv.......~ ~(}~\\i \.<:;)1 1"-1 ~ l _ J
A4. Building USQ (e.g., Residential, Non-Rasidential, Addition, Aceossory, otc,) 1Z~( ~Il fJr; L..-
A5. Latitude/Longitude: Lat Long. HQrlzontal Datum: 0 NAD 1927 0 NAO 1983
AS. Artsch allaas12 photollrap~orthQ bUilding If the CertJflc31e IS being used to ob~al" flood InSUrance.
A7, Suildins Di~gr;lm Number.....:L
AB, I"or a bUIlding WI!h a crawlapace or enclosur&(e)' 4'Z. zA- A9. For a building Wllh an atteched garego: 1..1' J CO
a) SquZlre roolZleo of criJwlspaOQ or enolos."8(s) ~ ~q fl a) Squllr.. foolllglil of attached garego ~ sq It
b) No. 01 PQrmnnenl nood o.pan/nge in Ino "r;lwl.p;lce or -? .A b) No. or permanent flood open/nga In tne anach"d liJRrage
enc;jo~urQ(':;) within 1 0 foot ebove ad!","onl !iI"'dO ~ Within 1.0 root abovo lldj;lcentgrade ~
c) To\al net area of (Iood openln,~ In A8 b . "2..3l)~ Sq in c) Totel not ilrea of nood openings In A9.b , sq In
d) Engmeered nood openings? 0 Yes No d) Engineered flood openings? 0 Ye$ No
SECTION B. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
:~PF l~sur.a.i;I~~'c:.o.~:is"y Clse:
, P,pll~ N'l.Mib'ar. . .
ZI~ Code
~3CoI(P
El2. County Name At:>
El3. Sta la
Ib
B1D.
IndiCllte the source_of the Ba~e Flood Elavallon (BFE data or bue nood deplh entered In Ilem 89.
o FIS Prorile .@IRM Community Detormlned . 0 Other (Describe)
Indicate olellalion dstum used for BFE in Item Be: 0 NOVD 1929 ~AVD 1900 0 Other (DescrlbQ)
Is tho bUilding located in a Coulal Barrier Resources SyttOI't1 (CeRS) area or Otherwise Protacted AnOIa (OPA)?
DeSignation Dale 0 CaRS DOPA
89. 8ase Flood EloVllllon(s) (Zone
AO, USO PilS'l flood depth)
Z ,3
611.
812
DYes
Wo
SECTION C. BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1 Sulldln9 elevationa are cuod en: 0 Conelructlon Drllwings" 0 l:l1,j,lding Under Construction" Inlshed Construction
"A new Elevallott CQrtificate will be required vvhen constructlort of tho building IS complelo,
C2. Elevations - Zones A1 .A30. AE, AH, A (with Bf=E). VE. V1-V30, V (with BFE), AR, ARIA, AR/AE, ARlA1.A30. AR/AH, ARIAO. Complete Itel't1s C2.a-h
below according to the buildi 9 d18fl' m spe cWed In Item A7. Use the Same datum as tho BFE.
e..nchmark Utilized , I Verti~1 D6Itum NA V.b ~8
Conversion/Comments
a)
b)
c)
d)
0)
Ch9ck the measuremant used.
Top ofbottol't1 floor (InCluding basement. crawlspace, or onelosura Iloor) ff ~.A.~eet B meters (Puerto RICO only)
Top of the next higher floor .~ foet moters (Puerto Ril;o only)
Bottom or the 10weSl horizontal structural mOmber 01 Zones only) .-er.=: feel 0 meten; (Puerto Rico only)
Attached garage (top of ala b) ~~~(oot 0 motors (Puerto Rico only)
Lo_sr elellation of machinery or oqf,Jipment aefYlcing the DuJldlng '0 .IE:! feot 0 melof:t (Puerto Rico only)
(Describe type or oquipmant and locellen in Comments) .
LOWllstad)acent (finiShed) grilde next to bUilding (lAG) Z5~L...~_J~8et
Highest ildjacent (finlshod) grade nexllo bUilding (HAG) 7:.s~...c:2....3leel
Lo_st adjaC61H grilde at lowesl elov..tion of dee\( cr ,.tairs, IncludlnSl ZQ;;'"C:) ( -L-f5?folJt
structural sup~ort
I)
g)
h)
D metert (Puerto Rleo only)
o motors (Puerto Rico only)
o motera (Puerto Rico only)
SECTION D. SUR.VEYOR., E'NGINlOeR, OR ARCHITECT CERTIFICATION
This certificatIon is to be slgngd and sealed by llland surveyor, enginear, or Ifchitect authorized by law to certJfy olevlltion
information. I oerrtry thst Ihlllnformstion on thf$ Certificate ("presents my but efforts (0 interpret thlll datB available.
I understsnd ttlsr sny false atstement msy be punisheblll by fine or imprisonment under 18 U. S. Code. SecNon 1001.
Qx;reck hot a II comments ara provldod on bacl< of form. Wore latitude and longitude In Section A..f!oVfded by a
~ ~ .., . liCensed land surveyor? Dy", U No
~~f~~a~UfU,~~fJa JU~t'~- LANe ~L~CPJje.r~r/~ T ItJG.
T'!"l.IMSJJ01lUL ~comPk5JjI.~ 1 ~ 9S~70(J
Address CI Slate ZIP Code
elephone L.CF(-
Replaces 811 previous editions
Signature
FEMA Form 61-31, Mar 09
See reverse side for continuation.
