RFP_26-06_Attachment_7_(REVISED)_-_Existing_Elevation_Certificates.pdf

Hurricane Ian

FEMA 4673-DR-FL

795 BIRO DRIVE

U.S. DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency National Flood Insurance Program

OMB No. 1660-0008 Expiration Date: November 30, 2022

ELEVATION CERTIFICATE

Important: Follow the instructions on pages 1–9.

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6

A1. Building Owner's Name

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

City State ZIP Code

Policy Number:

Company NAIC Number:

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.)

A5. Latitude/Longitude: Lat. Long. Horizontal Datum: NAD 1927 NAD 1983

A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.

A7. Building Diagram Number

A8. For a building with a crawlspace or enclosure(s):

a) Square footage of crawlspace or enclosure(s) sq ft

b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade

c) Total net area of flood openings in A8.b sq in

d) Engineered flood openings? Yes No

A9. For a building with an attached garage:

a) Square footage of attached garage sq ft

b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade

c) Total net area of flood openings in A9.b sq in

d) Engineered flood openings? Yes No

SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number B2. County Name B3. State

B4. Map/Panel Number

B5. Suffix

B6. FIRM Index Date

B7. FIRM Panel Effective/ Revised Date

B8. Flood Zone(s)

B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth)

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:

FIS Profile FIRM Community Determined Other/Source:

NGVD 1929 NAVD 1988 Other/B11. Indicate elevation datum used for BFE in Item B9: Source:

B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No

Designation Date: CBRS OPA

FOR INSURANCE COMPANY USESECTION A – PROPERTY INFORMATION

Michael Turcotte

795 Biro Drive

Port Orange Florida 32129

Parcel ID # 633703000180

Residential

29.144310 -81.005250

1A

N/A

N/A

N/A

N/A

N/A

N/A

City of Port Orange 120313 Volusia County Florida

12172C 0369 J 09-29-2017 09-29-2017 AE 7.0'

ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

City State ZIP Code

Policy Number:

Company NAIC Number

SECTION C – BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on:

*A new Elevation Certificate will be required when construction of the building is complete.

Construction Drawings* Building Under Construction* Finished Construction

C2. Elevations – Zones A1–A30, AE, AH, A (with BFE), VE, V1–V30, V (with BFE), AR, AR/A, AR/AE, AR/A1–A30, AR/AH, AR/AO.

Complete Items C2.a–h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.

Benchmark Utilized: Vertical Datum:

Indicate elevation datum used for the elevations in items a) through h) below.

NGVD 1929 NAVD 1988 Other/Source:

Datum used for building elevations must be the same as that used for the BFE.

Check the measurement used.

a) Top of bottom floor (including basement, crawlspace, or enclosure floor) feet meters

b) Top of the next higher floor

c) Bottom of the lowest horizontal structural member (V Zones only)

d) Attached garage (top of slab)

e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments)

f) Lowest adjacent (finished) grade next to building (LAG)

g) Highest adjacent (finished) grade next to building (HAG)

h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support feet meters feet meters feet meters feet meters feet meters feet meters feet meters

SECTION D – SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION

This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.

I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.

Check here if attachments.Yes NoWere latitude and longitude in Section A provided by a licensed land surveyor?

Certifier's Name License Number

Title

Company Name

Address

City State ZIP Code

Signature Date Telephone

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

Comments (including type of equipment and location, per C2(e), if applicable)

Form Page 2 of 6

Ext.

795 Biro Drive

Port Orange Florida 32129

GPS Observations (L-Net) NAVD 1988

7.6

N/A

N/A

7.2

7.1

7.3

N/A

N/A

Bill Hyatt FloridaSurveyor@aol.com LS 4636

Surveyor

Deal Land Surveying, LLC

804 South French Avenue

Sanford Florida 32771

04-03-2023 (407) 878-3796

ELEVATION ON C.2.E. IS TOP OF AIR CONDITIONING UNIT BASE

N/A

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

State ZIP CodeCity

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

Company NAIC Number

Policy Number:

SECTION E – BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)

FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1–E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1–E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).

b) Top of bottom floor (including basement, crawlspace, or enclosure) is

a) Top of bottom floor (including basement, crawlspace, or enclosure) is feet meters above or below the HAG.

metersfeet below the LAG.above or

SECTION F – PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

E2. For Building Diagrams 6–9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1–2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is feet meters above or below the HAG.

feet meters above or below the HAG.E3. Attached garage (top of slab) is

E4. Top of platform of machinery and/or equipment servicing the building is feet meters above or below the HAG.

