ELEVATION CERTIFICATE

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1 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE AND INSTRUCTIONS

2 NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE PAPERWORK REDUCTION ACT NOTICE Pulic reporting urden or the Elevtion Certiicte is estimted to verge 2.25 hours per response. Burden mens the time, eort, or inncil resources expended y persons to generte, mintin, retin, disclose, or provide inormtion to the Federl Emergency Mngement Agency (FEMA). You re not required to respond to the collection o inormtion unless vlid OMB control numer is displyed in the upper right corner o ech orm. You my send comments regrding the ccurcy o the urden estimte nd ny suggestions or reducing the urden to: Inormtion Collections Mngement, Federl Emergency Mngement Agency, 500 C Street, SW, Wshington, DC 20472, Pperwork Reduction Project ( ). Do not send completed orm(s) to the ove ddress. To otin or retin eneits under the Ntionl Flood Insurnce Progrm (NFIP), you must respond to this collection o inormtion. PURPOSE OF THE ELEVATION CERTIFICATE The Elevtion Certiicte is n importnt dministrtive tool o the Ntionl Flood Insurnce Progrm (NFIP). It is to e used to provide elevtion inormtion necessry to ensure complince with community loodplin mngement ordinnces, to determine the proper insurnce premium rte, nd to support request or Letter o Mp Amendment or Revision (LOMA or LOMR-F). The Elevtion Certiicte is required in order to properly rte post-firm uildings, which re uildings constructed ter puliction o the Flood Insurnce Rte Mp (FIRM), or lood insurnce Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, nd AR/AO. The Elevtion Certiicte is not required or pre-firm uildings unless the uilding is eing rted under the optionl post-firm lood insurnce rules. As prt o the greement or mking lood insurnce ville in community, the NFIP requires the community to dopt loodplin mngement ordinnce tht speciies minimum requirements or reducing lood losses. One such requirement is tht the community otin the elevtion o the lowest loor (including sement) o ll new nd sustntilly improved uildings, nd mintin record o such inormtion. The Elevtion Certiicte provides wy or community to comply with this requirement. Use o this certiicte does not provide wiver o the lood insurnce purchse requirement. Only LOMA or LOMR-F rom the Federl Emergency Mngement Agency (FEMA) cn mend the FIRM nd remove the Federl mndte or lending institution to require the purchse o lood insurnce. However, the lending institution hs the option o requiring lood insurnce even i LOMA/LOMR-F hs een issued y FEMA. The Elevtion Certiicte my e used to support LOMA or LOMR-F request. Lowest loor nd lowest djcent grde elevtions certiied y surveyor or engineer will e required i the certiicte is used to support LOMA or LOMR-F request. This certiicte is used only to certiy uilding elevtions. A seprte certiicte is required or loodprooing. Under the NFIP, non-residentil uildings cn e loodprooed up to or ove the Bse Flood Elevtion (BFE). A loodprooed uilding is uilding tht hs een designed nd constructed to e wtertight (sustntilly impermele to loodwters) elow the BFE. Floodprooing o residentil uildings is not permitted under the NFIP unless FEMA hs grnted the community n exception or residentil loodprooed sements. The community must dopt stndrds or design nd construction o loodprooed sements eore FEMA will grnt sement exception. For oth loodprooed nonresidentil uildings nd residentil loodprooed sements in communities tht hve een grnted n exception y FEMA, loodprooing certiicte is required.

