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1090 Jasmine Street ELEVATION 09.17.2010 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMS No. 1ss0-00W - Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9, SECTION A-PROPERTY INFORMATION 'd�F 064 ,a Al. Burkling Ownses Name A2. Bukftt+g Street Address(includIN Apt.,Unk,Suite,andlor Bldg.No:)or P.O.Routs and Box No. .,f ycx 1090 JASMINE STREET City ATLANTIC BEACH State FL ZIP Cods 32233 LOT 3,BLOCK 180,ATLANTIC BEACH SECTION"W (PIAT BOOK 18,PAGE 34) ,etc.) A4. Building Use(e.g.,RsakbMial.Non-t*s dw*W,Addition,Accessory,etc.)RESIDENTIAL A5, Latitude/l.ongkuds:Lat.30"19 57.1r N Long.A1"25.24.54"W Horizontal Datum: ❑ NAD 1927 NAD 1983 A8. Attach at least 2"oWsphs of the building it the Cartkidrie is being used to obtain flood Insurance. AT Bulkflng Diagram Number 1 A8. For a building with a crawtspace or snclosure(sk A9. For a building with an attached garage: a) Square footage of crawlspace or enclosuro(s) hm aq ft a) Square footage of attached garage NA sq ft b) No.of permanent flood openings In the crawtspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade jy(,S within 1.0 foot above adjacent grade M c) Taal net area of flood openings in A8.b WA sq in c) Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NFIP Community Name&Community Number 82.County Name B3.State ATLANTIC BEACH 120075 DWAL FL B4,Mapffl*W Number f_B6:_§U_ffIx 1 86.FIRM Index 87.FIRM Panel B8,Flood B9,Bass Flood Elevation(*)(Zone 120075 0001 D Date Ef octive/Revised Date Zone(s) AO,use base flood depth) NIA 04/17/89 "X"SHADED NIA 8110. Indicate the source of the Bass Flood Elevation(BFE)data or base flood depth entered in Item 89. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other(Describe) S11. indicate elevation datum used for BFE in item B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe)WA B12. Is the building located Ina Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? © Yes ® No Designation Date ❑ C8RS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ® Building Under Construction' ❑ Finished Construction *A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations—Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARIAE,AR/Ai-A30,ARIAH,ARIAD. Complete Items C2.a-h below according to the building diagram specified In Item A7. Use the same datum as the BFE. Benchmark Utilized Vertical Datum NGVD 1929 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawispace,or enclosure floor)7.A ®feet ❑meters(Puerto Rico only) b) Top of the next higher floor ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) ❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) COMMENT. ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) Cl feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to buil lIng(HAG) 91 ®feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stain,including Z.1 ®feet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation Information. I codify that the information on this CodWdote represents my best efforts to brtaMret the data availabled understand that any false statement maybe punt~&by fine or imprisonment under 1d U.S.Code,Section 1001.0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes ❑ No ,p Certifiees Name DONN W.BOATWRIP.S.M. License Number LS 3295 Q` Title PRESIDENT Company Name BOATWRIGHT LAND SURVEYORS,INC. Address 1 RT DRIVE City JACKSONVILLE BEACH State FL ZIP Code 32250 Signature Date 0911712010 Telephone (904)241-8550 V V� FEMA Form 81-31,Mar 09 See reverse side for continuation. Replaces aA previous editions IMPORTANT: In these spacn,copy the corresponding information from Section A. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. r 1090 JASMINE STREET ,s�r� tv City ATLANTIC BEACHState FL Zip Cods 32233 - Nf S'iw N SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Csrtil9cate for(1)community otficisi,(2)Insurance agent/company,and(3)building owner. Continents SECTION A&INFORMATION IS APPROXIMATE AND DETERMINED FROM GOOGLE EARTH. SECTION C2d-THERE IS A DETACHED GARAGE,FOUNDATION ELEVATION IS 7.5. Signature Date 09!17/2010 Check hen d attachments SECTIO BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(1MTHOUT SFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A.B, and C. For Items E1-E4,use natural grade,if available, Check the measurement used. In Puerto Rico only,enter meters. Et. 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 basemen,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2, For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see ages 8-9 of Instructions),the next higher floor (elevation C2.b In the diagrams)of the building is ❑feet El meters 1--)above or below the HAG. E3. Attached garage(top of slab)Is ❑feet ❑motors ❑above or ❑below the HAG, E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this Information In Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B.and E for Zone A(without a FEMA-issued or community Issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZiP Code Signature Date Telephone Comments ❑Check 4t%K aftachme SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the o ommuny s floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable items)and sign below. Check the measurement used In Items GS and G9. G1,❑ 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 taw to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located In Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(items G4-G9)to provided for cononuamity floodplain management purposes. G4.Pannit Number G3. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for. ❑New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Officlars Name Title Community Name Telephone Signature Date Comments ❑Check here if attachment FEMA Form 81-31,Mar 09 Replaces all previous editions w w a oWC ai 11Lys q R Q� 0 1oLHsTRFFT T ` 9TH ST po W 17 � T Y. r F FT 6TH STRF T ' 14 sr, T HR4 nv �� STRFFT T�G� R EL 5) CO' "F r� 4TNSTRFF T F N w v------------- plop U, r r Ljj z2ND SSR CO -� a a FFT 0 � s+ k .` 1ST STREET . _ k