86 AUREL ST � �' L_ �111�y
� V �
� �
FEDERAI EMERGENCY MANAGEMENT AGENCY O.M.B.No.3067-0077 ��
NAT10N/kL' FLOOD INSURANCE PROORAM ���uly 31,2002
oEC o s 2002 � ELEVATI�N CERTtFiCATE -
p Im rtan� Read tha instiuctions on 1 -7. �
3ECTION A-PROPERTY dWNER INFORMA710N '"�7�tipii��q�"op�EG4;:<
il i ��+ Ew Tvi.lA E� . , , '[��•..:�..�:_�,:_,�.
r�. w�+.urkw.�+�.m,u.�w+a�»i>e:.�.f��.�`.:^»'�':..�:.;w;;"�:
BUIIAINO 9TREET ADDRE39(Inciudinp Apt.,UNt,Suits,andlbr BldO.No.)QR P.O.ROUTE AND BOX NO. � "�"`"'""
. . . , ,>.. :..>.;M:w,:
3 y u E�. S G C.T � �N+««�iw"w.`�waw�www.�w.N«».w"�ww�n��::���
xrKrt N+e�ueSxr o,r,-
CITY STATE LP� DE
CLEARwATER . �E.AcH ,.F�C.o� �9A
PROPERTY DE3CRIPTION(Lot and B1ook Numb�ts.�ax P�ra�l Number,l�apai Desuiptbon,ebc.)
L -r 13. 8 . S2�jylANDAC.AY SUTi�D�V►s�oN "F'.�. !¢, � S. 32-35
Bu L ING (e.4,RQdda ql,Non-►add.nWl,add�lon,Aoc�osory�tte,' , omv+Qnes s�ct on t neoasaary.)
�ES19E N'CI A L
UITITUDE/LONOfTUOE(OPl10NAL) HORlZONTAL DATUM: 50URCE L,�GPS(Typ�):
( #�'-M'-f�,Mt` or it� (_J NAO i�Z7 LJ NAD 1983 ��USCi3�tnd Map LJ Other.
. SECTION B-FLOOD 1NSURANCE RAT�MAP(FIRM)INFORMATfON
Bt.NFlP COMMUNITY NAME 3 COMMUNITY NUMBER BZ.CUUNTY NAAAE 83.STATE
G►T'l' oF C�EF►RWATe'R 'f�' t25��� P/NELLf�S � F�-�R�P� �
.IutAP AND PANEL B5�SUFFUC B6.FIRM INOEX . 1 ANi L . LOOD .BASE FLOOD ELEVATION(S)
NlAu1BER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,uce deprth of 1loodinp)
000 � B-I�-`t� A^l$-qi . AE �� II � •�
810. Indiwto th�soux�of th�Bas�Flooa Elwatto�(BFE)d�ta or base 11ood depth entered In B9. j�
LJ F1S ProTfle �FIRM (J Community Determinsd �_J Other(Deacribe):
811. Indicate the elevaUon datum uaed torlhs BFE ln B9:Q�NGVO 1929 U NAVD 1988 LJ Othe�(Deacribe): �
B12 Is thQ buldiny bc�ted in a Coasfial.Bartbr Rasou�as 8ystom(CBRS}area or Otherwise Protected Area(OPA}? U Yes �No �
Doslynatfon Dabs: � tV
SECTION C-BUlLDtNO ELEVATION INFORMATION(SURVEY RECUIR q�_ �
{ YI/OM,��amv�t'asss arQ�sa�on: �,,,_JCo�strudion�rewin9s' �JBuYdtny Under Construction' �'�"�Finished Construcaon �
'A nvw EIQVaUon CQttlficate wip be requtred whea oonstruotlon of the buildin9ls complate. •«. . ,�
C2.Buildin9 D'iaqrim NumDor � (Saloetttw buAdin�diq�ram most slmDarto the bulldinfl forwhieh this eertifica�te is beiny eompleted-soQ �
payas 8 and 7. If�o dhpnm socutat�ly roprosants th��buOdUp, provfde a sketch or photosraph.) �
