ELEVATION CERTIFICATE
U.S. DEPARTMENT OF HOMEI.AND SECURITY
Federal Emergency Management Agency
National Flood [nsurance
Program
OMB No. 1660-0008
Expires March 31,2012
lmportant: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
For lnsurance Company Use:
Owne/s Name
A2.
BuilLing Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
1085,I3'" STREET
C¡ty BUCKHEAD RIDGE State FL
ZIP
Code
34974
43.
Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 92, REPI.AT OF 3"" ADDITION TO BUCKHEAD RIDGE SUBDIVISION
44. Building Use (e.9., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTAL
45. Lat¡tude/Long¡tude: Lat. 27^10'2'1" Long. 80^43'36"
Horizontal
46. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
Datum: !
NAD 1927
X
NAD 1983
A'7. Building Diagram Number 5
48. For a building with a crarvlspace or enclosure(s):
a)
b)
NA
Square footage of crawlspace or enclosure(s)
No. of permanent flood openings in the crawlspace or
enclosure(s) within 1.0 foot above adjacent grade
Total net area of flood openings in A8.b
Engineered flood
lrlo
c)
d)
49.
sqft
within 1.0 foot above adjacent grade NA
c) Total net aÍea of flood openings in A9.b NA
d) Engineered flood openings? E Yes X
NA
NA
openings? ! Yes X
For a building with an attached garage:
a) Square footage of attached garage NA
b) No. of permanent flood openings in the attached
sq in
sqft
garage
sq in
No
SEGTION B - FLOOD TNSURANCE RATE MAp (F|RM) TNFORMATTON
82. County Name
GLADES
GI.ADES COUNTY/UNINCORP. AREAS 1 20095
84. Map/Panel Number
85
0050
810.
Suffix
87. FIRM Panel
Effective/Revised Date
88. Flood
Date
Zone(s)
89. Base Flood Elevation(s) (Zone
AO, use base flood depth)
5-17-82
5-17-82
PC
't7.0
tso I-IKM ndex
B
FL
lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem 89.
FIS
¡tnn¡
Community Determined
Other (Describe)
[]
Profile X
!
fl
_
811. lndicateelevationdatumusedforBFEinltemBg: X NGVD1929 ! NAVD1988 ! Other(Describe)_
812. ls the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
DesignationDate_
nCenS
sEcTroN
C1.
!
Yes
XNo
G - BU|LD|NG ELEVATTON INFORMATTON (SURVEY REAUTRED)
!
!
X
Building elevations are based on:
Construction Drawings*
Buitding Under Construction*
Finished Construction
new Elevation Certificate will be required when construction of the building is complete.
Elevations - Zones A1-430, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/41-430, AR/AH, AR/AO. Complete ltems C2.a-h
below according to the building diagram specified in ltem 47. Use the same datum as the BFE.
'A
C2.
EOpA
Benchmark Utilized BURTON-BHRVertical Datum NGVD 29
Conversion/Comments NA
Check the measurement used.
a)
b)
c)
d)
e)
D
s)
h)
223
NA._
only)
NA._
NA._
the building 19.2
Top of bottom floor (including basement, crawlspace, or enclosure noor\
Top of the next higher
Bottom of the lowest horizontal structural member (V Zones
Attached garage (top of
floor
slab)
Lowest elevation of machinery or equipment servicing
(Describe type of equipment and location in Comments)
Lowest adjacent (finished) grade next to building (LAG)
Highest adjacent (finished) grade next to building (HAG)
Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
SECTION
D.
SURVEYOR,
17.ç.
19.8
18.9
X feet
X feet
! feet
X feet
X feet
n
!
fl
!
E
meters (Puerto Rico only)
meters (Puerto Rico only)
meters (Puerto Rico only)
meters (Puerto Rico only)
meters (Puerto Rico only)
feet D
X feet n
X feet n
meters (Puerto Rico only)
meters (Puerto Rico only)
meters (Puerto Rico only)
I
OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, eng¡neer, or architect authorized by law to certi! elevation
information. I certify that the informatíon on this Ce¡fifrcate represenfs my best effo¡ts to interpret the data available
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001
X
Check her
Were latitude and longitude in Section A provided by
licensed land
-^
surveyor? X Yes n
a
No
License Number
Title REGISTERED LAND SURVEYOR Company Name LELAND DYALS LAND SURVEYING
Address 304 SW3^"AVE
Signature
FEMA Form 8l-31. Mar 09
City OKEECHoBEE
Date
1/9/201 3
State FL
ZIP Code 34974
Telephone 863-763-4909
See reverse side for continuation.
Replaces all previous editions
IMPORTANT: ln these
information from Section A.
and Box No.
