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ELEVATION CERTIFICATE <br />ous No. 1660-0008 <br />Expiration Data. November 30. 2022 <br />NWORTAMr in these spaces, copy the coreaponding information from Section A. <br />FOR INSURANCE COMPANY USE <br />Building Sheet Address (including Apt, Unit. Suite, andlor Bldg. No.) or P.O. Route and Box No. <br />Policy Number. <br />5124 MCfIMANAMY RR, <br />City State ZIP Code <br />ELLENSBURG Washington 98MIS <br />Company NAIC Number <br />SECTIMI G — CONNUNITY WFORMATION (f3RTMAL) <br />The WW oiBaal who is authoriaed by law or ordinance to administer the oommunity's floodplain management ordinance can complete <br />Sections A. 8, C (or Q. and G of ibis Elevation Certificate. Complete the applicable items) and sign below. Cho* the measurement <br />used In Items G8-010. In Puerto Rico only, enter meters. <br />G1. ❑ The inftmration in Section C was taken from other documentation that has been signed and sealed by a ficeneed surveyor, <br />engineer. or architect who is authorized by law to cafy elevation information- (Indicate the source and data of the elevation <br />data in the Comments area below.) <br />g2, ❑ A community official completed Sea= E for a building located in Zone A (without a FEMA issued or community -issued SFE) <br />or Zone AO. <br />G3. ❑ The foil wkv inbrmation {hams G4—G1 0) Is provided far community tloodpfaln management purposes. <br />04_ Permit Number <br />G5. Dere permit Issued <br />t36. Date Ca fuxde of <br />1 <br />Compliance/Occupancy Issued <br />a h4. z� <br />G7. This permit has bean issued for: ❑ New Construction ❑ Substantial Improvement <br />G& Elevation of am -but lowest floor (including basamamt) <br />of the budding: lt5 ' -1 RAW ❑ meters Datum N&\)O 4'1 <br />G9. BFE or (in Zone AD) depth of flooding at the building site: _ l i' I .5 M feet ❑ meters paper �,�j� •2 <br />010. Community's design flood elevation: 5 feet ❑ meters Datum r <br />I ace! 01fidars Name Title <br />fr'elf v, 1,iLr 2e y { r - <br />Community Matte Telephone <br />p } <br />sell <br />Raba <br />rre <br />omme <br />Commenlis (inducting M* of eWiptnent and location. per C2(e), if applicable) <br />h SJ t.+k� ( J v\ -L rtel,..-l.. jriuj 1. 4-j rit��SS � 1 <br />_ <br />t7n,`�i1r,`{ Cu.ti`� �u�k CRi.c_1 <br />`.iJti,M, �i�t� �+,1)e�.t�- y`1e..� C Z 4l1'� }tet\ (�w� iL Gam. (t�:'vtiti7� h� r �.C� Y`�SvPL in-+• 1'1ti �'t...(„ <br />t { 1-11A..� tt w� <br />t.�. fY1r•AJA I?, 'M U,R�ie�� � � I7 �t: 1•�i[�(�.(r] <br />I?,j <br />1 f � ^ a, <br />cj�v � Sid, Vf ekfct tnt J � rLJ JL G— VkA2 , LLt�. i[,rdtt�- irl SiU 1„ <br />n�a.rC�'" <br />Q a C�er.Y.�FS ,�;��4 [ADZ.'w ar �: N i <br />❑x Check hers if anochmentL <br />r-mA tort um -u-33 tiznv) Replaces all previous ediliom Form Page 4 of 6 <br />