3 BUILDING OWNER S NAME FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Importnt: Red the instructions on pges 1-7. SECTION A - PROPERTY OWNER INFORMATION O.M.B. No Expires July 31, 2002 For Insurnce Compny Use: Policy Numer BUILDING STREET ADDRESS (Including Apt., Unit, Suite, nd/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Compny NAIC Numer CITY STATE ZIP CODE PROPERTY DESCRIPTION (Lot nd Block Numers, Tx Prcel Numer, Legl Description, etc.) BUILDING USE (e.g., Residentil, Non-residentil, Addition, Accessory, etc. Use Comments re, i necessry.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: ( ## o - ## - ##.## or ##.##### o ) NAD 1927 NAD 1983 SOURCE: GPS (Type): USGS Qud Mp Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE B4. MAP AND PANEL NUMBER B5. SUFFIX B6. FIRM INDEX DATE B7. FIRM PANEL EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth o looding) B10. Indicte the source o the Bse Flood Elevtion (BFE) dt or se lood depth entered in B9. FIS Proile FIRM Community Determined Other (Descrie): B11. Indicte the elevtion dtum used or the BFE in B9: NGVD 1929 NAVD 1988 Other (Descrie): B12. Is the uilding locted in Costl Brrier Resources System (CBRS) re or Otherwise Protected Are (OPA)? Yes No Designtion Dte: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevtions re sed on: Construction Drwings* Building Under Construction* Finished Construction *A new Elevtion Certiicte will e required when construction o the uilding is complete. C2. Building Digrm Numer (Select the uilding digrm most similr to the uilding or which this certiicte is eing completed - see pges 6 nd 7. I no digrm ccurtely represents the uilding, provide sketch or photogrph.) C3. Elevtions 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 C3.-i elow ccording to the uilding digrm speciied in Item C2. Stte the dtum used. I the dtum is dierent rom the dtum used or the BFE in Section B, convert the dtum to tht used or the BFE. Show ield mesurements nd dtum conversion clcultion. Use the spce provided or the Comments re o Section D or Section G, s pproprite, to document the dtum conversion. Dtum Conversion/Comments Elevtion reerence mrk used Does the elevtion reerence mrk used pper on the FIRM? Yes No ) Top o ottom loor (including sement or enclosure). t.(m) ) Top o next higher loor. t.(m) c) Bottom o lowest horizontl structurl memer (V zones only). t.(m) d) Attched grge (top o sl). t.(m) e) Lowest elevtion o mchinery nd/or equipment servicing the uilding (Descrie in Comments re.). t.(m) ) Lowest djcent (inished) grde (LAG). t.(m) g) Highest djcent (inished) grde (HAG). t.(m) h) No. o permnent openings (lood vents) within 1 t. ove djcent grde i) Totl re o ll permnent openings (lood vents) in C3.h sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certiiction is to e signed nd seled y lnd surveyor, engineer, or rchitect uthorized y lw to certiy elevtion inormtion. I certiy tht the inormtion in Sections A, B, nd C on this certiicte represents my est eorts to interpret the dt ville. I understnd tht ny lse sttement my e punishle y ine or imprisonment under 18 U.S. Code, Section CERTIFIER S NAME LICENSE NUMBER License Numer, Emossed Sel, Signture, nd Dte TITLE COMPANY NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS

4 IMPORTANT: In these spces, copy the corresponding inormtion rom Section A. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, nd/or Bldg. No.) OR P.O. ROUTE AND BOX NO. For Insurnce Compny Use: Policy Numer CITY STATE ZIP CODE Compny NAIC Numer SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy oth sides o this Elevtion Certiicte or (1) community oicil, (2) insurnce gent/compny, nd (3) uilding owner. COMMENTS Check here i ttchments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO nd Zone A (without BFE), complete Items E1. through E4. I the Elevtion Certiicte is intended or use s supporting inormtion or LOMA or LOMR-F, Section C must e completed. E1. Building Digrm Numer (Select the uilding digrm most similr to the uilding or which this certiicte is eing completed see pges 6 nd 7. I no digrm ccurtely represents the uilding, provide sketch or photogrph.) E2. The top o the ottom loor (including sement or enclosure) o the uilding is t.