721 BRUCE AVE �L�� 1.1.J - �}
Q l L��Q� IERGENCY MANAGEMENT AGENCY p,M.6. No. 3067-0077
j . FLOOD INSURANCE PROGRAM
���'��c�. �� �TION CERTIFICATE
� Q�(,�,J^��S��_(_,� ;ead the instructions on a es 1 -7.
� ` �� PROPERTY OWNER INFORMATION For Insurance CompanyUse;'' '
B ,� � Policy Number
B �C� :a
� I/or Bldg.No.)OR P.O.ROUTE AN�BOX NO. Company NAIC Number '
C STATE ZIP CODE
FL
P ;el Number,Legal Description,etc.)
i MANDALAY SUBIDIVSION
8 �essory,eta Use Comments sedion if necessary.) ;
L..���.+�.:.�.��..����..��.,. .. .�, .._._.__._fAL DATUM: SOURCE: �._�GPS(Type):,
( ##°-##'-##.##" or ##.##�l##� u NAD 1927 L�NAD 1983 �_�USGS Quad Map �Other�
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION C�"('�( ATER
B1.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
Pinellas Florida
B4.MAP AND PANEL 85.SUFFIX B6.FIRM INDEX B7.FIRM PANEL 88.FIOOD B9.BASE FIOOD ELEVATION(S)
NUMBER ar/�,r� DATE a EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding)
'� A-E 11.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
U FIS Profile �FIRM �Community Determined �J Other(Describe):
B11. Indicate the elevation datum used for the BFE in B9: ��� NGVD 1929 �_)NAVD 1988 �J Other(Describe):
B12. Is the building located in a Coastal Barrie�r Resources System(CBRS)area or Otherwise Protected Area(OPA)? �_�Yes (x�No
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
uilding elevations are based on: L�Construction Drawings• jJBuiiding Under Construction' �,�c�Finished Constn�ction
A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1 (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�epresents 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,AR/AE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3a-i below according to the building diagram specified 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 C,as appropriate,to document the datum conversion.
Datum ConversioNComments
Elevation reference mark used SEE Ca`�AZE�]'I'S Does the elevation reference mark used appear on the FIRM7 �_�Yes ��t�No
0 a)Top of bottom floor(including basement or enclosure) 6 . 1 ft.(m) � � ,�,"�-"—
❑ b)Top of next higher floor N A ft,�m� � 'Y ,,��r�', '� °'i,�,��'
O c)Bottom of lowest horizontal structural member(V zones only) N A ff,(m� o o , �.v •'``°'' �" ` 3^ �°
❑ d)Attached garage(top of slab) 5 4 ft.(m) E� ;'�� �' �� . �•F� 4'y, �
❑ e)Lowest elevation of machinery and/or equipment w ; ,�, �; ;� " 3 ;� +��� "
servicing the building 6 1 ft.(m) E; �„ 3� � ���lC,�,:,
❑ �Lowest ad'acent rade LAG 5 . 0 ft. m z'� <' �� y �h��'�'2^
1 9 ( ) — ( ) �. -��� �,��,��Q
❑ g)Hlghest adjacent grade(HAG) 5 . 3 ft.(m) �N •���.v .�',� �:.
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade�_ � �'�.,;'� ' ��'�,''
❑ 1 Total area of all ermanent o enin s flood vents in C3h 0 s . in. s .cm '�"r�'�'"�y
) P P 9 ( ) q ' ( q )
SECTION D-SURVEYOR, ENGINEER,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.
1 ce►tily that the Information Tn Sections A, B, and C on this cenificate represents my best efforfs to interprvt the data available.
I understand that any false statement may be punishable by frne or imprisonment under 18 U,S, Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
6960
Pr'�2S1CZP.Ilt COMPANY NAME
- Muzphy's Larra Survevina, Inc.
ADDRESS CITY STATE ZIP CQD
5760 11 Avenue N. 5t. PetersbL�rq FL 33�10
SIGNATUR DATE TELEPHONE
' 727/347-a740
FEMA Form 81-31,AUG 99 S R RSE SIDE FOR CONTINUATfON REPLACES ALL PREVIOUS EDITIONS
_ � _
.
FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Im ortant: Read the instructions on a es 1 -7.
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company'Uset''''
BUILDING OWNER'S NAME Policy Number '
M�.�hael W. Parkes and Michelle Parke�
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.NoJ OR P.O.ROUTE AN�BOX NO. Company NAIC Number ..
—Z21 Bruce Avenue
CITY ' STATE ZIP CODE
Clearwater � FL
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 5 Block A A REPLAT OF BLOCK 25 MANDALAY SUBIDIVSION
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) .
