720 BAY ESPLANADE O.M.B.NO. 3067-0077
� ELEVATION CERTIFICATE ExpiresMay31, 1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
�ie elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to
mine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANV USE
BUILDING OWNER'S NAME POLICY NUMBER
Mary Sagonias -- — ---- _ – --—_--- _--
STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
720 Bay Espalanade _ _ _ ___
OTHER DESCRIPTION(Lot and Block Numbers,etc.)
Lot 11, Block 26, MANDALAY
CITY STATE 21P CODE
Clearwater Beach FL 34630
SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the following from the proper FIRM (See Instructions):
1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOU ELEVATION
� (ir,n0 Zo�es,uss d�pth)
125096 � 0007 D 8/19/91 AE ' �_1 .0 '
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE): �NGVD'29 �_�Otfze�(describe on back)
8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site, indicate
the community's BFE:LJ_I___L1__J.L_�feet NGVD (or other FIRM datum–see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicat�the diagram number from the diagrams found on Pages 5 and 6 that best
scribes the subject building's reference level-- .
FIRM Zones Ai-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation
of�_�����.U feet NGVD (or other FIRM datum–see Section B, Item 7).
(b). FIRM Zones V1-V30,VE, and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of��___���.�____�feet NGVD (or other FIRM datum–see Section B, Item 7).
(c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is �___).�.__.�feet above�__� or
below❑ (check one) the highest grade adjacent to the building.
(d). F�RM Zone AO. The floor used as the reference level from the selected diagram is �_L_�.0 feet_above❑ or below��(check
one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference
level)elevated in accordance with the community's floodplain management ordinance? [_� Yes �] No [� Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:�X� NGVD'29 �__) Other(describe
under Comments on Page 2). (NOTE: lf the e/evation datum used in measuring the e/evations is different than that used on
the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: �� Yes U No (See Instructions on Page 4)
5.The reference level elevation is based on: � actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in p/ace, in which
case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certif�Ca
wip be required once construction is complete.) ,,�l,,'�r,��' .
6.The elevation of the lowest grade immediately adjacent to the building is:I I I I 14 I.� feet NGVD (or other F�,� � �
Section B, Item 7). �;-�� �
�.
.�•�►�
SECTION D COMMUNITY tNFORMATION !'"�� � C?
+ "the community official responsible for verifying building elevations specifies that the reference Igv�� '� ed in Se�i n C, _ �,''t�`�'
•,iot the"lowest floor"as defined in the community's floodplain management ordinance,the el�� bt.'�iqg's"I��!ti"
floor"as defined by the ordinance is: �_�__LJ__�.�� feet NGVD(or other FIRM datum–see Sec rE,'i�,� �j. �`�
�b,h�{r' ��,�.��,,,.
2. Date of the start of construction or substantial improvement —__ . ,,y► `J� ,c�
FEMA Form 81-31,MAY 93 REPLACES ALL PREVIOUS EDIT10N5 SEE REVE 51 ° ONTINUATION
SECTION E CERTIFICATION �
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones A1—A30, AE, AH,A (with BFE),V1—V30,VE, and V(with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A(without a FEMA or community issued BFE),a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8- Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not
included in the certification under Comments below. The diagram number,Section C, Item 1, must still be entered.
I certify that the information in Sections B and C on this certificate represenfs my best efforts to interpret the data available.
I understand fhat any false statement may be punishable by fine or imprisonmenf under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal)
Edward C. E1liott _ 3983
TITLE COMPANY NAME
Profess�o�al Surveyor & Mapper OVERBECK & ELLIOTT
ADDRESS � `"'� CITY STATE ZIP
793_.;3�a�, ��as�-��o�h�r llt. , Dunedin FL 34698
` SIQNATU ' � � DATE PHONE
_ ��� � 6/28/96 (813)734-7805
Copies shoulc�.detnacle of thls Certlficate for: 1)community offlclal,2)Insurance egent/company,and 3)bullding owner.
; ,
COMMENT$c
•
ON WITH - ON PILE3,
SLAB BASEMENT � PIERS,OR COWMNS
A V A A V
ZONES ZONES ZONES ZONES ZONES
REFERENCE
REFERENCE BASE IEVEI REFEHENCE
LEVEL FLOOD LEVEL
ELEVATION
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FLOOD �'`"'����"" �ADJACENT�:�.:�'���k:,, HEFERENCE FLOOD
. ELEVATION REFERENCE A0.IACENT p��E �.^�j; LEVEL ELEVATION
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The diagtams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor. •
Elevations for all V�ones should be measured at the bottom of the lowest horizontal structural member.
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