(m) in.(cm) ove or elow (check one) the highest djcent grde. (Use nturl grde, i ville.) E3. For Building Digrms 6-8 with openings (see pge 7), the next higher loor or elevted loor (elevtion ) o the uilding is t.(m) in.(cm) ove the highest djcent grde. Complete Items C3.h nd C3.i on ront o orm. E4. For Zone AO only: I no lood depth numer is ville, is the top o the ottom loor elevted in ccordnce with the community s loodplin mngement ordinnce? Yes No Unknown. The locl oicil must certiy this inormtion in Section G. SECTION F - PROPERTY OWNER (OR OWNER S REPRESENTATIVE) CERTIFICATION The property owner or owner s uthorized representtive who completes Sections A, B, C (Items C3.h nd C3.i only), nd E or Zone A (without FEMA-issued or community-issued BFE) or Zone AO must sign here. The sttements in Sections A, B, C, nd E re correct to the est o my knowledge. PROPERTY OWNER S OR OWNER S AUTHORIZED REPRESENTATIVE S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS SECTION G - COMMUNITY INFORMATION (OPTIONAL) Check here i ttchments The locl oicil who is uthorized y lw or ordinnce to dminister the community s loodplin mngement ordinnce cn complete Sections A, B, C (or E), nd G o this Elevtion Certiicte. Complete the pplicle item(s) nd sign elow. G1. The inormtion in Section C ws tken rom other documenttion tht hs een signed nd emossed y licensed surveyor, engineer, or rchitect who is uthorized y stte or locl lw to certiy elevtion inormtion. (Indicte the source nd dte o the elevtion dt in the Comments re elow.) G2. A community oicil completed Section E or uilding locted in Zone A (without FEMA-issued or community-issued BFE) or Zone AO. G3. The ollowing inormtion (Items G4-G9) is provided or community loodplin mngement purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit hs een issued or: New Construction Sustntil Improvement G8. Elevtion o s-uilt lowest loor (including sement) o the uilding is:. t.(m)dtum: G9. BFE or (in Zone AO) depth o looding t the uilding site is:. t.(m)dtum: LOCAL OFFICIAL S NAME COMMUNITY NAME SIGNATURE TITLE TELEPHONE DATE COMMENTS Check here i ttchments FEMA Form 81-31, JUL 00 REPLACES ALL PREVIOUS EDITIONS

5 INSTRUCTIONS FOR COMPLETING THE ELEVATION CERTIFICATE The Elevtion Certiicte is to e completed y lnd surveyor, engineer, or rchitect who is uthorized y lw to certiy elevtion inormtion when elevtion inormtion is required or Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, or AR/AO. Community oicils who re uthorized y lw or ordinnce to provide loodplin mngement inormtion my lso complete this orm. For Zones AO nd A (without BFE), community oicil, property owner, or n owner s representtive my provide inormtion on this certiicte, unless the elevtions re intended or use in supporting LOMA or LOMR-F. Certiied elevtions must e included i the purpose o completing the Elevtion Certiicte is to otin LOMA or LOMR-F. In Puerto Rico only, elevtions or uilding inormtion nd lood hzrd inormtion my e entered in meters. SECTION A - PROPERTY OWNER INFORMATION This section identiies the uilding, its loction, nd its owner. Enter the nme(s) o the uilding owner(s), the uilding s complete street ddress, nd the lot nd lock numer. I the uilding s ddress is dierent rom the owner s ddress, enter the ddress o the uilding eing certiied. I the ddress is rurl route or Post Oice ox numer, enter the lot nd lock numers, the tx prcel numer, the legl description, or n revited loction description sed on distnce nd direction rom ixed point o reerence. For the purposes o this certiicte, uilding mens oth uilding nd mnuctured (moile) home. A mp my e ttched to this certiicte to show the loction o the uilding on the property. A tx mp, FIRM, or detiled community mp is pproprite. I no mp is ville, provide sketch o the property loction, nd the loction o the uilding on the