Laserfiche WebLink
IMPORTANT: In those spaces, cgpy the corrcsponding information from Section A. <br />Building Street Address (induding Apt.,Unit, Suile, and/or Bldg. No.) or P.O. Roule and Box No, <br />480 CEDAR COVE RD. <br />Policy Number: <br />ZlP eode <br />9E926 <br />State <br />Washinglon <br />City <br />ELLENSBURG <br />Company NAIC Number <br />sEcTloN G - COmtuNtTy tNFoRltATtoN (opTlonlAL] <br />The local oflicial who is authorized by law or ordinanoe to administer lhe community's floodplain manegement ordinance can completeSections.A, B'-C-(o1 E-), and G of this Elevation Certificate. Complete lhe applicabl6 item(s) and sign uirow. Ctric* the measurementused in ltsms G8-G10. ln Puerto Rico only, enter meterc. <br />G1. I The.information.in Section C was taken from olher documentation that has been signed and sealed by a licensed surveyor,engineer, or arciilect who is authorized by law to certiff elevation information. (lndilate the sour@ arid oate of the elevationdata in the Comments area below.) <br />G2. fJ A cjmmgltY official completed Section E for a building located in zone A (without a FEMA-issued or community-issued BFE)or Zone AO- <br />G3 F. The following information (ltems G4€10) is provided for community floodplain management purposes. <br />lrD'tri*ocloz3 <br />G4. Permit Number G5. Date Permit lssued <br />io - \u'- 2.3 i.'l <br />G6. Date Certilicate ot <br />Compliance/Occupancy lssued <br />tl'tl 'Lc:'z\ <br />G7. This pemit has been issued for: F[New construction I substantial lmprovement <br />G8. Elevalion of as-built lowest floor (including basement) <br />of the building; <br />G9. BFE or (in Zone AO) depth of flooding at the building site <br />G10. Community's design flood elevation:l''icr(, <' filfeet fimeters Datum Ny,vD ?,:l <br />14nrr a) <br />14a,n 1 ffifeet I meters Darum N]6vb -J.:l <br />ftffeel f] meters Datum N)6vD a <br />A."(r". -1\'-.'* <br />Local Officiafe Name <br />t,.i, Lu' <br />Tite <br />ft 5.,,..j- fyla,.*..f <br />SCrl * cIa'L-K h.r'L <br />Date <br />4-ct-ZoLI <br />(including gpe of equipment and tocation, per C2(e), it applicable) <br />I Check here fi attac*rments. <br />ELEVATION CERTIFICATE OMB No. 1660{008 <br />Expiration Dale: November 30, 2022 <br />FEMA Form 06&0-33 (12119)Replaces all previous editions.Form Page 4 of6