700 BAYWAY BLVD .� T;,..a .-� ; �- , ,.;,��.�.,
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� � ��^rG'�� +�NATIONAL FLOOD INSURANCE PROGRAM I Expires July 31, 2002 I
��` �, ,�.��� �LEVATION CERTiF1CATE �
� Importan� Read the insfivc�ons on pages 1-7.
� � SECTtON A-PROPERTY OWNER INFORMATION Fa�o�araeCanp�ryuse:
BUILDING OWNER'S NAME G l��( 0� Gl�GJ4j2L*.%�1�{� '_Pd'icyNumber
BUILDING STREET ADQAESS(Including P,pt.Uni�Suita„aux�,/s�f�1� ;IVo.)OR P.A.ROUTE AND BOX N�. Camperry�NA1C Number.
�,'"a�� (�Y�ua� ������ � k�
C1TY G�� �Q`G� STAlE �L 71P CODE ,��.�(v�
,
PROP RTY DESCAIPTION(Lot and Blodc Numbers,Tax Patoel Number,I.egal Descript�n,ebc.)
�bT 24-. 6L��'l�- l� �aY�Si� �D1Vl�toN I�So.�
BUILDING USE(e.g., esidential,Non-reside�al.Addition,Accessory,etc. Use . merris aree,iF necessary•)
No�����+.ve�i-�ArL. CPol.�c��S�T�b�
LATITUDE/LONGITUDE(OPTIONAL) HORIZOM'AL DATUM: SOURCE GPS(Type):
� �°-��-##.�ar or �.�7 C}��ysz� ❑r�ia�isa3 CdtisGS cx,ad nnaa 0 oa,er
SECTION B-FL000 INSURANI��R�'T��.NIAP(FlRN�IN�OFiMA_TION
Bt.NFlP COMMUNf iY NAME�COMMUNITY NUMBEA 82 COUNTY NAME 83.STATE
Q�,.�— , q Fl.o,�ioR
B4.MAP AND PANEL B5.SUFFIX B7.FIRM AN� �.BASE ROOD 9.EllAT10N(S)
NUNBER 86.FlRM WOIX DATE /IS�QATE 88.FLOOD ZONHS� Rone A�O�u9e d�h diloodig)
�2.c,o°�to ar�lh � bl�,l � � 1 . t
810.�cate ihe source of the Base Fbad Bevation(BFE�data or base ibod deplh entered in
[„�F1S Pro�e [�IRM 0 CAnun�u�ty t3etetmined ' Olher([�cr�e):
st 1.hduxte U,e elevation datum used toru,e 8FE in B"s:[�'�ICV�1 s29 11��"�1�r(D�el�
;:
� «..... .
812 b the ts� located i�a Coastal Bartier CBR area or()tl�enMSe Area � �'Yes Wp . . pate
S� *:, C- LOIIV�4.EV N IN :. � , �iI�IREt� ,
c�.6�rsg elava4or�s are b�sed«x�]can�tian i�rawirx�s' p eu�ur� ' ,�� --, (�'F�shed C�stn�ion
'A new Bevatlon Certifir,ate Hn�be required wt�en construcbori af the bu�ng is camplete.
c2 e�ldng Diagra►n rkunber jp(sele�tti,e tx�d'u,y dagrarn most sir�ler to'u,e tx,k3r,g ror whic�f�lhis cerdr�ate is barrg camplebed-see pages s and 7. If no aer�am �
accurately�epre.ser�ts the buking,ptouide a sket�h or pttota�ra�pt�.)
q.Elevations—Zones A1-A30�AE,AH,A(with BFE1�VE,W-V30,V(wilh BFE),AR�ARIA,{1Fil'AE,AR/Ai-A30,AR/AH,ARIA�O
Canplete Items C3.-a�i below aocoid�ng to the b�a7cfng dagram speGfied in Item C2 State the dahm used if the datt�n is ddferent from the datum used fa the BFE in
Sectlon B,convert the datum to that used forthe BFE.Show field measuremerns and datum carversia�ca�ulstion. Use the space piauided or the C.at�area of
Section D or Sec�on G,as apPmPriate�to docurnent tl�e dah�m corroersien.
Da�um ConversioNCorturier�s _
Bevation r�erence mark used�Does the devatlon u�d appear on tha,FIAM? ❑Yes (�No .,w�w!Y, w��
) � C �s 1 � � (ml _ .� �:,�� `��;,`.
O a T of bottom floor uid basert�ent or endosuB m (�'("� ,���
u
0 b)Topafne�dhigherflaor � '�_(m) �' � �%�,�� 3 ,,,�'-��� ° �
a c)Bottom ot IoH►est hor'u.ontal sGt�u�al mert�er N��N) ,s�lm) o ",� �' a i�,�"; "�'f�'
0 d)Attac��ed 9a►a9e(teP;of slah) _.. _.:.�lm) �g " '"'�^
. #,:
❑ e)Lowest elevatiort of rnachinery andlor eq�pment � � ° �p ��,
senriang the b�ng(Descnbe in a Camnents area) �!��t(m) � �y" : F • �a,
. � � �"�"��/�\�"! �+�f�.� � � .� . . _ � h� �.�V�'. . �`�� R� .
O L.awest acent fi OaR m z_ �s r- 4' I `y�y •'
a 9)FG9hest adlace�1�19�lf'�1 �..•�lm) � ��� *y'� '�.,�,.
« .a �� �.
❑ h)No.d pertnaneM openings(flood verds)wi�in 1 R ebove adjacent grade� � ,� � $ �� "
O i)Total ares�all peRnanent openings(flood C3.h�s4!�(s4�1 �;
SECTION D-SURV�1fO R,ENGINE E R,O f�l RqitTECT CERTIFlCATIW�1
^ ��.— ^, ��, ��,_...�
This certification is to be signed and sealed by a landsuMeyor,engineer,or architect authorized by law to certity elev�tion infortnadon.