property. Include pproprite lndmrks such s nery rods, intersections, nd odies o wter. For uilding use, indicte whether the uilding is residentil, non-residentil, n ddition to n existing residentil or non-residentil uilding, n ccessory uilding (e.g., grge), or other type o structure. Use the Comments re o Section F i needed. I ltitude nd longitude dt re ville, enter them in degrees, minutes, nd seconds, or in deciml degrees, tken t the center o the ront o the uilding. Enter rc seconds to two deciml plces. Indicte the horizontl dtum nd the source o the mesurement dt (or exmple, tken with GPS, scled rom USGS Qud Mp, etc.). SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Complete the Elevtion Certiicte on the sis o the FIRM in eect t the time o the certiiction. The inormtion or Section B is otined y reviewing the FIRM pnel tht includes the uilding s loction. Inormtion out the current FIRM nd pmphlet titled Guide to Flood Mps re ville rom the Federl Emergency Mngement Agency (FEMA) wesite t or y clling I Letter o Mp Amendment (LOMA) or Letter o Mp Revision (LOMR-F) hs een issued y FEMA, plese provide the letter dte nd cse numer in the Comments re o Section D or Section G, s pproprite. Item B1. NFIP Community Nme & Community Numer. Enter the complete nme o the community in which the uilding is locted nd the ssocited 6-digit community numer. For uilding tht is in n re tht hs een nnexed y one community ut is shown on nother community s FIRM, enter the community nme nd 6-digit numer o the nnexing community. For newly incorported community, use the nme nd 6-digit numer o the new community. Under the NFIP, community is ny Stte or re or politicl sudivision thereo, or ny Indin trie or uthorized ntive orgniztion, tht hs uthority to dopt nd enorce loodplin mngement regultions or the res within its jurisdiction. To determine the current community numer, see the NFIP Community Sttus Book, ville on FEMA s wesite t or y clling Item B2. County Nme. Enter the nme o the county or counties in which the community is locted. For n unincorported re o county, enter unincorported re. For n independent city, enter independent city. Item B3. Stte. Enter the 2-letter stte revition (or exmple, VA, TX, CA). Instructions Pge 1

6 Item B4. Mp nd Pnel Numer. Enter the 10-digit numer shown on the FIRM pnel where the uilding or mnuctured (moile) home is locted. The irst six digits will not mtch the NFIP community numer: 1) when the sixth digit is C, in which cse the FIRM pnel is in countywide ormt; or 2) when one community hs nnexed lnd rom nother community ut the FIRM pnel hs not een updted to relect this nnextion. I the sixth digit is C, it is ollowed y our-digit mp numer. For mps not in countywide ormt, enter the community pnel numer shown on the FIRM. Item B5. Suix. Enter the suix letter shown on the FIRM pnel tht includes the uilding s loction. Item B6. FIRM Index Dte. Enter the eective dte or mp revised dte shown on the FIRM Index. Item B7. FIRM Pnel Eective/Revised Dte. Enter the mp eective dte or the mp revised dte shown on the FIRM pnel. This will e the ltest o ll dtes shown on the mp. The current FIRM pnel eective dte cn e determined y clling Item B8. Flood Zone(s). Enter the lood zone, or lood zones, in which the uilding is locted. All lood zones contining the letter A or V re considered Specil Flood Hzrd Ares. The lood zones re A, AE, A1-A30, V, VE, V1-V30, AH, AO, AR, AR/A, AR/AE, AR/A1-A30, AR/AH, nd AR/AO. Ech lood zone is deined in the legend o the FIRM pnel on which it ppers. Item B9. Bse Flood Elevtion(s). Using the pproprite Flood Insurnce Study (FIS) Proile, Flood Elevtion Tle, or FIRM pnel, locte the property nd enter the BFE (or se lood depth) o the uilding site. I the uilding is locted in more thn one lood zone in Item B8., list ll pproprite BFEs in Item B9. BFEs re shown on FIRM or FIS Proile or Zones A1-A30, AE, AH, V1-V30, VE, AR, AR/A, AR/AE, AR/A1-A30, AR/AH, nd AR/AO; lood depth numers re shown or Zone AO. Use the AR BFE i the uilding is locted in ny o Zones