200 BRIGHTWATER DR UNIT 8 & 9 r��r=.', t`� ; _..- �y...- 3 4 ,',
�; ��rj ��, �� + � � FEDERAL EMERGENCY MANAGEMENT AGENCY
.��" � "�'M '� ' '� � ' NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
, . � � Expires December 31, 2005
'
; �j�, .g�_�+, tt � �uu� � �� ��� ELEVATION CERTIFICATE
;:�._�1.� �---
� Important: Read the instructions on pages 1-7.
� �(?�rw F_tv� ���'v � r > �' � SEC110N A-PROPERIY OWNER INFORMATION Fo�irisurance Compary Use
q{�� Policy:Number
BUILDING STREET ADDRESS(Including Apt.,Unft,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
,��*CJ BRIGHTWATER DRIVE �j7- �� �
CITY STATE ZIP CODE
CLEARWATER, FLORIDA 33763
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT �', OF THE PLAT OF"BRIGHTWATER TOWNHOMES",PAT BOOK 126,PAGES 65&66
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Commerrts area,"rf necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.##" or ##.#####� ❑NAD 1927 ❑NAD 1983 �USGS Quad Map ❑Other:
SEC110N B-FLOOD INSURANCE RATE MAP(FIRIU�INFORMATION
61.NFiP COMMUNITY NAME&COMMUNITY NUPABER B2.COUNTY NAME B3.STATE
CITY OF CLEARWATER 12`.�J6 PINELLAS COUNTY FLORIDA
B4.MAP AND PANEL -�� B7.FIRM PANEL B9.BASE FLOOD ELEVATIOfV(S)
NUMBER B5.SUFFIX B6.FIRM �EX DATE EFFECTNEJREVISED OATE 68.FLOOD ZONE(S) (Zone A0,use depth offlooding}
125Q9Fi0007 D At.JGUST�i$-�- AUGUST 19,1991 AE EL.11.0 i
610.Ind�cate the source of Uie Base Flood Elevation(BF�data or base flood deptl�entered in B9. �
❑FIS Profile XXX FIRM ❑Canmunity Determined ❑Other(Descnbe): �
611.In�cate the elevation datun used fa t�e BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Otl�er(Desaibe):_ _(�)
612.Is the buading iocated in a Coastal Bamer Resou�es System(CBRS)area a Otherwise Proteded Area(OPA)? ❑Yes ❑No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATfON(SURVEY REQUIRED) �
a
C1.Building elevations are based on:�Consh�uc,fion Drawing�` ❑Buik�ng Under Construction* XXX Fnist�ed Construction ^1
� *A new Elevation Ce�tifiCa�wiu be required when ca�sttructi�on of ifie bu�ding is canplete. ��"
2.Buil�ng Diagam Nunber_ (Select the builcing dagam most sin�ar to the buiicing for which mis certificate is being canpleted-see pages 6 and 7. If no ciagram [j
accuratey r�nis ihe bu�ding,pravide a ske�h or photagaph.) �J
C3.Elevations-Zaies A1-A30,AE,AH,A(with BFE�,VE,V1 V30,V(with BF�,AR,ARIA,AR/AE,AR/A1-P30,AWAH,AR/AO W
Complete Items C3.-a-i below according to the bu�dng ciagam specfied in item C2.State the datr�m used.If ihe daUun is cifferent irom fhe daium used fa the BFE in w
Section B,cornrert the datum to that used for the BFE.Shanr field measurements and datim cornrersion calculation. lJse the space prarided or the Commenls area of
Section D or Section G,as appropriffie,to cbcunent the datum conversion.
Dahm NGVD 1929 Canversior✓Canments�UA
El�ration reference mark used No.155.EL.4.981 Dces the elevation reference mark used appear on the FIRM? ❑Yes XX No
a)Top of bottan floor(ncluding b�sernent or enclosure) 6. 50 it(m) � ,�c,4�.`°.y � ..