08/28/2008 14:13 FAX 2083787759
MARKSLANDSURVEVING
III 003/005
City
Stale
ZIP Code
~r
IMPORTANT: In these $paces, copy the corresponding Information from Sectlon A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. ROUt9 3nd Box No.
SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both $leiG:; of this Elevation Oertincate for (1) eorn",llnity offic::illl, (2) insurllnc::e agent/company. IInd (3) building owner,
Comments
Signature
o Cheek he re if attachments
SECrrON E - E1UrLDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
Date
For Zones AO and A (whhoUI lilFE), comp/Qte Items El-e~. If tho Cenificate i5 intended to al.lppol1a L.OMA or LOMR-F (equeat, oomploto Sections A. B,
a"d C. For ItemS E1-E4. use natural aredo, If ;1lvOllIsbiQ. Check the meallureme"l usc::d. In Puerto Rico only, enter fl'lelors.
Provide elevation Inrormatlon for thQ followtng and cheCK the appropriate boxes 10 show wnettler the elevation i$ above or below the highest adjacent
grade (HAG) and the lowest edJaclilnt grade (LAO)
a) Top of bonom 1100r (InclUding basement, crawlspace. or enclosure) is _, _ Df99t Dmelers DabovQ or Dbelow the HAG.
b) Top of bottom noor (including baumeht. crawlspace, or enclosure) is _' _ Deet Ometel'S Dabove or Dbelow the LAG.
r:or euUalng Diagrams 6-9 with permanent flood opening:! provided In SQl:tiW Items 8 w/or 9 (see ~e5 8-9 of Instructions), the next higher floor
(elevalJon C2.b in thQ diagrams) of the bul/(jlng Is _' _ 0 feel U meters U above or U beloW the HAG.
Attached garage (top of a/a b) Is _' _ 0 feet 0 morets 0 above or D below the HAG.
Top ot platform of macnlnory and/or 9quipment !lervlelng the building is~. _ 0 feet D metors 0 above or 0 below the HAO.
ZOnO AO only: If no flood dopth number 15 available. Is thQ top ot ltle bottom noor elavated In accordance wlth the colT111lunlty's tloodplain management
ordlnence? DYes 0 No 0 Unknown. The local offil;"illl must cerli1'y this Information in Section G.
SECTION F . PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION .
The property ownor or oWller'a authorized representative who comt:llo1es Sedlon! A, B, end S for ZOnQ A (without a FEMA.I!I$uod or c::ommunlty-ls!lu9d eFE)
or Zone AO must :!ign here. The Btetemen~ in Soot/on! A, 8, end E ara corre~r fo rh. besl of my know/edg..
Prop9ny Owner's Of OWner's Authorized Representative's NarTlll
El.
E2.
E3
E4,
E;i,
Addro ~:!
City
State
ZIP Code
SignattJre
Date
Telephone
Oomments
o Check ~ere It e~llet\!TICl\'lt15
SECTION G. COMMUNITY INFORMATION (OPTIONAL}
Tho local official who is EltJthorizod by law or o~dinence te administer the community', floodplain management ordinance ClIn complete Sections A, 8, C (Of E),
a.nd G of this Elevstion Certiflcato, Complete the epplicable Ilom(s) and aign below, Check the mU6urement used In Items G8 and 09.
01. D Ths information In Section C was taken from other documentation thathu been signed and seelad by a licensod su",eyor, engineer. or architect Who
is euthorized by 11Iw to certify elevation information. (Indicate thll source and date of the olevation data In tile Comments aree below,)
0:< D A community ofncial c::ompleted Section e 'or iI building 10C1lted In Zona A (without a FSMA-iSlSued Dr community-issued BFE) or Zone AD.
OJ. 0 The following Informafion (Items G4.(9) is prOVided for community floodplain management purpOseS.
G4. Permit Number Ci5. Dllte Permit Issued Ga. OatQ Certificate Of Complisnce/Occupaney I$sued
07. This permit haa been Issued for: 0 New Construction 0 SubstanUellmprovemenl
GS. Ela\llllion cf lis-built low9st noor (Ineluding basement) of tho building
G9. BFE or On Zone AO) depth of flooding at the building site
G1 O. CommunitY'S design flood elovallon
o feet
o feet
o feet
D metere (PR)
o motors CPR)
o meters (PR)
D<!Jtum
Datum
Dstum
Local Official's Neme
rille
Community Name
Telephone
Signeture
Dale
Comment~
FEMA Form 81-31, Mar09
o Cheek here If attechments
Replaces all previous editions
08/28/2008 14:13 FAX 2083787758
MARKSLANDSURVEVING
III 004/005
Building Photographs
Continuation Page
. . ,.' "'.''Y
Buildin~ Street Address (including tpt , Unit, Suite, andfo.r Bldg. No~ or P.O, Route and Box No.
I ~ vV. ''/W 0 Y,J~\/\/a~ U l\J~
city State 1 D - Zlr Code
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View' and "Rear View'; and, if required, "Right Side View' and "Left Side View.'
r:-(UJ NT V I evJ Ifo~
~ -2-3 -Oar
08/28/2008 14: 14 FAX 2083787758
MARKSLANDSURVEVING
III 005/005
Building Photographs
See Instructions for Item A6.
lCD
:r
If uSing the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the Instructions for Item A6. Identify all photographs with: date taken; 'Front VieW' and "Rear View"; and, if required, "Right
Side View' and "Left Side View." If submlttmg more photograpl'ls than will fit on this page, use the Continuation Page on the
reverse
rf?JJNf V /IdA! (qAMbJ-c
q~Z3 -0'1