AR/A, AR/AE, AR/A1-A30, AR/AH, or AR/AO. In A or V zones where BFEs re not provided on the FIRM, the community my hve estlished BFEs or otined BFE dt rom other sources. For sudivisions nd other developments o more thn 50 lots or 5 cres, estlishment o BFEs is required y the community s loodplin mngement ordinnce. I the BFE is otined rom nother source, enter the BFE in Item B9. Item B10. Indicte the source o the BFE tht you entered in Item B9. Item B11. Indicte the elevtion dtum to which the elevtions on the pplicle FIRM re reerenced. Item B12. Indicte whether the uilding is locted in Costl Brrier Resources System (CBRS) re or Otherwise Protected Are (OPA). Federl lood insurnce is prohiited in designted CBRS res or uildings or mnuctured (moile) homes uilt or sustntilly improved ter the dte o the CBRS designtion. An inormtion sheet explining CBRS res my e otined on FEMA s wesite t or y clling SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Complete Section C i the uilding is locted in ny o Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, or AR/AO, or i this certiicte is eing used to support LOMA or LOMR-F. I the uilding is locted in Zone AO or Zone A (without BFE), complete Section E insted. Item C1. Indicte whether the elevtions to e entered in this section re sed on construction drwings, uilding under construction, or inished construction. For either o the irst two choices, post-construction Elevtion Certiicte will e required when construction is complete. Select inished construction only when ll mchinery nd/or equipment such s urnces, hot wter heters, het pumps, ir conditioners, nd elevtors nd their ssocited equipment hve een instlled nd the grding round the uilding is completed. Item C2. Select the digrm on pges 6 nd 7 tht est represents the uilding. Then enter the digrm numer nd use the digrm to identiy nd determine the pproprite elevtions requested in Items C3.-g. I you re unsure o the correct digrm, select the digrm tht most closely resemles the uilding eing certiied, or provide sketch or photogrph o the uilding nd enter ll elevtions in Items C3.-g. Item C3. Indicte whether the elevtion reerence mrk (enchmrk) used during the ield survey is n elevtion mrk on the FIRM. I it is not, indicte the source nd dtum or the elevtion. Verticl control enchmrks other thn those shown on the Instructions Pge 2

7 FIRM re cceptle or elevtion determintions. Show the conversion rom the ield survey dtum used to the dtum used or the BFE(s) entered in Item B9. All elevtions or the certiicte must e reerenced to the dtum on which the BFE is sed. Show the dtum conversion, i pplicle, in this section or in the Comments re o Section D. For property experiencing ground susidence, the most recently djusted reerence mrk elevtions must e used or determining uilding elevtions. However, when susidence is involved, the BFE should not e djusted. Enter elevtions in Items C3.-g to the nerest tenth o oot (nerest tenth o meter, in Puerto Rico). Items C3.-d. Enter the uilding elevtions (excluding the ttched grge) indicted y the selected uilding digrm (Item C2.) in Items C3.-c. I there is n ttched grge, enter the elevtion or top o ttched grge sl in Item C3.d. (Becuse elevtion or top o ttched grge sl is sel-explntory, ttched grges re not illustrted in the digrms.) I the uilding is locted in V zone on the FIRM, complete Item C3.c. I the lood zone cnnot e determined, enter elevtions or ll o Items C3.-g. For uildings in A zones, elevtions,, d, nd e should e mesured t the top o the loor. For uildings in V zones, elevtion c must e mesured t the ottom o the lowest horizontl structurl memer o the loor (see drwing elow). I ny item does not pply to the uilding, enter N/A or not pplicle. BUILDING ON SLAB BUILDING WITH BASEMENT BUILDING ON PILES, PIERS, OR COLUMNS A ZONES V ZONES A ZONES V ZONES A ZONES c BASE FLOOD ELEVATION c ADJACENT BASE FLOOD ELEVATION ADJACENT Item C3.e. Enter the lowest elevtion o mchinery nd/or equipment such s urnces, hot wter heters, het pumps, ir conditioners, nd elevtors nd their ssocited equipment in n ttched grge or enclosure or on n open utility pltorm tht provides utility services or the uilding. I the mchinery nd/or equipment is mounted to wll, pile, etc., enter the pltorm elevtion o the mchinery nd/or equipment. Indicte mchinery/equipment type in the Comments re o Section G or Section D, s pproprite. I this item does not pply to the uilding, enter N/A or not pplicle. Items C3.