.< ti
b}Tap of next higher floor 15. 90 R(m) � , �,: , ,
c)Bottan of lowest ha¢ontal structurai mernt�er(Vzones only) WA. _it(m) o o ������ . . ��'
c�Attached 9arage(toP of slab) 6. 50 ft(m) W �. � •'�` ` -
e)Lowest ele�ration of machinery and/or equQment � m j>A f" `` 4 u.�
savicing the buildmg(Desaibe in a Canmenfs area) WA._ft(m) E��..� E3�C E A. hCkE I N r�' •;.�;
fl Lowest adjacent(finished}gade(LAG) 6. 0 ft.(m) �� � ^-°�'� ,r�' ,,� ., �..�°
9)Highest adjacer�(finist�ed)gade(!-iAG) 6. 2 ft.(m} � .�. ` .�/1�/t'i�� �'
h)No.of permanent openings(flood v�ts)wifhin 1 ft.above adjacent gade 14 � ,� , F
i Total area of aH t nin flood ven� in C3.h 632 in. ' ": �`
) P�� � 9S� ) S4� ;;.! •,.� ;
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTiFICATION
This certifica6on is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. ;
� !cetify that fhe informaGon in Sections A,B,and C on fhis cerSficate represenfs my besf etfods fo interpret the data available.
1 understand fhat any false statemenf may be punishab/e by Sne or imprrsonment under 98 U.S.Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A KLEIN PLS 5052
TffLE COMPANY W�ME
-PROFESSIONAL SURIJEYOR&MAPPER KLEfN&STAUB SURVEYING,INC.
� ADDRESS CITY STATE ZIP CODE
8016 Old County Road�} r, New Pat Richey FLORIDA 34653
SIGNATURE � DATE TELEPHONE
� 07/12J.03 (72�834-8140
IMPORTANT: in these spaces,copy the corresponding infomiation from Seation A For ir��rance comPary use:
BUILDING STREET ADDRESS(Including Apt,Unil,S�ie,ancLor Bldg.No.)OR P.O.ROIIfE AND BOX NQ Pdic,y Number
BRIGHTWATER DRIVE � •
CITY STATE ZIPCODE CanparyNAlCNumber
CLEARWATER FLORIDA 33763
SEC110N D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) •
Copy bol�sicies of t�is Ele�ration Certificate for(1)canmuniiy offiaal,(2)ir�sur�ce agent/comparry,and(3)buikling owner.
COMMENTS
rUA
❑ Chedc her�rf att�achments
SECTION E-BUILDING ELEVATION INFORMATtON(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BF�
Fa Zone AO and Zone A(wifhout BF�,canple�Items E1 tluough E4. if the Elevation Certificate is in�nded for use as suppating ir�amation for a LOMA or LOMR-F,
Section C must be canpleted.
E1.Builcing Diagam Nunber_(Select the builcing diagam most similar to the building fa which t�is certificate is being corrpl�ed—see pages 6 and 7. If no�agram aocurately
reFxesen�ihe bulcNng,provide a ske�h or photogaph.)
E2.The�p of the both�m floor(nclud�ng basement or endosure)of the builcing is _ft(m)_in.(an)❑abwe or ❑below(check one)the highest adjacent gade. (Use
natural gade,if availab�e).
E3.For Bui�ing Diagams 6�with openings(see page�,the ne�higher floor or elevated floor(elevation b)of the bu�ding is _ft(m)_in.(an)above the highest adjacent
gade. Complete iterr�s C3.h and C3.i on tror�t of fam.
E4.The k�p of the platform of machinery anc�or equipmer�senncing the budd'mg is _ft(m)_in.(an)❑abwe or ❑be�ow(chedc one)the highest adjacent grade. (Use
natur�l gade,if available).
E5.Fa Zwie AO only: If no flood depih ntmber is av�lable,is the top of the bottan floor elevated in aocordance wifh the canmunily's flooc�lain management ar�nance?
�Y� ❑rvo ❑Unkno�rm. The local o�iaal must ceitify Uus infamation in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATiVE)CERIIFlCATION
The property oNmer or owner's auf�a¢ed reFxesenta6ve who canpletes Sections A,B,C(I�ms C3.h and C3.i oniy),and E for Zone A(without a FEMA-issued a canmunily-
issued BFE)a Zone AO must sign here. Tf►e stateme�s in Sections A,8,C,and E�e correct to the best ofmy knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZFD REPRESEIJTATA/E'S�IAME •
P,DDRESS CITY STATE ZIP CODE
SIGI�IATURE DATE TELEPHONE
COMMEf�IfS
❑Check her�if attachments
SECTION G-CON�NUNITY INFORMATION(OPTIONAL)
The local oficial who is aufhaQ�ci by law or ordinance to actniruster the community's flooc$�lain mar�ag�nent orcinance can cxrr�lete Sections A,B,C(or E',and G of this Eledation
c�tificate. car,plete the�p�ab�e iten,(s)ar,d sign below.
