769 BRUCE AVE REF T0:
, E�EVATION CERTtFICATE 99-42254�-M.B. No. 3067-Oc
FEDERAL EMERGENCY MANAGEMENT AGENCY �pires July 31, )9<
— NATIONAL FLOOD INSURANCE PROGRAM 99-42373
� ATTEMION: Use ot this certificate does not provide a walver of the flood(nsurac�ce purchase requicemen�This form is used only to prc
vide etevatior�intorniation necessary to ensure oompC�anoe with applicable communiry floodptaln management ocdnances,to determine
the proper insurance premtum rate,and/or to support a request to�a Letter of Map Amendment or Revision(LOMA or LOMR).You are r
•req�hred to respond to this coqection of information unless a vaQd OMB control number is displayed in the upper right comer oi this torrr
Instructio�s tor completing this tonn can be found on the tollowing pages.
.__ SECTION A PROPERTY INFORMATION �-��— Foa wsuriwcecoMPnr�v use
BUIL�ING OWNER'S NAME ppUCY NUMgEq
DWIGHT D. AND DEBORAH DOSS CIIRTIS
STREET ADDRESS(Indudrq Apt,Urtit,Suite and/or 8tdp.Numbe�)OR P.O.HOUTE MIO BOX NUMBER COMPANY NAtC NUMBER
769 BRUCE AVENUE
OTHER DESCRIPTION(Lot and Blodc Numbers,etc.) �_� v� '
LOT 9, BLOCK 24, MANDALAY SUBDIVISION ��� ; " - �'�;1'
CfTY ,STATE,.—�.:-___�__.__ ��ZIPCODE! : ' .
_ CLEARWATER, FLORIDA �: `_;;
SECTION B FLOOD INSURANCE RATE MAP(FlRM)INFORMATION O C I �� � ZC O� ;; '.` �(
Provide the foilowing irom the proper FIRM(See instructions): �` �: ���___.� E
� , ....�. � y
1.COMMUNtTY NUMBER Z PANEL NUMBER �.SUFFlX 4.OATE OF FlRM INDEX 5. ��ZCN�E���-E�`��;�6.��ASE FLOOD E�EVATION +
..(bt,�Olonsa.'use:dePth}_.e.t
125096 0007 D 08-19-91 AE 11 '
7.Indicate the etevaGon datum system used on the FiRM for Base Flood Elevations(BFE�:�NGVD'29 ❑Other(describe on back)
8.For Zones A or V,where no BFE is provided on the FiRM,and the communityr has estabiished a BFE for this buiidng site,indicate
the community's BFE:�J.U teet NGVD(or other FIRM datum-see Section B, Item 7), �`\
SECTION C BUIl01NG ELEVATION INFORMATION
1. Using the Elevation Cenificate Instructions,indicate the diagram number irom the diagrams tound on Pages 5 and 6 that best
describes the subject building's reference level.�_ .
�(a). FIRM Zones A1-A30,AE,AH,and A(with BFE). The top of the reterence level floor from the selected diagram is at an elevation �
of I ( I I I�ol.�;feet NGVD(or other FIRM datum-see Section B,Item 7). �
(b). F(RM Zones V1-V30.VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from
l.1
the selected diagram,is at an elevation of � � ,U teet NGVD(or other FIRM datum-see Section B, Item 7).
(c). FIRM Zone A(without BFE). The floor usedas the reference level from the selected diagram is ��.lJ feet above❑ or �
below❑ (chedc one) the highest grade adjacent to the building. �
(d). FIRM Zone AO. The iloor used as the reference level from the selected diagram is L.�J.LJ teet above❑ or below l`—_J (cherk �
one)the highest grade adjacent to the building. If no flood depth number is available,is the building's lowest floor(reference �
level)elevated in accordance with the community's iloodplain management ordinance? � Yes ❑ No ❑ Unknown �
3. Indicate the elevation datum system used in determining the above reference level elevations:� NGVD'29 ❑ Other(describe �
under Comments on Page 2). (NOTE: Il the e/evation datum�used in measuring the elevations rs dillerent than that used on
the FIRM (see Section B, Item 7J, then conveR the elevations to the datum system used on the F/RM and show the conversion
equation under Comments on Page 2.) �
4. Elevation reference mark used appears on FIRM: ❑ Yes �lo (See Instructions on Page 4)
5.The reterence level elevation is based on: � actual construction ❑ construction drawings
(NOTE: Use o/construction drawings is on/y valid r/the building does not yet have the re/erence level lloor in place, in which
case lhis certi/icate wil/only be va/id/o�the burlding during the aourse ol construction. A post-construction Elevation Cerlilicate
will be required once const�uction is complete.J
6. The elevation o(the lowest grade immediately adjacent to the building is:l I I I I�fI.L7j feet NGVD(or other FIRM datum-see
Section B, Item 7).