E5. Zone AO 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? Yes Unknown.No The local official must certify this information in Section G.

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.

Property Owner or Owner's Authorized Representative's Name

Address City State ZIP Code

Telephone

Comments

DateSignature

Check here if attachments.

Form Page 3 of 6

Florida 32129Port Orange

795 Biro Drive

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

ZIP CodeStateCity Company NAIC Number

Policy Number:Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

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 Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8–G10. In Puerto Rico only, enter meters.

G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3. The following information (Items G4–G10) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued

G7. This permit has been issued for: New Construction Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: feet meters Datum

G9. BFE or (in Zone AO) depth of flooding at the building site: feet meters Datum

G10. Community's design flood elevation: feet meters Datum

Comments (including type of equipment and location, per C2(e), if applicable)

Local Official's Name Title

TelephoneCommunity Name

Date

Check here if attachments.

Signature

Form Page 4 of 6

32129FloridaPort Orange

795 Biro Drive

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

BUILDING PHOTOGRAPHS

See Instructions for Item A6.

Policy Number:

Company NAIC NumberZIP CodeStateCity

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.

Form Page 5 of 6

Photo One

Photo One Caption

Photo Two

Photo Two Caption

32129FloridaPort Orange

795 Biro Drive

Front View 03-31-2023

Rear View 03-31-2023

Clear Photo One

Clear Photo Two

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

BUILDING PHOTOGRAPHS

Continuation Page

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:

Company NAIC NumberZIP CodeStateCity

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.

Form Page 6 of 6

Photo Three

Photo Three Caption

Photo Four

Photo Four Caption

795 Biro Drive

32129FloridaPort Orange

Left Side View 03-31-2023

Right Side View 03-31-2023

Clear Photo Three

Clear Photo Four

111 FLEMING AVENUE

(STRUCTURE 1)

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6

Federal Emergency Management Agency National Flood Insurance Program

ELEVATION CERTIFICATE

Important: Follow the instructions on pages 1–9.

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

563297 SECTION A – PROPERTY INFORMATION FOR INSURANCE COMPANY USE

A1. Building Owner's Name Policy Number:

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

111 FLEMING AVENUE

Company NAIC Number:

City State ZIP Code

PORT ORANGE FL 32127

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL

A5. Latitude/Longitude: Lat. 29.1343771 Long. -80.9816033 Horizontal Datum: NAD 1927 NAD 1983

A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.

A7. Building Diagram Number 3

a) Square footage of crawlspace or enclosure(s) 1110 sq ft

b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 6

c) Total net area of flood openings in A8.b 909 sq in

d) Engineered flood openings? Yes No

A9. For a building with an attached garage:

a) Square footage of attached garage N/A sq ft

b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0

c) Total net area of flood openings in A9.b 0 sq in

SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number

120313 VOLUSIA COUNTY

B2. County Name

VOLUSIA COUNTY

B3. State

FL

B4. Map/Panel Number

12127C0388

B5. Suffix

J

B6. FIRM Index Date

09/29/2017

B7. FIRM Panel Effective/ Revised Date

09/29/2017

B8. Flood Zone(s)

AE

B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth)

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:

FIS Profile FIRM Community Determined Other/Source:

B11. Indicate elevation datum used for BFE in Item B9: NGVD 1929 NAVD 1988 Other/Source:

B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No

Designation Date: CBRS OPA

OMB No. 1660-0008

Expiration Date: November 2022 ELEVATION CERTIFICATE

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

111 FLEMING AVENUE

Policy Number:

City

PORT ORANGE

State

FL

ZIP Code 32127

Company NAIC Number

SECTION C – BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)

C1. Building elevations are based on: Construction Drawings* Building Under Construction* Finished Construction

*A new Elevation Certificate will be required when construction of the building is complete.