-g. Adjcent grde is deined s the elevtion o the ground, sidewlk, ptio sl, or deck support immeditely next to the uilding. For Zone AO, use the nturl grde elevtion, i ville. This mesurement must e to the nerest tenth o oot (nerest tenth o meter, in Puerto Rico) i this certiicte is eing used to support request or LOMA or LOMR-F. Items C3.h-i. Enter the numer o permnent openings (lood vents) in the wlls supporting the uilding tht re no higher thn 1.0 oot ove the djcent grde. Determine the totl re o ll such openings in squre inches (squre cm, in Puerto Rico), nd enter the totl in Item C3.i. I the uilding hs no permnent openings (lood vents) within 1.0 oot ove djcent grde, enter 0 (zero) or ech o Items C3.h nd C3.i. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Complete s indicted. This section o the Elevtion Certiicte my e signed y only lnd surveyor, engineer, or rchitect who is uthorized y lw to certiy elevtion inormtion. Plce emossed sel nd signture in the ox next to elevtions in Section C. A lt stmp is cceptle only in sttes tht do not uthorize use o n emossed sel over the signture o proessionl. You re certiying tht the inormtion in Sections A, B, nd C on this certiicte represents your est eorts to interpret the dt ville nd tht you understnd tht ny lse sttement my e punishle y ine or imprisonment under 18 U.S. Code, Section Use the Comments re o Section D, on the ck o the certiicte, to provide dtum, elevtion, or other relevnt inormtion not speciied on the ront. Instructions Pge 3

8 SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO & ZONE A (WITHOUT BFE) Complete Section E i the uilding is locted in Zone AO or Zone A (without BFE). Otherwise, complete Section C insted. Item E1. Select the digrm on pges 6 nd 7 tht est represents the uilding; then enter the digrm numer. I you re unsure o the correct digrm, select the digrm tht most closely resemles the uilding, or provide sketch or photogrph. Item E2. Enter the height in eet nd inches (meters nd centimeters, in Puerto Rico) o the top o the ottom loor (s indicted in the pplicle digrm) ove or elow the highest djcent grde (HAG). For post-firm uildings in Zone AO, the community s loodplin mngement ordinnce requires tht this vlue equl or exceed the se lood depth on the FIRM. Buildings in Zone A (without BFE) my quliy or lower insurnce rte i n engineered BFE is developed t the site. Item E3. For Building Digrms 6-8 with proper openings (see pge 7), enter the height in eet nd inches (meters nd centimeters, in Puerto Rico) o the next higher loor or elevted loor (s indicted in the pplicle digrm) ove the highest djcent grde (HAG). Be sure tht you hve completed Items C3.h nd C3.i on the ront o the orm to show the numer o permnent, proper openings (lood vents) within 1 oot ove djcent grde nd the totl re o the openings. Item E4. For those communities where this se lood depth is not ville, the community will need to determine whether the top o the ottom loor is elevted in ccordnce with the community s loodplin mngement ordinnce. SECTION F - PROPERTY OWNER (OR OWNER S REPRESENTATIVE) CERTIFICATION Complete s indicted. This section is provided or certiiction o mesurements tken y property owner or property owner s representtive when responding to Sections A, B, C (Items C3.h nd C3.i only), nd E. The ddress entered in this section must e the ctul miling ddress o the property owner or property owner s representtive who provided the inormtion on the certiicte. SECTION G - COMMUNITY INFORMATION (OPTIONAL) Complete s indicted. The community oicil who is uthorized y lw or ordinnce to dminister the community s loodplin mngement ordinnce cn