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620 BAYWAY BLVD UNIT 5 /� ��L" �� FEDERAL EMERGENCY MANAGEMENT AGENCY � � �� t�' � � � - NATIONAL FLOOD INSIJRANCE PROGRAM O.M.B. No. 3067 0077 ��c�,)Li�C Expires December 31, 2005 �� 3 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number MOORINGS, LLC UNIT No. � ��.�- BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 620 BAYWAY BOULEVARD C�� STATE ZIP CODE CLEARWATER FLORIDA 33767 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legai 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 DATUI•.?: SOURCE: ❑GPS(Type):,_____ � ��-��-��'� o� ��°) ❑NAD 1927 ❑ NAD^983 ❑ USGS Quad Map ❑Other: SECTION B•FLOOD INSURANCE t2ATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NA'.9E B3.STATE City of Clearwater 125096 PINELLAS FLORIDA B4.MAP AND PANEL E?.FIRM PANEL B9.BASE FLOOD ELEVATION(S) NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFEC(IVE/REVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding} 125096-0007 G SEPTEMBER 03,2003 SEFTEME3ER 03,2003 AE EL.11.0 B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered 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 Othervaise Protected Area(OPA)? ❑Yes �No Designation Date SECTION C-BUILDING ELEVATION IyFORMATION(SURVEY REQUIRED) C1.Building elevations are based on:�Construction Drawings' . ❑Builtling Under Construction* �Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2.Building Diagram Number 7 (Select the building diagram most similar io the building for which this certifcate is being completed-see pages 6 antl 7. If no diagram accuralely 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,AR'A,AWAE,AR/A1-A30,AWAH,AWAO Complele liems C3.-a-i below according to the building 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 appropriate,to do:;ument the datum conversion. Datum NAVD 1988 _ Conversion/Comments N/A Elevation reference mark used LP-15. EL.=4.191 Does the elevation reference marK used appear on the FIRM? ❑Yes �No o a)Top oi bottom Floor(including basement or endosure) _ 17.23 FT ft.(m) � ,� .. o b)Top of next higherfloor _ 27.5 FT ft.(m) `� � � a c� o c;doftom of lowest horizon[al structura mem�er�V zones oniy) N�A FT i.(m) � �- � o d)attached garage(top of block) _ 6.23 FT ft.(m) E� �'. - o e)Lowest elevation of machinery and/or equipment w '° V �.- � servicing the building(ELEVATOR EQUIPMENT) _ 11.3 FT ft.(m) � ' w �� o fl Lowest atljacent(finished)grade(LAG) _ 5.8 F7 ft.(m) z.m - � � `' `��+ o g)Highest adjacent(finished)grade(HAG) 5.9 FT ft.(m) "� � ^ ��07/01/04 o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 � o i)Total area of all permaneni openings(flood vents)in C3.h 1280 sq.in. J SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or archi;ect authorized by law to certify elevation information. I cerfify that the information in Secfions A,B,and C on this certificale represents my best efforfs to interpref the data available. I understand that any false stafement may be punishable by fine or imprrsonmenf under 18 U.S. Code; Section 1001. 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 Ro d 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. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For�nsura��a:comaany use: BUILDING STREET ADDRESS(Induding Apt.,Unfl,Suite,andlor Bldg No)OR P.O.ROUTE P,ND BOX N0 Poliq�Number _ 620 BAYWAY BOULEVARD CIIY STATE ZIP CODE Company NAIC Numbeer CLEARWATER FLORiDA 33767 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certifcate for(1)community offcial,(2)insurance ag°nUcompany;and(3)building owner. COMMENTS NIA ❑Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT 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 Certiricate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1.Building Diagram Number_(Select the building diagram most similar to the building for w��ich this certif cate is being compleled—see pages 6 and 7. If no diagram accuralely represents the building,provide a sketch or photograph.) E2.The top of the bottom floor(inciuding 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 flc;�r(elevation b)of the building is _ft.(m)_in.(cm)above the highesi adjacenf grade. Complete items C3.h and C3.i on front of form. E4.The top of the pialform of machinery andlor equipment servicing the building is _ft.(m)__in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use natural grade,if available). E5.For Zone AO oniy: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑No ❑Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owners authonzed representative who completes Sections A,B,C(liems C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community- issued BFE)or Zone AO must sign here. The statements in Sections A,B,C,and E are conect to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATNE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The lo:;al official who is authonzed by law or orainance to administer tiie communitys floodplain management ortlinance can complete Sections A,B,C(or Ej,and G or this Elevaiion Certifcate. Complete the applicable item(s)and sign below. G1.❑The information in Section C was taken from other documentation that has been signF�d and embossed by a licensed surveyor,engineer,or architect who is authonzed by staie or local law to certify elevation information (Indicate the source and date of ihe eleva;ion data in the Comments area below.) G2.❑A community oificial completed Section E for a building locaied in Zone A(without a F�MA-issued or community-issued BFE)or Zone A0 G3.�The following information(items G4-G9)is provided for community floaiplain management purposes. CG4 PERMIT NUMBER G5 DATE PERMIT ISSUED G6 DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED � G7.Thls permit has been issued for: �New Construction ❑Substantial 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 buiiding site is: _._ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMINUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check here if attachments FEMA Form 81-31,January 2003 Repiaces all previous editions