G 1.�The infama5on in SPction C rtias taken fran�her cbcuner�tation that has been signed and ernbossed by a licer�sed s�aveyor,engineer,or ar�hi�ct who is authorQed by state
or iocal law t�a artify elevation irfiot*.nation. (Indcate tl�e source and date of ihe eleuation data in the Canmenis area below.)
G2.0 A ax rununily otfiaal c,r�ed Sc�tion E for a buddmg located in Zone A(without a f EMA-issued or community-issued BFE�or Zone A0.
G3.�The foibwing infcxmation(Items C�J-G9)is prouided ftx carrnuruty flooc�lain manag�nent purposes.
G4.PERMIT NUMBER C�. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF C�MPfJANCE/OCCUPANCY ISSUED
G7.This permit has been issued for.0 New Construction ❑Substantial Improvement
G8.Elevation of as-built lowest floor(nduding baserrien��the builcing is: _._ft(m) Datun:_
G9.BFE or(n Zone AO)de{�th of flood�ng at the b�l�ng site is: __it(m) Dahm:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY t�IAME TELEPHONE
SIGNATURE DATE •
COMMENTS
� � �' �r` �C, �� ;^"? ` =' E �� �'� FEDERAL EMERGENCY MANAGEMENT AGENCY
� �' `` � NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
i '!
� .� i , f� Expires December 31, 2005
� ��.��_ � � tuu� � �,, ELEVATION CERTIFICATE
1 � ; Importarrt: Read tfie instrudions on pages 1-7.
ELO�'+�E�7 �r�v :.r �.�-' ' SEC110N A-PROPERIY OWNER INFORMATION For insurance Comparry Use:
qpp€ Policy Number
BUILDING STREET ADDRESS(Including Apt.,Und,Sude,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
ZCO BRIGHTWATER DRIVE ��T ,
CIIY STATE ZIP CODE
CLEARWATER, FLORIDA 33763
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT � OF THE PLAT OF"BRIGHTWATER TOWIVHOMES",PAT BOOK 126,PAGES 65&66
BUiLDING USE(e.g.,Resideritial,Non-residen5al,Addition,Accessory,etc. Use a Commerrts area,ff necessary.)
RESIDENTIAL
LATITUDEJLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(fype):
� �°_��_�_� o� �{#.�� ❑NAD 1927 ❑NAD 1983 �USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRN�INFORMATION
B1.NF1P COMMUNITY NAME&COM�vAJNITY f�viBER 82.COUf�fTY NAME B3.STATE
CffYOFCLEARWATER 12�.�096 LASCOIdUTY FLORIDA
84.MAP At�ID PANEL � B7.FIRM PANEL B9.BASE FLOOD ELEVATION{S)
NUMBER 85.SUFFIX .�IRM f�EX DATE EFFECTNE/REVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth offlooc�ng)
125(�J60007 D AUGUSTaB,-'�J94-� AUGUST 19,1991 AE EL 11.0
B10.Ind�cate the sour�e of the Base Fbod Elc�alion daha_or base fiood depth entered in 69.
❑FIS Profile XXX FIRM ❑Carununity Determined ❑Ofh�(Descnbe):_ �
B11.Ind�cate the elevation dahm used for the BFE in 89:�NGVD 1929 ❑NAVD 1988 ❑Olher(Desaibe):_ ...�
612.Is ihe bu�ng located m a Coasfai Barrier Resaaces Sj�stern(CBRS)area a Otlierwtse Protected Area{OPA)? ❑Yes ❑No Desic�ation Date_ r,
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) �
C1.BuikGng eleva6or�s aze based on:�Construciion Dravangs` ❑Buikfing Under Construction' XXX Fnished Construclion ^,
'A r�ew Elevation Certifica�wi�be requa�ed when castruction of tlie buading is canpiete. `��
• 2.Buil�ng Diac,�n Nunber_ (Select Uie builcjrrxx�day�rn most sina�to the buiking fa which tl�s cefificate is being canpleted-see pages 6 and 7. if no d�agam d
l acciaatey r�nis me buaduiy,provide a ske�h a phot«,�-aph.) �)
C3.Elevatias—Zones A1-A30,AE,AH,A(wiih BFE),VE,V1 V30,V(v�ih BFE�,AR,AWA,AR/AE,ARIA1-A30,AWAH,AR/AO u1
Compiete Items C3.-a-i below aocordirg to the buac5ng ciagarn specfied in Item C2.State ihe datrsn used if ihe dahun is d�frerent fran me datum used for the BFE in W
Section B,cornrert the datrmi to that used for the BFE.Shou�r field rneas�uanenls and dahan conversion c�culation. llse the space pra�ided or ihe Corrrnerds area of
Section D a Section G,as appro�xiate,to docunent the da6um conversion.
