FOR INSURANCE COMPANY USE

BUN.DING OWNERS NAME

ZZ lkSTREET ADDRESS (Includ g AIX- Unit. Suits ancYar pdg. Number) OR P.OMOUTE AND BOX NUMBER

3 -

POUCY NUMBER

COMPANY NAIC NUMBER

22 ,

STATE

OTHER DESCRIPTION and Block Numbers. alc.)

' 1.1)0 arz_-CITY

Llano

OM R . No 3067.0077Expre s M ay37. 19 9 3ELEVATION CERTIFICATE

FEDERAL EMERGENCY MANAGEMENT AGENCYNATIONAL FLOOD INSURANCE PROGRAM

Instructions for completing this form can be found on the following pages.

I. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX . i. FIRM ZONE 6. BASE FLOOD ELEVATIONon AO Zones. um O

044-o .6 1/

•b- 5- N

describes the subject building's reference level _I_

of I I

(b).

the selected diagram, is at an elevation of(c). GDE G-E feet above

• below 0 (check one) the highest grade adjacent to the butting.

• GD/E G> feet above 51. or below 0 (check

Yes El No @-W

()Indicate the elevation datum system used in determining the above reference level elevations:ANGVD '29 _T. Other (describeunder Comments on Page 2).th e FIRM (s e e Section B,

( LA C.4. -bet-)()Elevation reference mark used appears on FIRM: 0 Yes No (See Instructions on Page 4)

®The reference level elevation is based on: Kactual construction 0 construction drawings

/1//7Y+ i

1.is not the lowest floor as defined in the community's ^dgg\hdYaf

I,floor as defined by the ordinance is:I

0 atqC.Pe Y*- FENIA Form 01-31 MAY 90 REPLACES AU. PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION

A'

<<

UJI@N

Q

UJI@N

@_g lo m 63+ 0013,, ,

PHONE

Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.

commENTs Icn AD '

1 29 frzi

17 it .g-etv

CERTIFIERS NAME

l[nlTRU

) 3,5ADDR

24-UCENSE NUMBER lot A& Seel)

STATE

NG<N @<N@H@IO

The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.

Elevations for all A Zones should be measured at the top of the reference level floor.

Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.

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