complete Sections A, B, C (or E), nd G o this Elevtion Certiicte. I the uthorized community oicil completes Sections C, E, or G, complete the pproprite item(s) nd sign this section. Check Item G1. i Section C is completed with elevtion dt rom other documenttion, including elevtions otined rom the Community Rting System Elevtion Sotwre, tht hs een signed nd emossed y licensed surveyor, engineer, or rchitect who is uthorized y lw to certiy elevtion inormtion. Indicte the source o the elevtion dt nd the dte otined in the Comments re o Section G. I you re oth community oicil nd licensed lnd surveyor, engineer, or rchitect uthorized y lw to certiy elevtion inormtion, nd you perormed the ctul survey or uilding in Zones A1- A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/A1-A30, AR/AE, AR/AH, or AR/AO, you must lso complete Section D. Check Item G2. i inormtion is entered in Section E y the community or uilding in Zone A (without FEMA-issued or community-issued BFE) or Zone AO. Check Item G3. i the inormtion in Items G4.-G9. hs een completed or community loodplin mngement purposes to document the s-uilt lowest loor elevtion o the uilding. Section C o the Elevtion Certiicte records the elevtion o vrious uilding components ut does not determine the lowest loor o the uilding or whether the uilding, s constructed, complies with the community s loodplin mngement ordinnce. This must e done y the community. Items G4.-G9. provide wy to document these determintions. Item G4. Permit Numer. Enter the permit numer or other identiier to key the Elevtion Certiicte to the permit issued or the uilding. Item G5. Dte Permit Issued. Enter the dte the permit ws issued or the uilding. Instructions Pge 4

9 Item G6. Dte Certiicte o Complince Issued. Enter the dte tht the Certiicte o Complince or Occupncy or similr written oicil documenttion o s-uilt lowest loor elevtion ws issued y the community s evidence tht ll work uthorized y the loodplin development permit hs een completed in ccordnce with the community s loodplin mngement lws or ordinnces. Item G7. New Construction or Sustntil Improvement. Check the pplicle ox. Sustntil Improvement mens ny reconstruction, rehilittion, ddition, or other improvement o uilding, the cost o which equls or exceeds 50 percent o the mrket vlue o the uilding eore the strt o construction o the improvement. The term includes uildings tht hve incurred sustntil dmge, regrdless o the ctul repir work perormed. Item G8. As-uilt lowest loor elevtion. Enter the elevtion o the lowest loor (including sement) when the construction o the uilding is completed nd inl inspection hs een mde to conirm tht the uilding is uilt in ccordnce with the permit, the pproved plns, nd the community s loodplin mngement lws or ordinnces. Indicte the elevtion dtum used. Item G9. BFE. Using the pproprite FIRM pnel, FIS, or other dt source, locte the property nd enter the BFE (or se lood depth) o the uilding site. Indicte the elevtion dtum used. Enter your nme, title, nd telephone numer, nd the nme o the community. Sign nd enter the dte in the pproprite lnks. Instructions Pge 5

10 BUILDING DIAGRAMS The ollowing eight digrms illustrte vrious types o uildings. Compre the etures o the uilding eing certiied with the etures shown in the digrms nd select the digrm most pplicle. Enter the digrm numer in Item C2. nd the elevtions in Items C3.-C3.g. In A zones, the loor elevtion is tken t the top inished surce o the loor indicted; in V zones, the loor elevtion is tken t the ottom o the lowest horizontl structurl memer (see drwing in instructions or Section C). DIAGRAM 1 All sl-on-grde single- nd multiple-loor uildings (other thn split-level) nd high-rise uildings, either detched or row type (e.g., townhouses); with or without ttched grge. Distinguishing Feture The ottom loor is t or ove ground level (grde) on t lest one side. * BOTTOM DIAGRAM 2 All single- nd multiple-loor uildings with sement (other thn split-level) nd high-rise uildings with sement, either detched or row type (e.g., townhouses); with or without ttched grge. Distinguishing Feture The ottom loor (sement or underground grge) is elow ground level (grde) on ll sides. Buildings constructed ove crwl spces tht re elow grde on ll sides should lso use this digrm.