163 BAYSIDE DR �.; .�,,,.. . _ . _ __.�_ , .___._ , ...�
ELEVATION CERTiFiCATE e� �' ' ' � ` �
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FEDE�iAL EMERGENCY MANAGEMENT AGENCY€�.� ,
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NATIONAL FLOOD INSURANCE PROGRAM K" I��N 2 2 ��9� ' '
�'tTTENTiON: Use of this certificate does not provide a waiver of the flood insurance purchase r�ite enf.`�'liis form is us� �r�;
rovide elevation information necessary to ensure compliance with applicable community floodp in m�na�ement ordinances ^`
i �etermine the proper insurance premium rate, and/or to support a request for a Letter of Map A ����,g�r k3�yis���Qpp;rtA qr-1�c;,
I Instructions for completing this form can be found on the follo i���i��"J�'a_ r.E�<i��±�r�' �__.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE ;
�UILDING OWNEA'S NAME POUCY NUMBER �
� AGOSTINO DIGIOVANNI AND MARIANN DIGIOVANI �
STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER i
� }:63 BAYSIDE DRIVE _�
OTHEA DESCAIPTION(lot and Blocic Numbers,etc.)
� BAYSIDE SUBDIVISION NO. 4 . . .,.
� �m STATE � ZIP CODE
� GLEARWATER, FLORIDA
SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION � �
Provide the following from the proper FIRM (See Instructions): ,
i.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.0 TE OF IR INO 5.FIRM�ZONE 6.BASE FLOOD ELEVATION
�,.'��a„ (in AO Zones,use depth)
125096 0007 D"' ","�,'T�'*_+ AE �'" ._ .. � ..11 _
�: Indicate the eievation datum system dsed on the F1RM.for Base Fiood Elevation.$.(BFE): ❑NGVO'29 �Other(describe on kacic)
&For Zones A or V,where no BFE is provided on the FIRM, and the community has established a BFE for this buiiding site, indi��te
the community's BFE: ! I I,U feet NGVD (or ottter F1RM datum—see Section B, Item 7).
SECTION C' BUILDING ELEVATION INFORMATION
•� Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level 1_ . .
�ja). FiRM Zones Ai-A30,AE,AH,and A(with BFE).-The�top of the reference leve!floor from theselected.diagranl.is at an elevaY:�rr
of I i � I i.Fil,�8.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 �.0 feet above L I or
below❑ (check one) the highest grade adjacent to tf�e t�uilding. � ' � �
�d). F1RM Zone AO. The floor used as the reference level from the selected diagram is W.0 feet above❑ or below�(chF..,k
one)the highest grade adjacent to the building. If no flood depth number is available. is the building's lowest floor!raferenc.
ieveij elevated in accordance wiir inE commun�ry's tloocpfain managemeni ordinance% � `�es � No J unicnown
�.Indicate the elevation datum system used in determining the above reference level elevations:0 NGVD'29 r .Other(descrica
under Comments on Page 2). (NOTE: If fhe e/evation datum used in measurrng the e/evations rs differeni than ihat used on
fhe FIRM (see Section B, ltem 7j, then convert tha e/evations to the daium system used on the FlRM and show the conversion
equation under Comments on Page 2.) �
�. Elevation reference mark used appears on F1RM: C� Yes r' No (See Instructions on Page 4) .
3:The reference level elevation is based on: [XI actual construction � construction drawings
(NOTE: Use of consiruction drawings is on/y valid if the building does not yei have fhe�eference level floor in p/ace, rn which
case this ceRificate will only be valid for the building during ihe course of construction. A post-construction Elevairon Certificate
will be required once construction is complete.)
&,The elevation of the lowest grade immediately adjacent to the building is:� �� 5 �:8._,� ieet NGVD (or other FIRM datum-see
- Section B, Item 7). , .
SECTION D COMMUNITY INFORMATION
_.__ .__._ _
�.lf the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, It�_�n 1
is not the"lowest floor"as defined in the community's floodolain management ordinance,the elevation of the building's"towe��
floor" as defined by the ordinance is: � I I I I I,� feet NGVD (or other FiRM datum—see Section B, Item 7).
�. Date of the start of consiruction or substantial improvement .
BEMA Form 81-31�MAY 90 REPLACES ALL PREVIOUS EDITIONS SEe REVEASE SIDE FOR CC 'TI�`f.-?�i `iy
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 thP
certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a buiiding official, a property owner, o��
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unabie 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 certificatiort under Comments below. The diagram number, Section C, Item 1, must stiii be entered.
I certify-that the infomration in Sectfons B'and C on this certificate represents my best efforts to interpref the data availa6le.
1 understand fhat any false statement may be punisha6/e by fine or imprisanment under i8 U.S. Code, Secfion 1001.
CERTIFIER'S NAME " LICENSE NUMBEA(or Affix Seal)
GORDON: F. KILLION ., 3138 ;. _
TmE � ~ COMPANY NAME
OWNER ,..KZLLI.ON AND ASSOCIATES
AODRESS' - CITY STATE ZIp
1254— OUTH HIGHLAND AVE. __CLE�RWATER, .-�'LORIIlA 3375.6 � -
SIGNATURE `'''
- :... ._..._.._ ..... . ._ .... _ . . . 1��7/99 (���I )443-7067
,.. ,
Copies ould be made of,ihis Certfficate for;'1)community offic�ai,2j_.insurance agenU�ompany,and 3)building owner.
COMME�ITS: BENCH MARK USED PINELLAS COUNTY D�ISK NIAP # 155 LP-15 USCE
( 1968) EL 4.981
_ .. _._.. ._..___.. . ._ _ . ...... . ......_ _ .._ , ._ .. _
ON WITH ON PILES,
S�B BASEMENT PIERS.OR COLUMNS
A V A A V .
ZONES ZONES 20NES ZONES ZONES
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REFERENCE � ' " e�E . . I.EVEI FEPERENCE
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�FIOOD ' ��AQIACEN7��::; .: . REFERENC�..;� , :.M - B�D
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ELEVATION � -�--� REFERENCE ��qp,1ACENT � � GRADE '�:p�� �� LEVEL ELEVA710N
IEVEL GRADE .". '�},
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, The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations fo�aII A�ones should be measured at the top of the�eference level floor.
Elevations-for all V Zones should be measured at the bottom of the lowest horizontal structural member. •
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