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FEDERAL EMERGENCY MANAGEMENT AGENCY O,M.B. No 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM EAplres May31, 1993 FLOODPROOFING CERTIFICATE FOR NON-RESIDENTIAL STRUCTURES The (loodprooting of non-residential buildings maybe permitted as an alternative to elevating to or above the Base Flood Elevation; however, a tloodprooting design certification is required. This tone is to be used for that certification. Floodproofing of a residential building does not alter a community's Noodplain management elevation requirements or effect the insurance rating unless the community has been issued an exception by FEMA to allow tloodprooted residential basements. The permitting of a Noodprooted residential basement requires a separate certification specifying that the design complies with the local 8oodplain management ordinance. FORINSURANCE COMPANY USE BUILDING OWNER'S NAME I POLICY NUMBER STREE7 ADDRESS 0ndutlinp Apt, Unit. Suite anaor Bltlp. Number) OR P.O. ROUTE AND BOX NUMBER J COMPANY NAIC NUMBER O7HER DESCRIPTION (Lot antl Block Numbers. etc.) CRV STATE 21P CODE SECTION I FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM: COMMUNITY NUMBER PANEL NUMBER SUFFIX DATE OF FIRM INDEX FIRM ZONE BASE FLOOD ELEVATION pn AO 2orros, use tlePtbt SECTION II FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) Floodproofing Design Elevation In}ormetion: Building is floodproofed to an elevation of l i .L; feet NGVD. (Elevation datum used must be the same as that on the FIRM.) Height of tloodprooting on the building above the lowest adjacent grade is ~~ . Lf feet. (NOTE: for insurance rating purposes, the building's Jloodprooted design elevation must be at least one toot above the Base Flood Elevation to receive rating credit. ll the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result in a higher premium.) SECTION III CERTIFlCATION (ey a Registered Professional Engineer or Architect) ~NOn-Residential Floodproofed Construalon Certification: I certify that based upon development and/or review o/structural design, specifications, and plans tar construction that the design and methods of construction are in accordance with accepted standards of practice /or meeting the following provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed tlesign elevation indicated above, with walls that are substantially impermeable to the passage of water. All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated debris impact forces. 1 certiy that the information on this certificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine or impdsonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER for Affix Seal) TnlE COMPANY NAME ADDRESS CITY STATE ZIP SIGNATURE GATE PHONE Copies should be made of this Certlllcata tor: 1) community ofllclal, 2) Insurance agenUeompeny, and 3) building owner. Frau ~-- e. ~- ...vim ecaafrsFpIT10Y OFJt/YB7, WHICH15~aSt]IETE.