Laserfiche WebLink
IMPORTANT: ln tlrese spaces, copy the conespondlng lnformaton trom Secton A.FOR INSURANCE COMPANY USE <br />Building Steei Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. <br />390 HERON FARM LANE <br />Policy Number: <br />City Stet€ <br />Washington <br />ZIP Code <br />98926ELLENSBURG <br />Company NAIC Number <br />sEcTtoN E - BU|LDTNG ELEVATTON TNFORMATTON (SURVEY NOT REOUTRED) <br />FORZONE AO AND ZONE A (WTHOUT BFE) <br />For Zones AO and A (without BFE), complete ltems E1-E5. lf the Certificate is intended to support a LOMA or LOMR-F request, <br />complete Sections A, B,and C. For liems E1-E4, use natural grade, if available. Check lhe measurement used. ln Puerto Rico only, <br />enter meters. <br />E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevadon is above or below <br />the highest adjacenl grede (HAG) and the lowesl adjacent grade (LAG). <br />a) Top of bottom floor (including basement, <br />crawlspace, or enclosure) is <br />b) Top of boftom floor (induding basement, <br />crewlspace, or enclosure) is <br />I feet I meters ! above or I bebwthe HAG. <br />I teet f] meters I above or fl belowthe L{G. <br />E2. For Building Diagrans S-9 wilh permanent <br />fie next higher froor (elevation C2.b in <br />the diagrams) of the building is <br />flood openings provided in Sec-lion A ltems 8 and/or I (see pages 1-2 of lnstuctions), <br />E3. Attrached garage (top of slab) is <br />E4. Top of platform of machinery and/or equipment <br />servicing the building is <br />D feet I meters <br />I feet I metens <br />flfeet f]meten <br />I above or Ibelowthe HAG. <br />I above or Ibelowthe HAG. <br />fl aboveor flbelowthe HAG. <br />E5. Zone AO only: lf no flood depth number is available, is the top of tho bottom floor elevated in accordance wlth the community's <br />floodplain management ordinance? f] Yes f] No f] Unknown. The local ofiicial must oertifu thls lnformation in Section G. <br />sEcnoN F - PROPERTY OWNER (OR OWNER'g REPRESENTAnVEI CERT|nCAnON <br />The property owner or ownefs authorized representative who conpletes Sectons A, B, and E for Zone A (without a FEMA-issued or <br />community-issued BFE) or Zone AO must sign here. The s,tatemenb in Sec'tions A, B, and E are conect to tre best of my knowledge. <br />Property Owner or Ourne/s Authorized Representative's Name <br />Address City State ZIP Code <br />Signatrre Date Telephone <br />CommentE <br />n Check here if attachments. <br />ELEVATION CERTIFICATE OMB No. 1660-0008 <br />Expiration Date: November 3O,2022 <br />FEMA Form 086-0-33 (12119)Replaces all previous editons.Form Page 3 of6