R2SIC�EIIt1a1 '
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: j_�GPS(Type):i
( ##°-##'-##.##" or ##.#####� L�NAD 1927 L�NAD 1983 �_�USGS Quad Map �Othe :
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION C�N A ER
81.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
Pinellas Florida
B4.MAP AND PANEL B5.SUFFIX 66.FIRM INDEX B7.FIRM PANEL B8.FLOOD 89.BASE FLOOD ELEVATION(S)
NUMBER ��,r� DATE a EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding)
A–E 11.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
U FIS Profile �FIRM �Community Determined �J Other(Describe):
B11. Indicate the elevation datum used for the BFE in B9: �,g� NGVD 1929 �� NAVD 1988 ��Other(Describe):
B12. Is the buiiding located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? �_�Yes �x�No
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
uilding elevations are based on: L�Construction Drawings' jJBuiiding UndHr Construction' ��c�Finished Construction
A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1 (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,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3a-i below according to the building diagram specified 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 C,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used SEE C�IS Does the elevation reference mark used appear on the FIRM7 ��Yes �x� No
❑ a)Top of bottom floor(including basement or enclosure) 6 . 1 ft.(m) � � �-;�,
❑ b)Top of next higher floor N A ft,�m� o '� , �� ��� "'r,�.�"
O c)Bottom of lowest horizontal structural member(V zones only) N A ft,�m� y; , � �✓u �. _ j° '°
❑ d)Attached garage(top of slab) 5 . 4 ft.(m) E D _ �:� �' r� �m; ,�;.
❑ e)Lowest elevation of machinery and/or equipment W � ;�: � ,'.� " ,<.� � � -
servicing the building 6 1 ft.(m) �= ,,,., � � ��!(��:;'
� � �� ��` ;`.��;,�.
❑ �Lowest adjacent grade(LAG) 5 . 0 ft.(m) �N �.�y -��� � <;��
❑ g)Highest adjacent grade(HAG) 5 3 ft.(m) � � ,r ' �
❑ h)No.of permanent opeNn s flood vents within 1 ft.above ad'acent rade � y r, .`�°'� ���'�;T
9 ( ) 1 9 �_
❑ i Total area of all ermanent o enin s flood vents in C3h 0 s .�n. s .cm J ���"'��'"�'g�� ��
) P P 9 � )� q � ( q )
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certiry elevation information.
f certify that the information in Sections A, B, and C on this ce�ti�cate represents my best effoKs to interpret the data availab/e.
1 understand that any false statement may be punishable by�ne or imprfsonment under 18 U.S. Code, Secfion 1001.
CERTIFIER'S NAME LICENSE NUMBER
L 6960
COMPANY NAME
_ President D�urphy's Iarra Surveying, Inc.
ADDRESS CITY STATE ZIP CQD
5760 11 Avenue N. St. PetersbL,rq FL "33�10
SIGNATUR DATE TELEPHONE
' 727/347-a740
FEMA Form 81-31,AUG 99 S RE RSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
r •
IMPORTANT: In these spaces,copy the corresponding information from Section t.. For Insurance Company Use:':'
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AN��BOX NO. Policy Number
_�2 Bruce Avenue
CITY STATE ZIP CODE Company NAIC Number
Clearwater FL 33767'
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CER7IFICATION( N
Copy both sides of this Elevation Certificate for(1)community o�cial, (2)insurance agenUcompany,a ilding owner.
COMMENTS.
Elevntions Based on P.C.E.D. Benchmark (Aural RM 3)
Elevation = 6.193
. . . .
- F CL�AR A
� T��� Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITWOUT BFE)
For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting''
information for a LOMA or LOMR-F, Section C must be comp/eted.
E1.Building Diagram Number (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.)
E2.The top of the bottom floor(including basement or enclosure)of the building is �I_I�•(m) (_I_I�n.(cm) L�above or ��below
(check one)the highest adjacent grade.
E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevat�•d floor(elevation b)of the building is
� � I ft.(m)L��in.(cm)above the highest adjacent grade.
E4.For Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance?�_I Yes �_I No __I Unknown. The local o�:ial must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESEf�TATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B,and E for Zone A(without a FEMA-issued or
community-issued BFE)or Zone AO must sig�here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
�RESS C!T" STATE Z;P COCE
�NATURE DATE TELEPHONE
COMMENTS
I_I Check here if attachments
SECTION G-COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete
Sections A, B,C(or E),and G of this Elevation Certificate. Complete the applicable item(s)and sign below.
G1. U The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer,or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2.U A community o�cial completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or
Zone AO.
G3.L�The following information(Items G4-G9)is provided for community floodplain mar agement purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DAT�=CERTIFICATE OF COMPLIANCE/OCCUPANCY
ISSUED ,
G7.This permit has been issued for: L�New Construction L,�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 building site is: _ft.(m)Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
1MENTS , ,
� � Check here if attachments
FEMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS
— � _ _ _
. FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
� � NATIONAL FLOOD INSURANCE PROGRAM Expires December 31,2005
, � ELEVATION CERTIFICATE
Im rtant: Read the instructions on a es 1-7.
