620 BAYWAY BLVD UNIT 4 ��.o ,��
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
�t��.z.� Expires December 31, 2005
�003- oao89 ELEVATION CERTIFICATE
Important: Read the instr:�ctions on pages 1 -7.
SECTION A-PROPERT'Y OWNER INFORMATION For insurance Company Use:
BUILDING OWNER'S NAME Policy Number
MOORINGS, LLC UNIT No. ¢ �'�1.�-y-
BUILDING STREET ADDRESS(Inciuding Apt.,Unit,Suite,and/or Bidg.No.)OP.P.O.ROUTE AND BOX NO. Company NAIC Number
620 BAYWAY BOULEVARD
C�N STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPER7Y DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legat Description,etc.) —
Lots 9&10,BLOCK"A" Bayway Subdivision No.5 P.B.38,PGS.38-39
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUf S: SOURCE: ❑GPS(Type):____
� ��'-��-�•��� o� ���°) ❑NAD 1927 ❑ NAD'983 ❑ USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE t�ATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.COUNTY NF,:v1E B3.STATE
City of Clearwater 125096 PWELLAS FLORIDA
B4.MAP AND PANEL ^c'.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECI�IV.rJREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
125096-0007 G SEPTEMBER 03,2003 SEF i�MBER 03,2003 AE EL.11.0
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth enter:tl in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
B11.indicate the elevation datum used for the BFE in B9:�NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.Is the building located in a Coastal Bamer Resources System(CBRS)area or Othent,ise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION I;JFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Construction Drawings` ._ ❑Building Under Construction' �Finished Construction
'A new Elevation Certifcale will be required when construction of the building is complete.
C2.Building Diagram Number 7 (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch or photograph.)
C3.Elevations–Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,ARIAE,AWA1-A3Q AWAH,AR/AO
Complete Items C3.-a-i below according to the builtling diagram specifed in Item C2.State the datum used.If the datum is different from the datum used for the BFE in
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G,as appropnate,to document the datum conversion. .
Datum NAVD 1988 Conversion/Comments N/A
Elevation reference mark used LP-15. EL=4.191 Does the elevation reference mar�used appear on the FIRM? ❑Yes �No
o a)Top of bottom floor(including basement or enclosure) 17.23 FT ft.(m) � �.,, - •
o b)Top of next higherfloor 27.5 FT ft.(m) `�
�
-� .
a: �, •� _� �' �
o cj Bottom oi lowesl horizontal structural member(V zones oniy) _ N;A FT ft.(m) �� - c.-�
o d attached ara e to of block ^ G(y
) 9 9 � P ) 6.23 FT ft.(m) E� s �
o e)Lowest elevation of machinery and/or equipment W `° '
servicing the buiiding(ELEVATOR EQUIPMENT) 11.3 FT ft.(m) � � � � `a"`
�� �. < 4.
o fl Lowest adjacent(finished)grade(LAG) 5.8 FT ft.(m) z m
�
o g)Highest adjacent(finished)grade(HAG) 5.9 FT ft.(m) � � 0710,1/04
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 J
o i)Total area of all permanent openings(flo�d vents)in C3.h 1280 sq.in.
SECTION D-SURVEYOR,ENGWEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
I certify that fhe information in Sections A, 8,and C on this cerfificate represents my best efforts fo interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Secfion 100?,
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County ad 54 New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
° 07/01/04 (727)834�140
FEMA Form 81-31,January 2003 See reverse side for continuation. Repiaces all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bidg.No.)OR P.0 ROUTE AND BOX N0. Policy Number
_ 620 BAYWAY BOULEVARD
CITY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certifcate for(1)community official,(2)insurance aoenUcompany;and(3)building owner.
COMMENTS
N/A
❑Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NQT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE);complete Items E1 through E4. If the Elevation Ceriincate is intended for use as supporting informatlon for a LONA or LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Select the building diagram most similar to the building for w uch this certificate is being completed—see pages 6 and 7. If no diagram accuralely
represents the building,provide a sketch or photograph.)
E2.The top of the bottom floor(including basement or enclosure)of the building is _ft.(m)__in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6�with openings(see page 7),the next higher floor or elevated flcqr(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4.The top of the platform of machinery andlor equipment servicing the builtling is _ft.(m)__in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E5.For Zone AO only: If no flood depth number is available,is the top of the bottom floor elevatetl in accordance with the community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must certify this information in Sectio;��G.
SECTION F-PROPERTY OWNER(OR OWNEf�'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authonzed representative who completes Sections A,B,C(ilems C3.h and C3.i onlyj,and E for Zone A(without a FEMA-issued or communiry-
issued BFE)or Zone AO must sign here. The statements in Secfions A,8,C,and E are co;rect fo the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The lo;;al ofiiciai who is authonzed by law c�ordinance to administer tne community s floodplain management ordinance can complete Seciions A,B;C(or E),and G of this Elevation
Certifcate. Complete the appiicable item(s)and sign below.
G1.❑The information in Section C was taken from other do�umentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law io certify elevation information. (Indicate the source and date of the eleva(ion data in the Comments area below.)
G2.�A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following information(Items G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for:�New Construction ❑Substanfial Improvement
G8.Elevation of as-built lowest floor(including basement)of the building is: _._ft.(m) Datum:
G9.BFE or(in Zone AO)depth of flooding at the building site is: _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
❑Check here if attachments
FEMA Form 81-31,January 2003 Repiaces all previous editions