Dahm NGVD 1929 ConversoNCanmertls N!A
Elevation reference mark used No.155.EL.4.981 Does the eledation reference marlc used�pear rn the FIRM? ❑Yes XX No
a)Top of bottm�floor(nclud�ng basernerrt or enclos�ue) 6. 50 ft(m) � � .
b}Top of neut higher floor 15.�R(m} �'
c)Bottan of lowzst haQOntal structr�ral rr�ernber(V zones onty) WA._R(m) "R! � 'f''
oo� j `
c�Attached 9arage(toP of slab) 6. 50 ft(m) E�" ,
e)Loraest elevation of machinery and/or equgxnent m'm, .
servicing the bu�da�g(Descrbe in a Canmenls ar�) N!A._R(m) E�. BRUCE�A. �4tEl N � ,
fl Lourest ad�acent(finishec�gade(LAG) 6. 0 ft(m) �� : �
9)w9�adl�ent(finist�ed}9ade(HAG) 6. 2 R(m) m : Q7/'t2/03 .:�'
h)No.of permar�ent openings(flood venls)wi�an 1 ft.above ac�acent gade 14 ° ° �' �
J t'
)To1ai area of aB permar�ent openings(flood ven�)in C3.h 632 sq.in. {,: .' •
���
SECTION D-SURVEYOR,ENGINEER,ORARCHITECT CERTiFICATION
This certifica6on is to be signed and sealed by a land surveyor,engineer,or architect author¢ed by law to certify elevation information.
� 1 certity that the informa6on in Sections A,B,and C on this cefificate represenfs my best etforfs fo interpret fhe dafa availabie.
i understand that any fa�se sfatement may be punrshable by fine or imprrsonment under 18 U.S.Code,Section 1001.
CERT)FIER'S NAME LICENSE NUMBER
BRUCE A KLEIN PLS 5052
TfftF COMPANY NAME
PROFESSIONAL SUf2UEY0R 8�MAPPER KLEIN&STAUB SURVEYING,INC.
qpp�� CITY STATE ZIP CODE
� 8016 Old County Ro�5�l � New Pat Richey FLORIDA 34653
SIGNATURE DATE TELEPHONE
- O7/12J.03 (72�834-8140
IMPORTANT: In t�ese spaces,copy the corresponding infom�ation from Section A F«i�si,rance compary use .: •
BUILDING STREET ADDRESS(Includng Apt.,Un�,S�ie,andla Bkk�.No.)OR P.O.ROl1iE AND BOX N0. Pdic,y Number
BRIGHTWATER DR1VE
CITY STATE ZIPCODE ComParry NAIC Number
CLEARWATER FLORIDA 33763
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) -"' ` �
bofh sides of tliis Eleration Certificate for 1 carmun oifiaal, 2 iru�xance a nb �
�pY () �y () 9e c�rr�r�',and(3)buildng owr�er.
COMMENTS
N/A
❑Check here ii att�achments
SECTiON E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONEA(IMTHOUT BFE�
For ZoneAO and Zone A(wilhout BFE�,cmiple�Items E1 it�ough E4. If fhe Elevation Certificate is in�nded for use as supporting infamation for a LOMA or LOMR-F,
Section C must be carpleted
E1.B�alcing D�agam NUr�ber_(Select the buiking c�ag-am most sir�lar to the building for which this ceitificate is being canpleted—see pages 6 and 7. If no ciagram accuratefy
represenis the buldng,{xande a ske�h or photogaph.)
E2.The bp of riie botk�rn floa(�clucing basernent or�re)of the b�l�ng is _ft(m)_in.(an)�abv�re a ❑below(check one)tl�e highest adacent gade. (Use
natr�gade,if available).