C2. Elevations – Zones A1–A30, AE, AH, A (with BFE), VE, V1–V30, V (with BFE), AR, AR/A, AR/AE, AR/A1–A30, AR/AH, AR/AO.

Complete Items C2.a–h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.

Benchmark Utilized: X 404 Vertical Datum: NAVD 1988

Indicate elevation datum used for the elevations in items a) through h) below.

NGVD 1929 NAVD 1988 Other/Source:

Datum used for building elevations must be the same as that used for the BFE.

Check the measurement used.

a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 3.5. feet meters

b) Top of the next higher 5.5. feet meters

c) Bottom of the lowest horizontal structural member (V Zones only) N/A. feet meters

d) Attached garage (top of slab) N/A. feet meters

e) Lowest elevation of machinery or equipment servicing the building 6.0. feet meters

(Describe type of equipment and location in Comments)

f) Lowest adjacent (finished) grade next to building (LAG) 3.4. feet meters

g) Highest adjacent (finished) grade next to building (HAG) 3.6. feet meters

h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A feet meters structural support

SECTION D – SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION

This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.

I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.

Were latitude and longitude in Section A provided by a licensed land surveyor? Yes No Check here if attachments.

Certifier's Name License Number

Digitally signed

Kenneth by Kenneth Osborne

Osborne Date: 2022.10.17 16:16:44 -04'00'

Kenneth J. Osborne 6415

Title Registered Professional Surveyor

Company Name

TARGET SURVEYING, LLC

Address 6250 N Military Trail #102

City State ZIP Code West Palm Beach FL 33407

Signature

10/10/2022

Telephone

(561)640-4800

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

Comments (including type of equipment and location, per C2(e), if applicable)

ELEVATIONS IN SECTION C2-E ARE ELEVATIONS OF A/C SLAB. SQUARE FOOTAGE BASED ON

FOOTPRINT OF BUILDING

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City

PORT ORANGE

State

FL

ZIP Code 32127

Company NAIC Number

SECTION E – BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)

FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1–E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1–E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).

a) Top of bottom floor (including basement, crawlspace, or enclosure) is . feet meters above or below the HAG

b) Top of bottom floor (including basement, crawlspace, or enclosure) is . feet meters above or below the LAG

E2. For Building Diagrams 6–9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1–2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . feet meters above or below the HAG

E3. Attached garage (top of slab) is . feet meters above or below the HAG

E4. Top of platform of machinery and/or equipment servicing the building is . feet meters above or below the HAG

E5. Zone AO 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? Yes No Unknown. 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 completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.

Property Owner or Owner's Authorized Representative's Name

Address City State ZIP Code

Signature Date Telephone

Comments

Check here if attachments.

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

PORT ORANGE FL 32127

Company NAIC Number

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 Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8–G10. In Puerto Rico only, enter meters.

G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3. The following information (Items G4–G10) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued

G7. This permit has been issued for: New Construction Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: . feet meters Datum

G9. BFE or (in Zone AO) depth of flooding at the building site: . feet meters Datum

G10. Community's design flood elevation: . feet meters Datum

Local Official's Name Title

Community Name Telephone

Signature Date

BUILDING PHOTOGRAPHS

See Instructions for Item A6.

OMB No. 1660-0008 Expiration Date: November 30, 2022 ELEVATION CERTIFICATE

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

PORT ORANGE FL 32127

Company NAIC Number

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.

Photo One

Photo One Caption FRONT VIEW

Photo Two

Photo Two Caption SIDE VIEW

Continuation Page

OMB No. 1660-0008

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.

Photo One

Photo One Caption REAR VIEW

111 FLEMING AVENUE

(Structure 2)

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6

National Flood Insurance Program

Important: Follow the instructions on pages 1–9.

