Elevation Certificate Template - Douglas County Page 5

BUILDING PHOTOGRAPHS

OMB Control Number: 1660-0008

ELEVATION CERTIFICATE,

page 4

See instructions for Item A6.

Expiration: 11/30/2018

FOR INSURANCE COMPANY USE

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

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

Policy Number:

City

State

Zip Code

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.

FEMA Form 086-0-33 (7/15)

Replaces all previous editions.

Page 6 of 15

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Parent category: Business