' SECTION D COMMUNITY INFORMATION
t. I(the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item t
is not the'lowest floor"as detined in the community's tloodplain management ordinance,the elevation of the building's'lowest
ftoor'as defined by the ordinance is: � I I I I I.0 feet NGVD(or other FIRM datum-see Section B, Item 7).
2. Date of the start of construction or substantiaf improvement - - � �
FEMA Form 81-31,MAR 97 REPLA�S All PREVfOUS EOfT10NS SEE REVERSE SI�E FOR CONT1NU.aTtON
���� �
, - - • SECTION E CERTIFICATION
�
This certification is to be signed by a land surveyor,engineer,-orarchitect who isauthorized by state or loca(!aw fo certify elevation
•intormation when the elevation intormation for Zones A1—A30,AE,AH,A(with BFE),V1=V30,VE,and V(with BFEj is required.
• Community officials who are suthortzed by local law or ordnance to provide floodplain management information,-may also sign the
certification. In the case of Zones AO and A(without a FEMA or communiy issued BFE),a building offiaal,a property owner,or an
- owner's representative may also slgn the certification.
Reterence level diagrams 6:7 and 8-Distingu.ishing Features—Ii the certifieris unable to certify to breakaway/nori=breakaway wall,
enGosure size,location ot serviang eqvipment,area use,wall openings,or unfinished area Feature(s),then list thefeature(s)not
included in the certification under Comments below. The diagram number,Section C,Item 1,must still be entered.
/cenify that the in/ormation in Sections 8 and C on this cer7iTrcate represents my best eflorts to interpref the data availabfe.
I understand that any lalse statement may be punishable by line or imprisonment under 18 U.S. Code,Section f 001.
CERTIFIERS NAME IICENSE NUMBER(u AKx Seal)
LELAND E. BEDWELL #5889� �
T17LE COMPANY NAME
P.S.M. F.L.A. SIIRVEYS
ADORESS . CITY STATE ZIP
72nd STRE OR #209 LARGO FLORIDA 33777
SIG�:ATU • � DATE PHONE
• v
Copies uld be made ot th ificate tor:1)communtty otficial,2)insurance agenUcompany�and 3j building owner.
. W,�
COMMENTS: =, i ��;:
�
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�;,, � ., � �U:, '` j
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• �_ '
ON N!(TH ON PILES,
SLAB BASEMENT PIERS,OR COLUMNS
A V A A V
ZONES 20NES 20NE5 ZONES ZONES
REFERE�+CE
IEVEL REFERENCE
REFERENCE BASE �EyE�
IEVEI F1000
EIEVATION
_ 1
t:�:�' _'- :;y::a,•a.".':' :�2�:. �:6�:
..i�i<± �'�'�� .
" ' B.LSE
BASE ... � :::�::;�;:��.�'' ' HEiEREMLE i1000
FlOOO � �" �D.1�CENT
ELEvAT10N ' qEFENENCE �AWAGENT c'�� �E�� EIEVAiION
LEVEI G�E
'��s'�:.'�
,;`aD��CENr
�.�....... . ... ... .'w,n;:''� GRADE
+ ll(11
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top ot the reference level floor.
• Elevations for all V Zones should be measured at the bottom oi the Iowest horizontal structural member.