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

563297 SECTION A – PROPERTY INFORMATION FOR INSURANCE COMPANY USE

A1. Building Owner's Name

Policy Number:

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

111 FLEMING AVENUE

Company NAIC Number:

City State ZIP Code

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) ACCESSORY

A5. Latitude/Longitude: Lat. 29.1343771 Long. -80.9816033 Horizontal Datum: NAD 1927 NAD 1983

A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.

A7. Building Diagram Number 1A

a) Square footage of crawlspace or enclosure(s) N/A sq ft

b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A

c) Total net area of flood openings in A8.b N/A sq in

A9. For a building with an attached garage:

a) Square footage of attached garage N/A sq ft

b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A

c) Total net area of flood openings in A9.b N/A sq in

d) Engineered flood openings? Yes No

SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number

120313 - VOLUSIA

B2. County Name

VOLUSIA COUNTY

B3. State

FL

B4. Map/Panel Number

12127C0388

B5. Suffix

J

B6. FIRM Index Date

09/29/2017

B7. FIRM Panel Effective/ Revised Date

09/29/2017

B8. Flood Zone(s)

AE

B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth)

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:

FIS Profile FIRM Community Determined Other/Source:

B11. Indicate elevation datum used for BFE in Item B9: NGVD 1929 NAVD 1988 Other/Source:

B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No

Designation Date: CBRS OPA

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

PORT ORANGE FL 32127

Company NAIC Number

SECTION E – BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)

FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1–E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1–E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).

a) Top of bottom floor (including basement, crawlspace, or enclosure) is . feet meters above or below the HAG

b) Top of bottom floor (including basement, crawlspace, or enclosure) is . feet meters above or below the LAG

E2. For Building Diagrams 6–9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1–2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . feet meters above or below the HAG

E3. Attached garage (top of slab) is . feet meters above or below the HAG

E4. Top of platform of machinery and/or equipment servicing the building is . feet meters above or below the HAG

E5. Zone AO 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? Yes No Unknown. 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 completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.

Property Owner or Owner's Authorized Representative's Name

Address City State ZIP Code

Signature Date Telephone

Comments

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

PORT ORANGE FL 32127

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 Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8–G10. In Puerto Rico only, enter meters.

G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3. The following information (Items G4–G10) is provided for community floodplain management purposes.

G4. Permit Number

G5. Date Permit Issued

G6. Date Certificate of Compliance/Occupancy Issued

G7. This permit has been issued for: New Construction Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: . feet meters Datum

G9. BFE or (in Zone AO) depth of flooding at the building site: . feet meters Datum

G10. Community's design flood elevation: . feet meters Datum

Local Official's Name Title

Community Name Telephone

Signature Date

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6

See Instructions for Item A6.

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.

Photo One

Photo One Caption FRONT VIEW

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6

Continuation Page

563297 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

111 FLEMING AVENUE

Policy Number:

City State ZIP Code

If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.

Photo One Photo One Caption

Photo Two Caption

216 GRANT STREET

SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

SECTION A – PROPERTY INFORMATION FOR INSURANCE COMPANY USE

Policy Number:

Company NAIC Number:

A1. Building Owner's Name:

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

City: State: ZIP Code:

A3. Property Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number:

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.):

A5. Latitude/Longitude: Lat. Long. Horizontal Datum: NAD 1927 NAD 1983 WGS 84

A6. Attach at least two and when possible four clear photographs (one for each side) of the building (see Form pages 7 and 8).