* BOTTOM (BASEMENT) g (determined y existing grde) g (determined y existing grde) DIAGRAM 3 All split-level uildings tht re sl-on-grde, either detched or row type (e.g., townhouses); with or without ttched grge. DIAGRAM 4 All split-level uildings (other thn sl-on-grde), either detched or row type (e.g., townhouses); with or without ttched grge. Distinguishing Feture The ottom loor (excluding grge) is t or ove ground level (grde) on t lest one side.* Distinguishing Feture The ottom loor (sement or underground grge) is elow ground level (grde) on ll sides. Buildings constructed ove crwl spces tht re elow grde on ll sides should lso use this digrm. * HIGHER S BOTTOM HIGHER S BOTTOM (BASEMENT) g (determined y existing grde) g (determined y existing grde) * A loor tht is elow ground level (grde) on ll sides is considered sement even i the loor is used or living purposes, or s n oice, grge, workshop, etc. Instructions Pge 6

11 DIAGRAM 5 All uildings elevted on piers, posts, piles, columns, or prllel sher wlls. No ostructions elow the elevted loor. DIAGRAM 6 All uildings elevted on piers, posts, piles, columns, or prllel sher wlls with ull or prtil enclosure elow the elevted loor. Distinguishing Feture For ll zones, the re elow the elevted loor is open, with no ostruction to low o lood wters (open lttice work nd/or redily removle insect screening is permissile). ELEVATED Distinguishing Feture For ll zones, the re elow the elevted loor is enclosed, either prtilly or ully. In A Zones, the prtilly or ully enclosed re elow the elevted loor is with or without openings** present in the wlls o the enclosure. Indicte inormtion out openings in Section C, Building Elevtion Inormtion (Survey Required). ELEVATED ENCLOSURE g (determined y existing grde) (For V zones only) c g (determined y existing grde) c (For V zones only) DIAGRAM 7 All uildings elevted on ull-story oundtion wlls with prtilly or ully enclosed re elow the elevted loor. This includes wlkout levels, where t lest one side is t or ove grde. The principl use o this uilding is locted in the elevted loors o the uilding. Distinguishing Feture For ll zones, the re elow the elevted loor is enclosed, either prtilly or ully. In A Zones, the prtilly or ully enclosed re elow the elevted loor is with or without openings** present in the wlls o the enclosure. Indicte inormtion out openings in Section C, Building Elevtion Inormtion (Survey Required). DIAGRAM 8 All uildings elevted on crwl spce with the loor o the crwl spce t or ove grde on t lest one side, with or without n ttched grge. Distinguishing Feture For ll zones, the re elow the irst loor is enclosed y solid or prtil perimeter wlls. In ll A zones, the crwl spce is with or without openings** present in the wlls o the crwl spce. Indicte inormtion out the openings in Section C, Building Elevtion Inormtion (Survey Required). WALKOUT LEVEL g g OPENINGS** h i OPENINGS** h i CRAWL SPACE ** An opening (lood vent) is deined s permnent opening in wll tht llows or the ree pssge o wter utomticlly in oth directions without humn intervention. Under the NFIP, minimum o two openings is required or enclosures or crwl spces with totl net re o not less thn one squre inch or every squre oot o re enclosed. Ech opening must e on dierent sides o the enclosed re. I uilding hs more thn one enclosed re, ech re must hve openings on exterior wlls to llow loodwter to directly enter. The ottom o the openings must e no higher thn one oot ove the grde underneth the lood vents. Alterntively, you my sumit certiiction y registered proessionl engineer or rchitect tht the design will llow or the utomtic equliztion o hydrosttic lood orces on exterior wlls. A window, door, or grge door is not considered n opening. Instructions Pge 7

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