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Flood Control Preliminary Elevation Certificate FM-1/1M <br /> w�11CwI 1. APN 257-110-06 Date dune 4, 2013 FM-1 <br /> Qr Flood Zone AE FMA M <br /> warvna rnr You Check Form Used <br /> Base Flood Elevation 33' Datum NAVD 88 <br /> Minimum M/H Substructure Elevation <br /> Minimum Equipment Elevation ASCE Structure Classification <br /> Minimum Finished Floor Elevation ASCE Minimum Flood Elevation•(DFE) <br /> Signature '(Design Flood Elevation) <br /> The information below must be signed and sealed by a licensed land surveyor or qualified civil engineer <br /> authorized by law to certify elevation information. I certify that the information on this sheet represents <br /> my best effort to interpret the data available. (See FM-1/1M Instruction Sheet on how to fill out this form.) <br /> Main Structure I Residence I lon Pre-Existing <br /> 2a. 2b. (Complete this section for Manufactured Structu(es) <br /> Original Lowest Original Lowest 31.4' <br /> Adjacent Elevation Adjacent Elevation <br /> Fill Material/Structure Fill Material/Structure 1.8' <br /> Minimum Finished Floor Minimum Mobile Home 33.2' <br /> Elevation Substructure Elevation <br /> Difference Datum Difference 1.8' <br /> 3.Water Tank/Equipment Pre-Existing <br /> Original Lowest Immediate Adjacent EI. 31.4' O None <br /> Fill Material/Structure 1.8' <br /> Minimum Equipment Elevation 33.2' <br /> Difference 1.81 <br /> 4. Propane/Butane/Fuel Tank Pre-Existing <br /> Original Lowest Immediate Adjacent EI. 31.4' Q None <br /> Fill Material/Structure 1.8' <br /> Minimum Equipment Elevation 33.2' <br /> Difference 1.8' <br /> 5. Certifiers Name Company Name <br /> Michaell L.Quartaroli _ Quadaroli&Associates Inc. e,\��L ILA <br /> Title License Number L G,9 <br /> Licensed Land Surveyor L.S.4450 �G <br /> Address <br /> 310 Sun West Place,Ste.A NOL. <br /> City State Zip Code <br /> Manteca CA 95337 <br /> Telephone Cell Q <br /> (209)239-4908 <br /> Signatur Date r ` PL Of t RE <br /> Owner Signature Date <br /> 4/28/2010 F E M A Elevation Certificate Is required prior to final Questions?,Call(209)953-7612 <br /> J TLOOMFlood Zone ConstwcdonMFl Zone PAMPHLEIFOWS&HANDOUTS�C&FM Forms 04-28-10 <br /> Job No.2013-107 <br /> Reset For Print Form <br />