FOR INSURANCE COMPANY USE BUN.DING OWNERS NAME ZZ lk STREET 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 Ll ano O M R . No 3067.0077 Expres M ay37. 19 9 3 ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL 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 ELEVATION on 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 (describe under Comments on Page 2). th e FIRM (see 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 atq C.Pe Y* - FENIA Form 01-31 MAY 90 REPLACES AU. PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION A'