C3.Elevatlons-Zones A1,a30,AE,AH,A(wltl�BFE),VE,V1 V30,V(with BFE),AR,AR/A,ARJAE,AR/A1-A30,AR/AH,AR/AO
Comple�b�Items C3a-i bebw accordin9 to tM buUdinp dfaQnm spedtfed in Item C2.Stabe the datum used. If the datum is different from (�
th�datum used for the 6FE in 8octio�6,convrrt th�daturtl to that used for tho BFE. Show fiad mstsuroments and.datum conversion
calculation. Use the space prwided or 1hQ Commen�aree of Sedion D or Sactlon G, as appropr'wte,b�docurrunt the datum conve�sion. �
Datum Co�verstoNCoRUnents �
Elevation referenoe mark used siEE Cew�w�eNT.s Does the elavation reference mark used sppear on the FIRM? �,r,�;Yes jZ4No
O a)Top oi boitom tbur{includin9 baaemant or enebsure) 4 . .f�? ft(m) � ,
O b)Top ot nazt hlghar fbor 5 .SZ tk.(m� 1O `
O c)Bottom ot IowQSt hort�ordol�Gruchiral member(V zonea onlyj -:-- -.»R(m) � _
O d)�itached 9araye(top of slab) L:�lRPo A'c' S .Z�ft.(m) �
O �)Lowsst skvatbn oi macNnsry sndlor squlptrwnt W�
' sorviciny th�buf(ding A/G � .Z R(m) � �
❑ n Lowest ad�aoent flrade(LAG) 4 .�1t(m) �
0 y)Hiphest adJaceM flrade(HA�3) S .�ft.(m) � ,
0 h)No.of p�rmanent openings(flood vents)witl�ln 1 R ebow adJ�wrrt gmdQ• —
❑ �Total area of all pem�anent openirt�s(flood vants)in C3h ^— aq. in.(sq. cm)
SECTION D-SURI/EYOR.ENC;INEER.OR ARCHITECT CERTIFICAnON
ThK c�rtttlatbn is to b� sfgn�d snd stal�d by a land�urvoyo�,anfltnoar,or archftect authortzod by 4aw to cartify alovation Iniorm�iion,
I covtlty th�t U�o tnbrmatlon in Svctlons A, 8,�r►d C on this catfdoete repiesenls my bsat etl�ais to interpret ths Cata svailab/e.
I undarstand that any faJao stetomont maybo pLniahabls 6y!!ns orimprisonrnenl under 18 U.S Code Seetiorr 1001
���� LAUREN R. PENNY UCENSE NVMBER
4931
�� LAND $URVEYOR COMPANY �, R. PENNY ;6 A880C.. INC.
JRESS , • ITY 3TA� ZJP CODE • '
10730 — 102 ND. �VENUE NORTH �� � • SEMINOLE, FLORIDA gg��8�
SIGNATURE DATE TELEPHONE.
2 -�- Zoo Z (72T)3�8-4360'
FFM4 Fn.rn R1_�1 sl I(:AA RFF RFVFQCF CIt1F F�1A rr1N:"ItJI IeTln►J pFPI �►r`.FC pl I PRFVIf11 IR Ff�IT1�IPIG
pl/Ol�/�000 THU l0:73 F1i.�1 �i. uU�
IMPORTANT: fn these spaces�r•apy the corresponding information from Section A. ';,���'�"����yz�j�„
�UILDING StREET ADORESS(Ineludin9 Apt.,Udt,Sulte,and/or Bldy.No.)OR.P.O.ROUTE AND BQX NO. ;;;�',oTi�r,�R[cMi�her• � ,,;`„.