C¡ty BUCKHEAD RlDGEState FL ZIP Code 34974
sEcTloN D - SURVEYOR, ENG|NEER, OR ARCHTTECT CERT|F|CAT|ON
(CONTTNUED)
Copy both sides of this Elevation Certiñcate for (1) community official, (2) insurance agenUcompany, and (3) building owner
Comments THE AC UNIT lS ON THE EAST SIOE OF THE HOME.
SKIRTING WAS NOT INSTALLED AT THE TIME OF THE SURVEY.
CEBTERLINE OF ADJACENT ROAD ELEVATIoN: 19.8'
Date
Signature
SEGTION E - BUILDING ELEVATION
11912013
X
Check here if attachments
AT|ON (SURVEY NOT REQUTRED) FOR ZONE AO AND ZONE A (WTTHOUT BFE)
For Zones AO and A (without BFE), complete ltems E1-E5. lf the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For ltems E1-E4, use natural grade, if available. Check the measurement used. ln Puerto Rico only, enter meters.
El
.
E4
Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is
feet
below the HAG.
meters D above or
b) Top of bottom floor (including basement, crawlspace, or enclosure) is
below the l-AG.
feet
meters
above or
For Building Diagrams 6-9 with permanent flood openings provided in Section A ltems 8 and/or 9 (see pages 8-9 of lnstructions), the next higher floor
(elevation C2.b in the diagrams) of the building is
feet
meters
below the HAG.
above or
Attached garage (top of slab) is
feet meters above or below the HAG.
Top of platform of machinery and/or equipment servicing the building is
below the HAG.
feet
meters
above or
E5.
Zone AO
82.
E3.
I
!
_._
_._
_._
!
_._
only: lf no flood depth number is available,
ordinance?
!Yes ! No f]
!
n
n
n
_._
I
!
!
n
!
!
n
n
!
!
!
!
top of the bottom floor elevated in accordance with the community's floodplain management
Unknown. Thelocal official mustcertifythisinformationinSectionG.
is the
sEcTloN F - PROPERTY OWNER (OR OWNER'S REPRESENTATTVE) CERT|F|CAT|ON
The property owner or owne/s authorized representative who completes Sections A, B, and E tor Zone A (without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements rn Secúlons A, B, and E are correct to the best of my knowledge.
Property Ownef s or Owner's Authorized Representative's Name
Address
City
State
Signature
Date
Telephone
ZIP Code
Comments
!
Check here if attachments
sEcTtoN G - coMMUNtTy
TNFORMATTON (OPT|ONAL)
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),
and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in ltems GB and G9.
G1 .
t]
The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (lndicate the source and date of the elevation data in the Comments area below.)
G2.
fl
t]
A community official completed Section E for a building located in Zone A (without a FEMA-issued or communiÇ-issued BFE) or Zone AO.
G3.
The followíng information (ltems G4-G9) is provided for community floodplain management purposes.
G5. Date Permit lssued
G4. Permit Number
G7.
G8.
G9.
This permit has been issued
for: !
New
Construction !
Elevation of as-built lowest floor (including basement) of the
BFE or (in Zone AO) depth of llooding at the building
G6. Date Certificate Of Gompliance/Occupancy lssued
Substantial lmprovement
building:
site:
G10. Community's design flood elevation
n
feet
E
feet
! meters (PR) Datum
n meters (PR) Datum
n
feet
E
Local Official's Name
Tte
Community Name
Telephone
Signature
Date
meters (PR) Datum
-
Comments
!
FEMA Form 81-31. Mar 09
Check here if attachments
Replaces all previous editions
Building Photographs
See lnstructions for ltem 46.
For lnsurance Gompany Use:
Building.Sheet Address (including
1085
l3'"
STREET
þt.,
Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
City aucrnenD RIDGE State FL ZIP Code
¡+gz+
Policy Number
Conìparry l,lAlc Number
lf using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for ltem A6. ldentify all photographs with: date taken; "Front Vier,r/' and "Rear Vievy''; and, if required, "Right
Side Viev/' and "Left Side View." lf submitting more photographs than will fit on this page, use the Gontinuation Page on the
reverse.
FRONT V|EW (1-9-2013
REAR V|EW (r-9-2013)
Building Photographs
Continuation Page
For lnsurance Gompany Use:
Building Street Address (including Apt., Unit, Suite, andior Bldg. No.) or P.O. Route and Box No.
Policy Number
1085 13'" STREET
City eucrnenD RrDcE State FL ZIP Code
Gomparry l,lAIC Nunúer
33471
lf submitting more photographs than will fit on the preceding page, affix the additional photographs below. ldentify all
photographs with: date taken; "Front Vievr/' and "Rear Vievr/'; and, if required, "Right Side Viev/' and "Left Side View."
LEFT-S|DE/WEST VrEW
(1
-9-201 3)
LEFT-SIDE/WEST
(1
-9-201 3)
5'lt"
Vr
EW