RLS#0409-0392 SECTION A-PROPERTY OWNER INFORMATION Fa Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
TIMOTHY LINDBLOM
BUILDING STREET ADDRESS(Including Apt.,Unft,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
721 BRUCE AVE
CITY STATE ZIP CODE
CLEARWATER FL 54774
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 5,BLOCK A,REPLAT OF BLOCK 25,MANDALAY SUBDIVISION
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" or ##.#t#q4#� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNITY NAI�&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
CIIY OF CLEARWATER 12509G PINELLAS FL
64.MAP AND PANEL 67.FIRM PANEL 89.BASE F100D ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIftEVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of Aooding)
1250960102 G 91312003 91312003 AE 11'
610.Intlicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile �FIRM ❑Communihr Determined ❑Other(Describe):_
B11.Indicate the elevation datum used forihe BFE in B9:0 NGVD 1929 �NAVD 1988 ❑Other(Describe):_
612.Is the building located in a Coastal Bamer Resources System(CBRS)area a Otherwise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building eleva6ons are based on:❑Construction Drawings"' ❑Building Under Construction* �Finished Corutruction
"A new Elevation Certificate will be required when construction of the building is complete.
C2.Bui�ding Diagram Number 1(Select the building diagram most similar to the buikJing 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.Eleva6ons—Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARIAE,ARIA1-A30,ARIAH,ARIAO
Complete Items C3:a-i below according to the building diagram specfied in Item C2.State the dahim used.If the datum is different from ihe datum used fa 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 document the datum conversion.
Datum NAVD'88 ConversionlComments NONE
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes �No .
o a To of bottom floor includin basement or endosure 4. 7 ft m � � ���'�` K°�1°�� '
) p � 9 ) � ) , �, �
o b)Top of next hgher floor NIA._it(m) `� ����`���� ����"�� .
o c)Bottom of lowest horizontal structural member(V zones only) NIA._ft(m) �� '�<y-a���
00
o d)Attached garage(top of slab) 4. 0 ft.(m) �� � ,`'� ,� ,� ;
o e)Lowest elevation of machinery andlor equipment W`°
servicing the building(Descnbe in a Comments area) 4.9 ft(m) �� � �" ;�
o�Lowest adjacent(finished)grade(LAG) 4.1 ft.(m) z� ��; `�r'����`��a' c"
o g)Highest adjacent(finished)grade(HAG) 4. 3 ft.(m) �� ���'�i�� �L�� � «�, �;'"���
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade NIA J �'� .s��,,t.��'�' "�
o i)Total area of all permanent openings(flood vents)in C3.h NIA sq.in.(sq.cm)
SECTION D-SURVEYOR,ENGINEER,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 the informafion in Sections A,8,and C on this certificate represenfs my best effo�ts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001.
CERTIFIER'S NAME GALEN BELL LICENSE NUMBER 4224
TITLEPROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME AMERICAN SURVEYING AND MAPPING,INC.
ADDRESS CITY STATE ZIP CODE
1030 N ORLANDO AVE,SUITE B WINTER PARK FL 32789
SIGNATURE DATE TELEPHONE
911612004 407�A26-7979
FEMA Form 81-3' See reverse side for continuation. Replaces all previous editions
L � 1
IMPORTANT:`In these spaces,copy the corresponding informa6on from Section A Fa Insuranc:e Company Use:
BUILDING STREET ADDRESS(Indudirg Apt.,Unit,Suite,andlor BMg.No.)OR P.O.ROUTE AND BOX N0. Pdicy Number
721 BRUCE AVE '
CITY STATE ZIP CODE Canpany NAIC Number
CLFARWATER FL 54774
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community oificial,(2)insurance agenUcompany,and(3)building owner.
COMMENTS
ELEVATIONS SHOWN HEREON ARE BASED ON PINELLAS COUNTY DATUM
MACHINERY DESRIBED IN C3E IS AN AIC UNIT
❑Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WRHOUT BFE)
For Zone AO and Zone A(without BFE),compiete Items E1 through E4. If the Elevation Certificate 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 which this certificate is being completed—see pages 6 and 7. If no diagram accurately
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,rf available).
E3.For Building Diagrams 6�with openings(see page 7),the next higher floor or elevated floor(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 plafform of machinery andlor equipment senriang tt�e building is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if availabie).
E5.For Zone AO only: if no flood depth number is available,is the top of the bottom floor elevated in accordance with the communit�Js floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local oificial must certi�this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFICATION
The properry owner or owner's authorized representative who completes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(wiUiout a FEMA-issued a communiry-
issued BFE)or Zone AO must sign here. The statements in Sections A,8,C,and E ar�correct to 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-COMMUNffY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the communit�s floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete the applicable item(s)and sign below.
G1.�The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law to certify elevation ir�ormation. (Indicate the source and date of the elevation 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.
G3.0 The following information(Items G4G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF CON�LIANCBOCCUPANCY ISSUED
G7.This 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 buikling 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 Replaces all previous editions