3G- AuRsc, sTt�eET � z.� � ,<� � q
C� STATE ZIP CODE �aMp�lt�,r, ��1�� "
C�EA'R�l�4TER �ERCK rc.OR�'�A ,; > >,«:�w ,�K„„,?
SECTION D-SURVEYOR,ENGINEER.OR ARCHITECT CERTIFICATION(CONTINUfD)
Copy both sides of this Elevation Certificate far(1)community official, (2)insurance agsnUcompany, and(3)building owner.
COMMENTS
_ �A��-� oF �EniGH►'��'RK: �PINE(.LAS CouNT�( $ tr� �' ISZ
��Au Ac. `R-M-3+ �q7
, ELEV, (o � �
, I I Check here if aitachments
SECTION E-BUILDfNG HLEVATlON 1NFORMATtON(SURVEY NOT REQUIRED)FOR ZONE AO and ZONE A(WITHOUT BFE)
For Zone AO and Zona A(without BFE),complete Items E7 through E3. If fhe E/evation CeRifica�e is rnfended for use as suppo�ling
information for e LOMA or LOMR�; Sect;on C must be complatad.
�1. Building Oiagram NumbeP (Salect tho buAding diagram most similar ta the building for which this certficate is being complated-
seQ pages 6 and 7. If no di�gram accuretely represents the building, provide a sketch or photograph.)
E2.The top of the bottom floor(induding basement or enclosu��of the building is LJ_�it.(m)LL�in_(cm) LJ above or U below
(chock one)tha highest adjacerrt grade,
E3. For Zone AO only; If no tiaod dQpth number is avalabfe,ia the top of the battom floor elevated in accordance with the ce►rununitys
_ floodplain mana9ement ordinanee? Yes LJ No Unknown. The local official must certify this information in Sec6on G.
SECT101Y F-PROPERTY OWNER(OR OWNER'S REPRESENTiATIVE)CERTI�FIrCAnON
The property owner or owners authoreed representative who complctes Sections A, 6, and E for Zone A(without a FEMA-issued or
community-issued BFE)or Zone AO must sign here_
PROPERTY owrrER�s oR owNER�s AuTHORIZED REPRESENTATIVE�s NAME —
ADDRESS CITf ��STA�fE ZIR CODE �
SIGNATURE DATE TELEPHONE
COMMENTS
_ ( I Check here ff attachments
SECTION[i-COMMUNlTY INFORMATION(OPTIONAL)
The Ixal ofEicial who is authorized by law or ardinance to administer the cornmunit�s floodplain martagement ordinance can canplete
Sections A, B,C(or E),and G ofthis Elevation Certific�rbe. Complete the applicable item(s)and sign below.
G1.�j The informatan in Sect�on C was taken from other documentation that has been signed and embossed by a!icensed sunreyor,
engineer,or architect who is authar¢ed by state or local law to certify elevation informafion. (Indicate the source and date of the
elevaUon data 6n the Comments area bebw.)
G2. U A community off�.-ial comple�tmd Section E for a building located in Zone A(wdhout a FEMA-issued or community-issued BFE}or
Zune AO_
G3. �j The following inforr�tion(fbems G4-09)is provided for corrttnunity floodplain management purposes_
G4.PERMIt NJMSER G5_ DATE PERMIT 153UED G8. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
ISSUED
GT.'Yhis perrr�h�s been issued for L(New Construcfion LJ Substantfal Improvement
G8. Elevation of as-buift lovv�st floor(irtcluding basement)of the building is: _ft_(m)Datum:
G9_ BFE or(in 2one AO)depth a!ifooding�t the building sita is: �R.(m)Datum:
LOC/�L OFFICfAL'S NAME TIT�E
COMMUNITY W1h4E TEIEPHONE
SI A URE DATE
CdMMENTS �
( f Check here if attachments
FFI�AO Cnrm R�Z� 41 Ir GG RFPI G1!'FC A1 1 PRFVIfII I.0 FfIITIl1NC