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3/&(*6*&/-*5*

SUPPLEMENTAL INFORMATION FOR SECTION C

2496 0

2496 4 XX

33154 Agua Dulce Canyon Road

Saugus, CA 91390

X

NGVD 1929

N/A

N/A

N/A

N/A

0 Yes

2 5,

9878E4?!8@8E;8A6K!@4A4;8@8AG!4;8A6K

A4G=BA4?!9?BB7!=AFHE4A68!CEB;E4@

ELEVATION CERTIFICATE

=X[Z\^MY^1!EQMP!^TQ!UY]^\_OÛZY]!ZY![MSQ]!+!'.(

F86G=BA!4! CEBC8EGK BJA8E!=A9BE@4G=BA!

DAD= OWNER'S 'AME

BASAIL

BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.33154 AGUA DULCE CANYON ROAD

STATEAGUA DULCE

CZWUOb Number

Company NAIC A_XNQ\

M@E CODE

PROPER r DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)4CA1!-,+,'*++'*+* 560!("'.'45"3%' .+ ()/#"*, --,5$!/'+!045#&

r-UiLDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, UR!YQOQ]]M\b(%SOLID COVERED PATIO ADDMON TO EXISTING STRUCTURE

LATITUDE/LONGIIUDL: (OPTIONAL)!!"#$%& ""%"''$'('>#

HORIZONTAL DATUM:INAD 1927 6= NAD 1983

SOURCE: (Type):USGS Quad Map

5,*6/32!)!%!-033+!=AFHE4A68!E4G8!@4C!$9=E@%!/2-341(6/32

COMMUNITY NAME & COWUNITY NUMBER

LA COUNTY UHNCORPORATED AC.iiifN 08504382. COUNTY NAME

LOS ANGELES

83. STATE

CA

84. MAP AND PANEL

NUMEER 85. SUFFIX 86. FIRM INDEX DATE

87. FIRM PANEL

EFFECTIVFJREVISED DATE

89. BASE FLOOD ELEVATION(S)

68. FLOOD ZONE(S) (Zone AO, use

B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 69.

Community Determined0 NAVD 1988 0 Other (Describe):

612, Is the building located in a Coastal Banter Resources System (CBRS) area or Otherwise Protected Area (OPA)? ,7 No Designation Date

5,*6/32!*!%!)7/0+/2.!8?8I4G=BA!=A9BE@4G=BA!$FHEI8K!E8DH=E87%!

Bilking elevations are based on: QW 0 Finished Construction

king for which this certificate is being completed - see pages 6 and 7. If no diagram

accurately represents the building, provide a sketch or photograph.)

Section 6, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of

Section D or Section G, as appropriate, to document the datum conversion.

Elevation reference mark used Does the elevation reference mark used appear on the FIRM?

a)Top of bottom floor (including basement or endosure)

b)

c)

d)Attached garage (top of slab)

e)Lowest elevation of machinery and/or equipment

servicing the building (Describe in a Comments area)

2. 7

-

- _ft(tri)

M.3Oft.

h)No. of permanent openings (flood vents) within 1 ft. above adjacent grade

i)Total aèa of al permanent openings (flood vents) in C3.h __sq. in. (sq. cm)

F86G=BA!7!FHEI8KBE&!8A;=A88E&!BE!4E6<=G86G!68EG=9=64G=BA

This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by WMa!^Z!OQ\ÛRb!QWQ`MÛZY!UYRZ\XMÛZY(

certify that the information in Sections A, B and 6ZY this certificate represents my best efforts to interpret the data available.

ustand (hal any false statement me.y be punishable 0D!4693!;>!imprisonment A923> 18 S. Code, Section 1001.I P NUMBER

A 0 #"%!$" 9D

4--zs C:..4\STATE,

DATE . TELEPHONE' '*&&

130 * er,./3"#A

Res

EQ[WMOQ]!MWW![\QÙZ_]!QPUÛZY]FQQ!\Q`Q\]Q!]UPQ!RZ\!OZYÛY_MÛZY(9Z\X!/+'-+&!(+1UY_M\b!,**-

NAME

- 0/21

SIGNATURE

COMMENTS

!""$#%% STikiiE ZIP CODE

TELEPHONE

CITY

DATE

IMPORTANT: In these spaces, copy the con esponding information from Section A.

33154 AGUA DULCE CANYON ROAD

CODE

F86G=BA!7!'!FHEI8KBE& 8A;=A88E&!BE!4E6<=G86G!68EG=9=64G=BA!$6BAG=AH87%

El 6TQOV!TQ\Q!UR!M^^MOTXQY^]!

F86G=BA!8!'!5H=?7=A;!8?8I4G=BA!=A9BE@4G=BA!$FHEI8K!ABG!E8DH=E87%!9BE!LBA8!4B!4A7!LBA8!4!$J=G<BHG!598%

Section C must be completed.

E2. The top of the bottom floor (including basement or endosure) of the building is _ft.(m) _in.(cm) above Z\ below (check one) the highest adjacent grade. (Use

_in.(an) above the highest acgacent

E4.The top of the platform of machinery and/of equipment servicing the building is _ft.(m) _in.(cm) 9@ above or <Z below (check one) the highest adjacent grade. (Use

natural grade, if available).

E5. For Zone AO only:

El CI C] I\Y\]e\(!HVS!

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

issued BEE) or Zone AO must sign here. 4

8W!6TQOV!TQ\Q!UR!M^^MOTXQY^]

SECTION ;!'!6B@@HA=GK!=A9BE@4G=BA!$BCG=BA4?%

G1.

>,(9@

G3.0 The following information (Items 04-09) is provided for community flocdplain management purposes.

65.

This permit has been issued ton New Construction <Z_ft.(m)

fL(m)

AD97A_

DATE

11 Check here if attachments

Replaces all previous editionsFEMA Form 81-31, January 2003

33154 Agua Dulce Canyon Road, Saugus 91390dpw.lacounty.gov/WMD/NFIP/ECDocs/33154 Agua Dulce...

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