33,35,37 WALCOTT DRAddress: 33, 35, 37 Walcott Drive
Legal: Boynton Bekes Plat 3-B
Lots 3, 2, l
Control #
Allowable Coverage % Set Backs - Side
Allowable Height Lot Area
Side
Use:
Zone:
Sewer:
Water:
Impact:
R FFE:
F1Z:
BFE:
Issue
Date
Structure Height ,No. Stories Type Oooupnnoy
Floors Por~ ' , , ~YI~O0~
Type c~tion Standpipos ( ) ¥'es ( ) Nd Location
Elevator ( ).Yes ( ) No Electric Shut Off Location .
Nearest Hydrant ",', Roof Access Located At
Permit
No. Contractor 'Architect Owner Valuation
....... Ilazardoum S~or. ~o,.
Location of Stairs
Final
Date Purpose
Address: 33, 35, 37 Walcott Drive
Legal: Boynton B~kes plat 3-B
Lots 3, 2, 1
Control # "
Allowable Coverage % Set Backs - Side
Allowable Height Lot Area
Side Fr. R
Use:
Zone:
Sewer:
Wa ter:
Impact:
FFE:
F1Z:
BFE:
Structure Height ,No, stories .__.. Type Oeoupnncy==_,. ....Hazardou~
Floors por~/-~t'o-~ ' Type ~oo~
Type cbnst'ruction - "s~ndp~pos ( ) Y~s~("~ N~ L'o'~atio~.~
Elevator ( ).Yes * ( )"No "Electric Shut Off Location
Nearest Hydrant ".,. Roof Access Located At Location of Stairs
Iss%/e
Da~e
Permit
No.
Contractor
Architect
Owner
Valuation
Final
Fee Date
Purpose
o~,
co
m
rn
m
m
z
o)
co the corresoonding information from Section A.
iMPORTANT: In these spaces, py ~,
STATE
SECTION D- SURVEYOR, EN(31NEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy.0oth sides of this Elevation Certificate for (1) community official, (2)insurance agent/company, and (3) building owner.
COMMENTS
j..j Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AD and ZONE A (WITHOUT BFE)
For Zone AD and Zone A (without BFE), complete items E1 through E3. If the Elevation Certificate is intended for use as supporting
information for a LOMA or LOMRrF, Section C must be completed.
El. Buildir~ Diagram Number . (Select the building diagram most similar to the building for which this certificate is being completed -
see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement Or enclosure) of the building is L._L._I ft.(m) b.L_lin.(cm) L_I above or L_[ below
(check one) the highest adjacent grade,
E3. For Zone AD 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? L_~Unkn°wn' 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 co'.mpletes Sections A, B, and E for Zone A (without a FEMA-issued or
community-issued BFE) or Zone AD must sign here.
PROPERTY OWNER'S OR OWNER'S AUT--"~'RIZED ~NAME
CiTY STATE ZIP CODE
ADDRESS
DATE TELEPHONE
SIGNATURE
COMMENTS
g~ Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance,can~ complete
ect~ons A, B, C or E) and (3 of this Elevation Cert ficate. Complete the applicable item(s) and sign below.
S ' / ( ' _ : _ . -,.__ -~__ A~..r docUmentation that has been signed and embossed by a licensed surveyor,
G1 I (Indicate the source and date of the
r local law to certify elevation mformat~On-eng n ,
elevation data in the Comments area below.)
G2. L_[ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or
Zone AD,
G3 L.~ The following information (items G4--G9) is provided for community floodplain management purposes.
. MIT NUMBER GS]-'~--_-_-_-_-_-~-. DATE PERMIT ISSUED~ DATE CERTIFLCATE OF COMPLIANCE/OCCUPANCY
G4 PER ' ISSUED ~. // ~
G§ BFE or (in Zone AD) depth of flooding at the building site is:~/f' ~ ft.(m) Datum:
LOCAL OFFICIAL'S N~ / TITLE ' '__
~u~~E ~ ' ..... T--'~P h O N E~C'~
Check here if attachments
REPLACES ALL PREVIOUS EDITIONS
FEMA Form 81-31, AUG 99