Page 2
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GARAG£� LOT 9 �/
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. BLOCK 2� 74.0'
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SINGLf S�ORY 10.0'
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� RESID£NCE
2 0 �i
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_//DFF 12.0' 36.2' S.8'
� _ _ E
-- STEPS _I
20' BLDG LIME 20' BLDG LINE �
CO/yC � 2�.0'
F� DRIV£ FIR 5/8' �
FIR !/P' NO ID �' 1� t" � I NO !D
BLOCK LORNER NO rD BAS/S F BEARING-� Q((,HT OF VA I
N.89'417I"b'. 59.18' CMl 1✓EST 59.30' lH) 5' CSV �
' S9' fP) 2 0' S9' CPJ � yB 2 0 �
3�.0' �•�� I
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£DG£ OF PAVEM£NF� � � � ' � � � � � � �� N
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�1_ _____�— � ' - � �.�_.,.._.._ ._..._
_ CENTERLINE�_ , ,._...._ .._ . . I
BRUCE AVENUE 60' ROW `
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•� I LEGAL DESCRIPTION : i � _, -v-�-�=' " 1
1
'LOT 9, BLOCK 24, MANDALAY SUBDIVISION, `---°-
ACCORDING TO THE PLAT THEREDF, AS
RECORDED IN PLAT BOOK 14, PAGE 32, OF
THE PUBLIC RECORDS DF PINELLAS COUNTY, o > >s 3o bo �
FLORIDA. �Ra,PH[c SCALE
CERTIFIED TO :
DrTIGHT D. AND DEBORAH DOSS CURTIS FLOOD ZONE : 'AE� E�E�� tl� �
COMMUNITY PANEL 125096-OG07D
DATED : 08-19-91
SUNBELT TITLE AGENCY (FLOOD ZONE : "B","C"."D", & "x" nRE NoT
AMERICAN PIDNEER TITLE INSURANCE C�MPANY IN DESIGNATED FL000 HAZARG ZONE AREA.)
IJOTE�
IN COMFLIANCE WITH F.A.C.
CERTIFICATION : bi�»-b.00si <5� <E> cIF �oc.aTtori ❑�
EASEMENTS �R RIGHT-OF-WA'! OF RECORD,
1 CERTIFY THAT THIS SURVEY WAS MA�E UNDER MY DIRECTION ANO THAT IT MEETS pTHER THAN THOSE ON RECOP.D PLaT, IS
THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE BOARD OF PROFESSIONAL REQUIRED, THIS INFORMATION MUST BE
LAt�D SI RvFYORS AND MAPPE CHAPTER 61G17-6, FLORIDA ADMINIS7RATIVE FURNISHED TO THE SURVEYOP. AND MAPPER.
CODE :S AFiT T S�CilO 72 027 FLORID STATUTES. N07E� FENCES MEANDEI? ON O? OFF LINES.
� $,!3�Q�q - CAPPROXIMATE COCATION ONL"�
BY ._ -��---- -- --- SURVEY DATE :-------�!
L* ON h. FINSTAD, �2453 JEFFRY H. HILLIGOSS, PLS /�4488 LELAND F. DySARD, PLS �3859
�`'�AY.Y E. F1NSTwD, PSM /{5901 KENNE'fH W. SMITH, PSM �5744 STEPH�N MACDONALD, PL,S #4001
LELAND E. BEDWE;IJ., PSM �/5884 C. DREW BRANCH, PSM �{5542 ERROL A. AYUSO, PSM /{5955
NOT A CERTIFiCATIGN Or TITLE. ZONING, EASEMENTS OR FREEDOM OF ENCUMBRANCES.
� NOT VAI.iD WITHOUT SURVEYOR'S SIGNATURE AND EMBOSSED SEAL
SURVEY IS VALID fQR 90 DAYS. PLEASE REFER TO REVERSE SIDE FOR GENERAL NOTES & ABBREVIATIONS.
10810 72nd STREET SUITE 209 REVISIONS
F.L.A. SURVEYS CORP. LaRGO, FLORiDA 33777 C�{.G'����a���
727-797-3603 . FAX 797-356Z
PROFESSIONAL LAND SURVEYORS & MAPPERS-LB 6569 3808 GUNN HwY SUtTE 206
I PFOJECT �vU:
T41,APG FI (lAl��� 3�F?d