Model Acknowledgement of Conditions For Mitigation of Property in a Special Flood Hazard Area With FEMA Grant Funds Property Owner Street Address City

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Model Acknowledgement of Conditions For Mitigation of Property in a Special Flood Hazard Area With FEMA Grant Funds Property Owner Street Address City State Zip Code Deed dated, Recorded Tax map, block, parcel Base Flood Elevation at the site is feet (NGVD). Map Panel Number, effective date As a recipient of Federally-funded hazard mitigation assistance under the Hazard Mitigation Grant Program, as authorized by 42 U.S.C. 5170c / Pre-Disaster Mitigation Program, as authorized by 42 U.S.C. 5133 / Flood Mitigation Assistance Program, as authorized by 42 U.S.C. 4104c / Severe Repetitive Loss, as authorized by 42 U.S.C. 4102a, the Property Owner accepts the following conditions: 1. That the Property Owner has insured all structures that will not be demolished or relocated out of the SFHA for the above-mentioned property to an amount at least equal to the project cost or to the maximum limit of coverage made available with respect to the particular property, whichever is less, through the National Flood Insurance Program (NFIP), as authorized by 42 U.S.C. 4001 et seq., as long as the Property Owner holds title to the property as required by 42 U.S.C. 4012a. 2. That the Property Owner will maintain all structures on the above-mentioned property in accordance with the flood plain management criteria set forth in Title 44 of the Code of Federal Regulations (CFR) Part 60.3 and County Ordinance as long as the Property Owner holds title to the property. These criteria include, but are not limited to, the following measures: i. Enclosed areas below the Base Flood Elevation will only be used for parking of vehicles, limited storage, or access to the building; ii. All interior walls and floors below the Base Flood Elevation will be unfinished or constructed of flood resistant materials; iii. No mechanical, electrical, or plumbing devices will be installed below the Base Flood Elevation; and iv. All enclosed areas below Base Flood Elevation must be equipped with vents permitting the automatic entry and exit of flood water. For a complete, detailed list of these criteria, see Pamlico County Ordinance. 3. The above conditions are binding for the life of the property. To provide notice to subsequent purchasers of these conditions, the Property Owner agrees that the County will legally record with the county or appropriate jurisdiction s land records a notice that includes the name of the current property owner (including book/page reference Page 6

to record of current title, if readily available), a legal description of the property, and the following notice of flood insurance requirements: This property has received Federal hazard mitigation assistance. Federal law requires that flood insurance coverage on this property must be maintained during the life of the property regardless of transfer of ownership of such property. Pursuant to 42 U.S.C. 5154a, failure to maintain flood insurance on this property may prohibit the owner from receiving Federal disaster assistance with respect to this property in the event of a flood disaster. The Property Owner is also required to maintain this property in accordance with the flood plain management criteria of Title 44 of the Code of Federal Regulations Part 60.3 and County Ordinance. 4. Failure to abide by the above conditions may prohibit the Property Owner and/or any subsequent purchasers from receiving Federal disaster assistance with respect to this property in the event of any future flood disasters. If the above conditions are not met, FEMA may recoup the amount of the grant award with respect to the subject property, and the Property Owner may be liable to repay such amounts. This Agreement shall be binding upon the respective parties heirs, successors, personal representatives, and assignees. Page 7

THE COUNTY OF PAMLICO A NORTH CAROLINA municipal corporation By: Timothy A. Buck, County Manager of the COUNTY OF PAMLICO & [Name of Property Owner] [Name of Property Owner] [SEAL] [SEAL] WITNESSED BY: [Name of Witness] [SEAL] Pamlico County, North Carolina I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document for the purpose stated therein and in the capacity indicated:. Date: Official Signature of Notary Notary Public Notary s Printed or typed name My Commission Expires: Page 8

Notice of Voluntary Interest Pamlico County Hurricane Florence HMGP Property Acquisition Project Homeowner Interest Sign-up Sheet and Voluntary Notice Please complete this form if you are interested in exploring further your options for reducing your flood losses through the buyout of your property. Signing this does not commit you to any action. Property Address: Owner(s) Mailing Address: Owner(s) Name(s): Contact Phone Number: Contact Email Address: Pamlico County is required by FEMA to inform you that your participation in this project for open-space acquisition is voluntary. Neither the State of North Carolina nor Pamlico County will use its eminent domain authority to acquire the property for open-space purposes if you choose not to participate, or if negotiations fail. Owner's Signature Date Owner's Signature Date Page 9