A7. Building Diagram Number:

A8. For a building with a crawlspace or enclosure(s):

a) Square footage of crawlspace or enclosure(s): sq. ft.

b) Is there at least one permanent flood opening on two different sides of each enclosed area? NoYes

c) Enter number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade:

Non-engineered flood openings: Engineered flood openings:

sq. in.d) Total net open area of non-engineered flood openings in A8.c:

sq. ft.e) Total rated area of engineered flood openings in A8.c (attach documentation – see Instructions):

sq. ft. f) Sum of A8.d and A8.e rated area (if applicable – see Instructions):

A9. For a building with an attached garage:

sq. ft.a) Square footage of attached garage:

Yes No N/Ab) Is there at least one permanent flood opening on two different sides of the attached garage?

c) Enter number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade:

Non-engineered flood openings: Engineered flood openings:

sq. in.d) Total net open area of non-engineered flood openings in A9.c:

sq. ft.e) Total rated area of engineered flood openings in A9.c (attach documentation – see Instructions):

sq. ft. f) Sum of A9.d and A9.e rated area (if applicable – see Instructions):

B1.a. NFIP Community Name: B1.b. NFIP Community Identification Number:

B2. County Name: B3. State: B4. Map/Panel No.: B5. Suffix:

B6. FIRM Index Date: B7. FIRM Panel Effective/Revised Date:

B8. Flood Zone(s): B9. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Depth):

B10. Indicate the source of the BFE data or Base Flood Depth entered in Item B9:

FIS FIRM Community Determined Other:

B11. Indicate elevation datum used for BFE in Item B9: NGVD 1929 NAVD 1988 Other/Source:

B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No

Designation Date: CBRS OPA

B13. Is the building located seaward of the Limit of Moderate Wave Action (LiMWA)? Yes No

N/A

IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

U.S. DEPARTMENT OF HOMELAND SECURITY

Federal Emergency Management Agency

National Flood Insurance Program

ELEVATION CERTIFICATE

OMB Control No. 1660-0008

Expiration Date: 06/30/2026

FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 2 of 19

W 75 FT OF E 450 FT OF N 149.83 FT OF LOT 1B ELIZABETH BUNCH GRANT PORT ORANGE - 634104010131

WHEELER, DOROTHY MARIE 2023-067

216 GRANT STREET

PORT ORANGE FL 32127

RESIDENTIAL

29.139262 N -080.986729 W

1A

N/A

N/A N/A

N/A

N/A

N/A`

N/A N/A

N/A

N/A

N/A

PORT ORANGE 120313

VOLUSIA FL 12127C0388 J

09/29/2017 09/29/2017

AE 4 FEET

FOR INSURANCE COMPANY USE

Company NAIC Number:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

City: State: ZIP Code:

SECTION E – BUILDING MEASUREMENT INFORMATION (SURVEY NOT REQUIRED)

FOR ZONE AO, ZONE AR/AO, AND ZONE A (WITHOUT BFE)

For Zones AO, AR/AO, and A (without BFE), complete Items E1–E5. For Items E1–E4, use natural grade, if available. If the Certificate is intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement used. In Puerto Rico only, enter meters.

Building measurements are based on:

*A new Elevation Certificate will be required when construction of the building is complete.

Construction Drawings* Building Under Construction* Finished Construction

E1. Provide measurements (C.2.a in applicable Building Diagram) for the following and check the appropriate boxes to show whether the measurement is above or below the natural HAG and the LAG.

a) Top of bottom floor (including basement, crawlspace, or enclosure) is: metersfeet above or below the HAG.

b) Top of bottom floor (including basement, crawlspace, or enclosure) is: below the LAG.above ormetersfeet

E2. For Building Diagrams 6–9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1–2 of Instructions), the next higher floor (C2.b in applicable

Building Diagram) of the building is: below the HAG.above ormetersfeet

E3. Attached garage (top of slab) is: below the HAG.above ormetersfeet

E4. Top of platform of machinery and/or equipment servicing the building is: below the HAG.above ormetersfeet

E5. Zone AO 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? Yes No Unknown The local official must certify this information in Section G.

SECTION F – PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge

Check here if attachments and describe in the Comments area.

Comments:

Property Owner or Owner's Authorized Representative Name:

Address:

City: State: ZIP Code:

Ext.: Email:Telephone:

Signature: Date:

FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 4 of 19

ELEVATION CERTIFICATE

IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19

Company NAIC Number:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

City: State: ZIP Code:

The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete

Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item(s) and sign below when:

G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2.a. A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item

E5 is completed for a building located in Zone AO.

