HomeMy WebLinkAbout05060068-Elevation CertificateO.M.B. No. 3067-0077
BUILD NG STREET ADDRESS (Including Apt, Urat, Suite, and/or B~dg. NO,) OR P.O. ROUTE AND BOX NO
11713 River Road
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
NUM E I I I
3t O, indicate the source
[] FIS ProBe [] FiRM [] Commun~ Determined [] O~er (Des~13e):
)11, Indicate the ~evafion datum uesd for the BFE in B9: (~:~ NGVD 1929 E] NAVD 1988 E] Offer (Desc~be): .
SECTION C BUILDING ELEVATION I RMATION (SURVEY REQUIRED)
*A ~ew Elevation Cer~ will be required when construction s compete,
CZ Buildthg Diagram Number _2 (Select the building diagram most sim la' to the building ~ which this cerlir~ate is ~ng completed - see pages 6 and 7. if no diagram
accurately represents the building provide a sketch or photograph.
C3. Bevations -zones Al-A30, AE, AH, A (with
us~'doalcui, If the datum is d~erent from the aatum used for the BFE ir,
a~. Use the space pro~d~or the Comments area of
referencemarkusedaopearon~heRRM? r-]Yes (5~No
:, '_~,(m)
743.4_[(m)
member {V zones only)
741. Off,(m)
,
UCENSE NUMBER 20200053
~ect M~NAME Welhe~
10505 North College Avenue
(317)846~611
20O3
information from ,Section
r Road, 744,05 (NGVD 1929) Permanent ~
~P,~ PROPERTY ~WAY FOR ~
Fa-Zone AO ar~ Zone A (witheut BFE), co ~ for a LOMA ~r LOMR-F,
.fl.(m)._in,(cm)r'-Iab3veor [] b~ow(checkone)thehighestadjsce~tgrade, (Use
openings (see page 7), thenext higher floor or elevaea fleer (eJevatic~ b) of~e building is _fL(m} __in.(cm) above the highest adjacent
_in.(cm} [] above er [] I~Iow (ched~ one) the high~st adjacent grade. (Use
community's floodplain management ordinance?
issued BFE) or Zone AO must sign here, The s~atemen~s/n tofrnykno~
PROPERTY OWNER'S OR OWNER'S AUTHORIZED-REPRESENTATIVES NAME --
CiTY ~zJPcoDE-~
COMMENTS
[] Check here if attachments
GS. BevalJon of as*built lowest floor (including basement of the building is: . ._ff.(m) Datum:
39. BFE or (in Zone AO) deph o[ flooding at the building site is . ft,{m) Datum:
~AL'S ",lAME
TELEPHON~