HomeMy WebLinkAbout05050113-Cert. of ElevationFEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROG~
ELEVATION CERTIFICATE
Important: Read the inStmc~ons on
BUILDING STREET ADDRESS (including Apt., Unit, Suite, anci/or Bldg. No.) OR P.O. ROUTE AND BOX I
1785 Pine Valley Dr,Ma
~ STATE
Camtel IN
~mbem, Tax~n, etc.)
ZIP CODE
~1. Non~, ^ddilion, Acoesso~J. etc. 'Use a Comments area,
Existing Residential
-LA--OPTIng)- --HOP, m'a'AL DA'PJM: SOUECE: ~):~
~7~7~O
RMPANEL -~ Bg. BASEFLOODELEVATION(S) l
SEODAm ]aS. FLOOOZONE(S)I (ZoneAO, used~r~g) |
_J
B10~ Base Fkx~d FJevati~ (BFE) data or base f~od deCh ~temd In Bg.
E~Ro~ E~F~ 0 Comm~n~O~e~ned r-lO~er(Desc~):__
BlI. Indicatethe deva~ion datum used for the BFE in Bg: E;~ NGVD 1929 I-i NAVD 1988 I--I O~er (Describe):
B12.1s~e '' iocatedinaCoastaiBam'Resoums CBRSamao~O~m~SeProtectedAreaOPA? C]Yes ~No ' atJonDate
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
~ Itc'ns C3...a..i below acc~g to the building diagm ~ in Item C2. State be datum used. if the datum is dlferem from the datum used for the BFE in
Sect~ D ~r ~ G. as api:m:~m, to doomm~ the da~m coavemmm.
D~m 1929 Convemion~.;ommems
o a)Topo itorenc~re) 80~_. ~_jt.(m)
o b) Toper
o c; sth~c~ura memba'(V z~nes rely) .__~,(m)
o ~ slab) 80~_, 20~.(m)
b aCommer~ m 804.94__~(~
8o...2.2.23._~,(m)
e (HAG) ~, ~,(m)
oh~
o i)T~
~N D. ~R~O~ ~N~ ~ ~HffE~ C~FICAT~N
] ~ t~ ~e th~ in ~ A, B, ~d C ~ th~ ~ e~ my ~ ~ ~ ~e ~ aval~b~.
I un~tand ~at an: ~1~ stat~ent ma ~j nishab~ b~r i~ dson~ under~8 U.S. Cede ~i~ l~f, _
~RTF~S ~E N~n E 8k~ Jr. WCENSE NU~ ~I ~7
COMPANY NAME Fatc~ Engineethg, Inc.
13110PmmiseRoa~
CITY
NoUes~e
-- DATE
4/2r2005
STATE ZiP CODE
IN 46060
TELEPHONE
(317) 841-3141
~IL~
46O32
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ~ONTINUED)
Copy bolfl sides of this 8eva~n Ce~lcate for (1) community oFtdaJ, (2)~nsura'~e aga~t/~y, and (3) buitding owner.
P~ Adjacent to Cam~ C~'~
[] Ched( h~re if attachments
~ is intended for use as s~ppor[ing i~formation for a LOMA or LOMR-F.
g ~ which [qis ceY~ate is I:~ng competed - see pages 6 and 7, If no c~agram accura[ay
[] aboveor [] betow(checkone)~ehighest adjacentgrade, (Use
age 7), the next higher floc~ or elevated fleor (elevation b) of lhe bJiiding is _ ff.(m) _in.(cm) abovelhe highest adjacen[
I~alformofma~ne~a~d/orequlpme~tsav~ng~lel3ui~ngis _lt.(m)_in,(cm) E] above or r"lbetow(ched~one)thehighestadj~grade. (Use
natural grade, if av~e).
ES.F~'ZoneAOon~y: Ifnoflooddep~ nu,~is available isfftetopdthebottom f,:~'elevatedin acco~with thecommuni~sflood~ain rrenageme~t ordi~?
SECTION F - PROPERTY OWNEE (OR OWNER'S REPRESENTATIVE) CERTIFICATION
T~ properly owner or o~efs au~:~ n~esentaWe who comtes Sec~ons A, B, C (ttems C3.h and C3.i only), and E ~ Zone A (wi~o~t a FE~q~ ~ ~un~-
issuedBFE) o~ZoneAOmu~signhere~ Thes~ts~ne~h Secfk~A B C andEa~scor~ttothebestofrnyknowisdge.
STATE,
TELEPHONE .
SECTION G - COMMUNITY INFORMATION (OFRIONAL)
The l~;aJ ofid~ ~ is autho~ by law or o~l~nce to adrrb',Mer ~e (mE), and G d this BevaJon
cetir~, ~the appr~e ~em(s) and s~ ~,
cr local law to cer~ e~va~Jon J~, (In,cate [he source and date of the dev~icn data is ~he Comments a/ea below.)
G2, {~ A comrmr~ otT~a[ ~ Section E f~a built,rig ~cated in Zone A (without a FEMAJ~ssued or commun~-bsued BFE) or Zone AO.
G3,1~ The f~lo~ng ~ (items G4-G9) b povided fox community ~xx~ain management pu~
RTFICATE OF C
G7. This pem~t hes been issued for, E] New Comtmc~o~ Cq ~tJaHm~
GS. ~ o~ as4~lt lowest ftc:or (indudhg basement) of the ~g is: 804,__~fL(m) Datum: NGVD 1929
Gg, BFE or (in Zcne AO) depth d~1o(X~ng at the building site is: 805,20 ff,(m) D~um: NGVD 1929
-~-OMMENTS -- --
~TITLE
TELEPHONE
DATE
[--] ~ h~ if nfl~dhrnnnt~