federal emergency management agencydpw.lacounty.gov/wmd/nfip/ecdocs/44525 92nd street east,...
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NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
mportant Read the insbuctions on pages 1 - 7.
O. tvi. C. !#.*(*$%!')&,+&$++(+-""
SECTION A- PROPERTY OWNER INFORMATION
BUILDING OWNER'S NAME%$$'"!(&&#
BUILDING STREET ADDRESS (Inducing Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.44525 92ND STREET EAST
STATELANCASTER CA
—Poky
.Compa lAIC Number.. ......
ZIP CODE93535
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Descrip(ion, etc)TAX PCL NO. 3376-011-001BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.DETACHED
( &&'#$!-5<!$&&"( NAD 1927 NAD 1983SOURCE: GPS (Type):
USGS Quad Map Other:
SECTION B- FLOOD INSURANCE RATE MAP (FIRM)INFORMATION
#"
+(*),
clinging)
B10.0 RS Profile 0 FIRM 0 Community Determined
B11. NGVD 1929 NAVD 1988 0 Other (Desabe):DYes [g] No Designation Data
MING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl Buiding elevations are based on: 0 Construction Drawings* 0 Finished Construction
be required when construction of the bulding is carob*.
C2.
C3.
NGVD1929
Does the elevation reference mark used appear on the FIRM? 0 Yes tg No
2445.CIft(m)
b) _ft.(m)
c)
d)Attached garage (bp of slap 2445. Oft(m)
e)
servicing the buiding (Desate in a Comments area)
f)
g) 2444. ift(m)
h)No. of pemanent openings (
i) ma of at pemanent openings (flood vents) in 3.h
This certification is tube signed and sealed by a laid surveyor, engineer, or architect authorized by law to certify elevation information.C on
US. Code,
crty93534
STATE ZIP CODECA 93535ACASTER
AT: In these spaces, copy the conesponcTmg information from Section ksTREET ADDRESS (Incising Apt, Unit, Suiik anc ig. No.) OR P.O. ROUTE AND BOX NO.
AND STREET EAST
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n Check here if attachments
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E2.
E3. t(m) _in.(cm) thove the highest adjacent
grade. Complet ite ms C3.h aid
E4. t(m) _in.(cm) 0 above or 0 below (check one) the highest adjacent grade. (Use
Ea ForZone AO only If no food depth nunter is elevatO in azcordance wit the community's loodplan management ordinance?
es DNo 0 Unknown. The local official must certify this information in Section
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over oramier's authorized
it Sec s ate knowledge.
crrY93534
11/32006
Check here if Atachments
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0 The donation in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by &le
management purposes.
0 New Construction 0 Substantia Improvement
_ft.(m)
Check here if attachment
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