E3.For Buik6ng Diagams 6-8 with openirx�s(see page�,the next t�floor or elevated floor(elevation b)of the bud�ng is _ft(m)_in.(an)above the hi�adpcent
gade. Cm�lete items C3.h and C3.i on ftorrt of fam.
E4.The t�p of the plat(�orm of machinery ar�+or e�iprnent servicing the buldmg s _ft(m)_in-(an)0 abare or ❑below(chedc one)the f�gt�t adacent gade. (Use
nahr�gade.rf avaihable)-
E5.For Zone AO or�y: If no flood d�th nunber is available,s the top o(the bottcrn floor elevated in aocordarxe wifh tlie carurwnily's flooc#.�lain mamagement orcinance?
❑Yes ❑No ❑Urdvwwn. The local offidal must ce�tify tlUS ir�famation in Section G.
SEC110N F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION
The prope�ty oNmer a owner's autl ior¢ed repre�ative who car�tes Sec6ons A,B,C Q�ms C3.h and C3.i ordy),and E fa Zone A{without a FEMA-issued or ca�vnunily-
issued BFE�or Zone AO must su�here. The statemenls in Secbons A,B,C,a�d E a�e care�ct to the best ofmy knowledge.
PROPERTY OWNER'S OR OVIMER'S AUTHORI7FD REPRESENTATNE'S NAME
ADDF�SS CITY STATE ZIP CODE ,
•
SiGNATURF pnTE ;�L�P�OT�
COMMENTS
❑Check here rf attachments
SECitON G-CON�IAUNITY INFORMATION(OPTIONAL)
The local otficial who is authotQ�d by law or adin�ce to acinir�ster the canmurgly's flooc�l�n managetr�ent arinance can car�lete Sections A,B,C(or�,and G of this Elevation
Certificate. Complete the app�Cab�e item(s)and sign below
Gt.❑The infamation in�tion C vyas t�cen fran dher docunerrtation that has been signed and ar�bossed by a licerued sunre�ror,engineer,or archi�ct who is aufhor¢ed t�state
or ioc�law t�catify ele�ration ir�famation. Qndcate tlie source and date of the elevation data n ttie Canmenls ar�below.)
G2.❑A axrununiiy o�ial c�l�fi,.�d S�xtion E for a budc�g located in Zone A(without a fEMA-issued or canmunity-+ssued BFE�or Zone A0.
G3.�The fo�g ir�omiation(ftars C,4-G9)is provided fur c�rrmunity flooc$�lain management purposes.
G4_PERMfT NUMBER C�.DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCFJOCCUPANCY ISSUm
c�.m��r,����d ro�❑t�ew cor,�ao� ❑s�,�i i��,t
GS.Elevatim of as-buift lou�st floor(nduc�ng baserr�entj of the builting is: __ft(m) Datun:_
G9.BFE a(n Zone AO}depth of floocing at the buil�ng site is: __ft.(m) Dahm:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHOt�
SIGNATURE DATE
�
COMME�ITS
�
j� �� CITY OF CLEARWATER
� a� DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
POST OFFICE BOX 474g� CLEARWATER� FLOa�DA 33758-4748
MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CLEARWATER, FLORIDA 33756
TELFPHOrrE(72� 562-4567 Fnx(72� 562-4576
MEMO OF REVIEW FOR CORRECTNESS & COMPLETION
In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
The attached elevation certificate is complete and correct
X Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. BUILDING OWNER'S NAME BRIGHTWATER TOWNHOMES LLC Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
200 BRIGHTWATER DRIVE-UNIT 8
CITY STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:❑GPS(Type):
(##°-##'-##.##" or ##.#�##°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
64.MAP AND PANEL B7.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER g5.SUFFIX 66.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8•FLOOD ZONE(S) �Zone AO,use depth of flooding)
8/1 S/1992
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑Other(Describe)
611. Indicate elevation datum used for BFE in B9: � NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
612. Is the building located in a Coastal Barrier Resources S stem(CBRS)area or Othenvise Protected Area OPA? ❑Yes ❑No Desi nation Date
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construction Drawings` ❑ Building Under Construction* ❑Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. 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.)