1 certify that the information in Sections A,B,and C on this cerrGidffcate represents my bes�t efforts to iMerpcet the data available.
I understand that any false siatement may be punishable by fine or rmprisonmen[under 18 U.S.Code,Sectlon 1001.
GER�"IFIER'S NAME _ UG�ISE NUMBER
J��2��' �. ��-rr 5�9 3
� ��a�2�T �if�`�E'lc� cornPavir ruwtE,�.� C�(�.o��, tN c.
a�RESS:3cc� '�P�2-� P�-�� P�lr�[� �L��RWA'TC� STATE �� ZIP���5�
SIGNATURE DA1`E TELEPHONE
1'Z���o2 C�2-t�531-35�5
- - -- - - __ __
°EMA Form 81-31,JUL 00 SEE REVERSE SIDE FOR COP•lTINUATION REPIAGES ALL PREVIOUS EDITIONS
� m � _____ _
..- � ,.
. . .. . ,. . . �.'�3Mf i'F:':t+YY_ut�r:� . - . . . . ....
NT: In tft ase spaces,copy the carresponding ir�fonnation from Sectian A. r�rinsurancacanpenyuse:
�TAEFT A;J�'rESS(Induding Apt,Uni�Suite,arxUor BkJg.No.)OR P.O.ROUTE AND BOX N0. Po6�y Number
'7� ' P � -��u ,
.� .�.L�GP�Wi�CECL �JEAr�'� STATE �� D'�'7S,(o� "Ca�arryNAlCNumber
SEC110N D-SURVEYOR,F.�VGINEER,OR ARCHITECT CERTIFlCATION(CONTiNUED)
Capyr bo�i sides of this�evation Cer6ficate for(1)communiry offiaal,(2)insurance agenUwm�rry,and(3)buiidng owner.
COMM1�MS '
❑Checic here if attachmerns
SECTION E-BUILDING ELEVATION INFORMA710N(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BF�
For Zone AO and Zone A(witl�aut BFE�,oompfete Items Ei through E4. ff the Eevation Certificate is i�tended for use as supporbr�g infortnation for a LOMA a LOMR-F,
Sedian C must be campleted.
E1.Buking Diagram Number_(Select the buik�ng d�agr�n most srtdiar to the buiic5ng fwwhich this cer6ficate is being canp�ted—see pages 6 and 7. If no dagram acauately
�ts the buik5ng�Provide a sketch or P�9�)
E2 The Oop of ihe bottom flaor(indu�ng basert�ent or endasure)�the buil�ng is _ft.(m)_in.(cm)Q above or ❑below(chedc a�e)tlte high�t adajacer�t grade. (Use
r�ual gra�,if availabfe).
E3.Fa B�id�ng Diagrams 6-8 with�penings(see Page�,the next higtier flooror elevated flaor(el�tion b)of the buik5ng is _n(m)_in.(cm)above tlie hi9hest a�nt
�ade. Complete items qh and p.i an iront af form.
E4:Fa Zone P�anly If no flaod depth number is av�lable,is the tap d the bottan flaor elevated in accordance wiih the carxnuniiys floodplah management ortinance?
❑Yes ❑No ❑Unfmown. The lacal afl�rtwst cerMy this ir�ormatlan in Sectlon G.
SECTION F-PROPEATY OWNER(OR OWNEA'S REPRESENTATN�CERTIFlCATION
The prope�ry owner orowners authorized repres�tadve who campletes Sedions A,B,C(Items q.h and q.i ordYl�and E forZane A(witl�out a FEbWissued ar cartxrx�r-
issued BFE)or Zone AO must sign here. The statemenls in Sectlar�s A,8,C,arxi E are cortect to U�e best d my knowledge.
PROPERTY OWNER'S Ofi OWNER'S AUTHORIZED REPRESENTATNE'S NAME
ADORESS CRY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attadiments
SECTION G-COMMUI�Y INFORMA710N(OP110NAL)
The lac�al atfiaal wfw i�autltotrzed by law at or�nance to adrrur�ster the�iys flaodplain m.anageme�orcinarxe can complete Sectians l�B,C(or E��and G d this�svatlon
C�. Compfete the applicable it�r�s)anC�below.
�1.�The infortna3ion in Sectiori C was taicen irom alher docurnentatian th�has been signed and ernbossed by a C�surveyor,engineer,or ar�ted who is autl�orized by
slate orlocal 18w to certify elevat�t7r�dmation. (In�cate tlte souree and date d the elevatia�data in the Camner�ts area below.)
G2�A oomrtn�niry oifiaal qmplAted Secdan E fa a bu�irg located in Zone A(wilhout a FEidA-issued or canrtp�nityissued BFE)ar l_one A0.
q.0 The�fiolbwing i�fom�ation(Items G41',9)is prauided for commuroiY����P��
G4.PEAMIT NUMBEA G5.DATE PEAMR ISSU� G6.DATE CERTIFlCATE OF COMPLIANCFACCUPANC`f ISSU�
G7.This pertnit has been iss�ued for.�New Car�strtx�ion ❑Substarrtial Impravement
GB.8euelion af as-buift lowest floor(r�dtx�ng basertient)of the buikfuig i� __ftlml Dahim:_
G9.BFE a('m Zone AO)depth of flooc5ng at the b�rilding ste is: __R(m) Daturr�_,
IACALOFFICIAL'S NAME TffLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMN�NTS
❑Checfc here'rf attachmer�ts
FEMA Fortn 81-31,JUL 00 REPLACES ALL PREVIOUS EDITIONS