G2.b. A local official completed Section H for insurance purposes.

G3. In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H.

G4. The following information (Items G5–G11) is provided for community floodplain management purposes.

Permit Number:

G8. This permit has been issued for: New Construction Substantial Improvement

G9.a. Elevation of as-built lowest floor (including basement) of the building: Datum:metersfeet

G9.b. Elevation of bottom of as-built lowest horizontal structural member: Datum:

G10.a. BFE (or depth in Zone AO) of flooding at the building site: Datum:

G10.b.

Datum:

Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member:

G11. Variance issued? Yes No If yes, attach documentation and describe in the Comments area.

The local official who provides information in Section G must sign here. I have completed the information in Section G and certify that it is correct to the best of my knowledge. If applicable, I have also provided specific corrections in the Comments area of this section.

NFIP Community Name:

Local Official's Name: Title:

Comments (including type of equipment and location, per C2.e; description of any attachments; and corrections to specific information in

Sections A, B, D, E, or H):

SECTION G – COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION)

G6. Date Permit Issued:

Date Certificate of Compliance/Occupancy Issued:

G5.

G7.

metersfeet metersfeet metersfeet

Address:

City: State: ZIP Code:

Ext.: Email:Telephone:

Signature: Date:

FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19

ELEVATION CERTIFICATE

IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19

Company NAIC Number:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

City: State: ZIP Code:

SECTION H – BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES

(SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY)

The property owner, owner's authorized representative, or local floodplain management official may complete Section H for all flood zones to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be completed. Enter heights to the nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Diagrams (at the end of Section H

Instructions) and the appropriate Building Diagrams (at the end of Section I Instructions) to complete this section.

H1. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the Lowest Adjacent Grade (LAG):

a) For Building Diagrams 1A, 1B, 3, and 5–9. Top of bottom floor (include above-grade floors only for buildings with subgrade crawlspaces or enclosure floors) is:

meters above the LAGfeet

b) For Building Diagrams 2A, 2B, 4, and 6–9. Top of next higher floor (i.e., the floor above basement, crawlspace, or enclosure floor) is:

above the LAGmetersfeet

H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated to or above the floor indicated by the

H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate Building Diagram?

Yes No

FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 6 of 19

ELEVATION CERTIFICATE

IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19

The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections

A, B, and H are correct to the best of my knowledge. Note: If the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G.

Check here if attachments are provided (including required photos) and describe each attachment in the Comments area.

Property Owner or Owner's Authorized Representative Name:

Comments:

SECTION I – PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION

Address:

City: State: ZIP Code:

Ext.: Email:Telephone:

Signature: Date:

Company NAIC Number:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

City: State: ZIP Code:

ELEVATION CERTIFICATE

IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19

BUILDING PHOTOGRAPHS

See Instructions for Item A6.

Instructions: Insert below at least two and when possible four photographs showing each side of the building (for example, may only be able to take front and back pictures of townhouses/rowhouses). Identify all photographs with the date taken and "Front View," "Rear View,"

"Right Side View," or "Left Side View." Photographs must show the foundation. When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9.

Photo One

Photo One Caption: Clear Photo One

Photo Two

Photo Two Caption: Clear Photo Two

FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 7 of 19

216 GRANT STREET

PORT ORANGE FL 32127

FRONT 07-21-2023

REAR 07-21-2023

Company NAIC Number:

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.:

City: State: ZIP Code:

ELEVATION CERTIFICATE

IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19

BUILDING PHOTOGRAPHS

Continuation Page

Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," "Right Side

View," or "Left Side View." When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9.

Photo Three

Photo Three Caption: Clear Photo Three

Photo Four

Photo Four Caption: Clear Photo Four

FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 8 of 19

A/C PAD 07-21-2023

5028 PALMETTO STREET

5088 PALMETTO STREET

National Flood Insurance Program

OMB No. 1660-0008 Expiration Date: November 30, 2022

ELEVATION CERTIFICATE

Important: Follow the instructions on pages 1–9.

Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.

FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6

A1. Building Owner's Name

A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

City State ZIP Code

Policy Number:

Company NAIC Number:

A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)

A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.)

A5. Latitude/Longitude: Lat. Long. Horizontal Datum: NAD 1927 NAD 1983

A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.

A7. Building Diagram Number

b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade

c) Total net area of flood openings in A8.b sq in

d) Engineered flood openings? Yes No

A9. For a building with an attached garage:

a) Square footage of attached garage sq ft

b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade

c) Total net area of flood openings in A9.b sq in

d) Engineered flood openings? Yes No

SECTION B – FLOOD INSURANCE RATE MAP (FIRM) INFORMATION

B1. NFIP Community Name & Community Number B2. County Name B3. State

B4. Map/Panel

B7. FIRM Panel Effective/ Revised Date

B8. Flood Zone(s)

B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth)

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:

FIS Profile FIRM Community Determined Other/Source:

NGVD 1929 NAVD 1988 Other/B11. Indicate elevation datum used for BFE in Item B9: Source:

B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No

Designation Date: CBRS OPA

FOR INSURANCE COMPANY USESECTION A – PROPERTY INFORMATION

GROVES, AUSTIN 2023-086

5088 PALMETTO STREET

PORT ORANGE Florida 32127

E 1/2 OF LOT 10 EXC N 40 FT & LOT 11 EXC N 40 FT BLK 4 NORWOOD - 631012040110

RESIDENTIAL

29.1311637 -080.9809813

1A

N/A

N/A

N/A

480.00

N/A

N/A

PORT ORANGE 120313 VOLUSIA Florida

12127C0388 J 09-29-2017 09-29-2017 AE 4

Expiration Date: November 30, 2022

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

State ZIP CodeCity

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

Company NAIC Number

Policy Number:

SECTION E – BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED)

FOR ZONE AO AND ZONE A (WITHOUT BFE)

For Zones AO and A (without BFE), complete Items E1–E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1–E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.

E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).

b) Top of bottom floor (including basement, crawlspace, or enclosure) is

a) Top of bottom floor (including basement, crawlspace, or enclosure) is feet meters above or below the HAG.

metersfeet below the LAG.above or

SECTION F – PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION

E2. For Building Diagrams 6–9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1–2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is feet meters above or below the HAG.

feet meters above or below the HAG.E3. Attached garage (top of slab) is

E4. Top of platform of machinery and/or equipment servicing the building is feet meters above or below the HAG.

E5. Zone AO 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? Yes Unknown.No The local official must certify this information in Section G.

The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.

Property Owner or Owner's Authorized Representative's Name

Address City State ZIP Code

Telephone

Comments

DateSignature

Check here if attachments.

Form Page 3 of 6

Florida 32127PORT ORANGE

Expiration Date: November 30, 2022

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

ZIP CodeStateCity Company NAIC Number

Policy Number:Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

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 Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8–G10. In Puerto Rico only, enter meters.

G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)

G2. A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.

G3. The following information (Items G4–G10) is provided for community floodplain management purposes.

G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued

G7. This permit has been issued for: New Construction Substantial Improvement

G8. Elevation of as-built lowest floor (including basement) of the building: feet meters Datum

G9. BFE or (in Zone AO) depth of flooding at the building site: feet meters Datum

G10. Community's design flood elevation: feet meters Datum

Comments (including type of equipment and location, per C2(e), if applicable)

Local Official's Name Title

TelephoneCommunity Name

Date

Check here if attachments.

Signature

Form Page 4 of 6

32127FloridaPORT ORANGE

Expiration Date: November 30, 2022

IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE

FEMA Form 086-0-33 (12/19) Replaces all previous editions.

BUILDING PHOTOGRAPHS

See Instructions for Item A6.

Policy Number:

Company NAIC NumberZIP CodeStateCity

Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.

If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.

Form Page 5 of 6

Photo One

Photo One Caption

Photo Two

Pho…