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 C3.-a-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,conveR 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 Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�levafion certificates shall be maintained by the community and copies with the attached memo made availab/e by request
Fa�wK HirsHnRn,Mnvoa
GEORGE N.CRE7'EKOS,COUNCILMEMRER JOIIN DORAN,COUNCILMGMBER
PAUL F.GIHSON,COUNCILMGMBGR � CARLEN A.PG7'ERSEN,COUNCILM@MBBR
��EQUAL EMPLOYMEN'f AND Af�FIKMA'fIVE AC170N EMYLOYER�
,� ��.�� ,�� � ���� �� t��l�,
, FEDERAL EMERGENCY MANAGEMENT AGENCY
;� �< 'm� , � L003 (,� I NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067 0077
, ,1�,l_ i E x pires December 31, 2005
a '� �wi
����_� ELEVATION CERTIFICATE
� w,,.,..,,w.... - -
i t}�'JE�.OF�ENT SERVICES ��E.P�� Important: Readtheinstructionsonpages1-7.
`" -�---'���" SECTION A-PROPERTY OWNER INFORMAl10N For Irisurance Compary Use:
� ...._.------
BUILDING OWNER'S NAME Policy Number
BUILDING STREET ADDRESS Qncluding ARt.,Unrt,Suite,andlor Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
, .��� BRIGHIWATER DRIVE U,tl�f
C�7y STATE ZIP CODE
CLEARWATER, FLORIDA 33763
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT� OF THE PLAT OF"BRIGHTWATER TOWNHOMES",PAT BOOK 126,PAGES 65&66
BUILDING USE{e.g.,ResideMiai,Non-residential,Addition,Accessory,etc. Use a Comments area,ff necessary.)
RESIDENTIAL
LATITUDEILONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.#i€' or ##_#####� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP�FIRIII�INFORMATION �
B1.NFIP COMMUNffY NAME&COMNRJNITY NU(v1BER 62.COUNTY NAME B3.STATE (7
CITY OF CLEARWATER 125096 PINELLAS COUNTY FLORIDA "�
B4.MAPAND PANEL �C 67.FIRM PANEL B9.&4SE FLOOD ELEVATION(S) �j
NUMBER B5.SUFFIX B6.FIRM If�EX DATE EFFECTIVElREVISED DATE 88.FLOOD ZONE(S) (Zone A0,use depth offlooding) <5
125096-0007 D Al1GUST _� � AUGUST 19,1991 AE EL.11.0 (�J
610.Ind�cate the source�Uie Base Floai Efevation(BFE)data a�base flood depth entered in B9. d
❑FIS Profile XXX FIRM ❑Cmronunity Determined ❑Oth�(Descnbe): v
B11.Ind�cate the elevation datun used for the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Oth�(Desaibe): �
B12.Is the building la;ated in a Coaslal Bamer R�System(CBRS)area a Othentiise Proteded Area(OPA)? ❑Yes ❑No Designation Date_ �
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) �
C1.Buikling ele�rations are based on:�Consh�uction Dtawings'` ❑Buildng Under Construction* XXX Finished Construction
'A new Elevation CertifCa�v�,iu be required when construction of ihe bu�ding is complete.
•2.Building Diagam Nunber_ (Sele�t ihe buiking d�agam most sin�ar to the builcing fa which this certibcate is being canpleted-see pages 6 and 7. If no ciagram
accuratey represenis the bu�aing,provide a ske�n«pl,otoyrapl,.)
C3.Elevations—Zaies A1-A30,AE,AH,A(�rith BF�,VE,V1 V30,V(v�,ith BF�,AR,AWA,AR/AE,ARlA1-P30,AWAH,AR/AO
Canplete Iterr�s C3.-a-i beJow according to the buil�ng ciagam specified in Item C2.State ihe dahun used.If ihe dahxn is cifferer�from tt�e datum used fa the BFE in
Section B,conve+t the dahxn t�that used for ihe BFE.Shav fieid measuremenLs and dattm corrversion caiculatiai. Use the space pravided or the CarmeMs area of
Section D or Section G,as apprapriate,to docunent the datum corrveision.
Datun NGVD 1929 ConversioNCommenls N!A
Elevation reference mark used No.155,EL.4.981 Does the elevation r�erence maric used�ai the FIRM? ❑Yes XX No
a)Top of bottan floor(ncluding basemer�or enclosure) 6. 50 ft.(m) � �"a ' ,.�-a Y <,�'r
b)Top of next higher floor 15. 90 ft(m) � v d�;, :� r
c)Bo�an of lowest horQOr�tal structural rr�rnber(V zones only) tWA. _ft(m) o o,;� ;' .,a �,,` i1`
c�Athached 9arage(toP of slab) 6. 50 ft(m) �� , �.� = .
e)Lo�.est ele�ration of machrc�ery ancVor ec��xxnent "�� !
servicing the bu�dmg(Desaibe in a Canmenis ar�) WA._ft.(m) �� �RI�E f�,KL �
fl Lowest adjacent(finishec�gade(LAG) 6. 0 ft.(m) z�'_ �.,l,� �. e►, �.
9)Hi9hest adlacer�(finis�9ade(HAG) 6. 2 ft.(m) �m �` ,��� 07/.1��'Jb3 ,
h)No.of permanent openings(flood ven�)witlnn 1 ft.above ac�acent grade 14 J ', L. �. :' .�,^.�,'
)Total area of aa permanent openings(flood ven�)in C3.h 632 sq.in. "
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This cer6fication is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
� 1 cerfify that the informafion in Secfions A,B,and C on fhis cer5ficate represenfs my best eff�rts to interpret the data available.
1 understand that any false sfatemenf may be punishable by fine or imprrsonment under 18 U.S.Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A KLEIN PLS 5052
TITLE COMPANY NAME
�PROFESSIONAL SURVEYOR&MAPPER KLFIN&STAUB SURVEYING,INC.
�ADDRESS CI1Y STATE ZIPCODE
8016 Old County R New Pat Richey FLORIDA 34653
SIGNATURE DATE TELEPHONE
_' . 07/12i.a3 (72�834-8140
�
IMPORTANT: In these spaces,copy i�e corresponding infortnation from Se�tion A Forar�urance compary use:
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and�or Bldg No.)OR P.O.ROUTE AND BOX N0. Pdu,y Number
BRIGHTWATER DRIVE ,
CITY STATE ZIPCODE ComparryNAlCNumber '
CLEARWATER FLORIDA 33763
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION�CONTINUED) •
Copy both sides of ihis Elevation Certificate ior(1)canmunily offiaal,(2)insurance agent/comparry,and(3)buiiding rnNner.
COMMENTS
N/A
❑ Gheck her�'rf aUachments
SECTION E-BUILDING ELEI/A710N INFORMATtON(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT B�
Fa Zone AO and Zone A(wi�hout BF�,canple�ftems E1lhrough E4. If the Elevation Certificate is intended fa use as supporting infamation for a LOMA or LOMR-F,
Section C must be completed.
E1.Builcing Diagarn Ntmber_(Select the builcing diag�r�most similar to fhe building for which this certificate is being corripl�ed–see pages 6 and 7. If no cfagram accura
�Y
reFxesents the buld�ng,prwide a sket�h or photogaph.)
E2.The b�p of the botD�m floa(mcluc�ng basernent or erx�OSUre)of the builcing is _ft(m)_in.(an)❑abwe a ❑below(check one)the highest adacent c�ade. (lJse
natural gade,if available).
E3.For Bui�ing Diagams 6�with openings(see page�,the neact hi�floor or elevated floor(elevation b)of the buiiding is _it(m)_in.(an)abwe the highest adjacent
gade. Corriplete itans C3.h and C3.i on tror�of fam.
E4.The bp of the platf�am of machinery and�a eqti�pment se�vicing the budding's _ft(m)_in.(an)❑aba✓e or ❑below(check one}the highest adjacent grade. {lJse
naiural gade,if available).
E5.For Zone AO only: If no flood depth ntn�ber is avail�le,is the top of the bottan floa elevated in accordance v�tli tlie canmunily's floodpiain management a�f nance?
❑Yes ❑No ❑Unknown. The local ofiaal must certify this infamation in Section G.
SEC710N F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION
The properiy oumer a owner's author¢ed represeMative who canpletes Sections A,B,C(I�ms C3.h and C3.i oniy),and E for Zone A(without a FEMA-'ssued or canmunity-
issued BFE}or Zone AO must sign here. The stafeme�s in Se�ior�s A,8,C,and E�e corred to the best of my knowledg2.
PROPERTY OWNER'S OR ODUNER'S AUTHORIZED REPRESEM'ATIVE'S Nl4ME •
ADDRESS CITY STATE ZIPCODE
SIGNATURE DATE TELEPHONE
COMMENTS
� ❑Check here rf attachments
SECTION G-CONANUNITY INFORNIATION(OPTIONAL)
The local ofi�;�l who is autha¢ed by I:��:r or�rdi�ance to aclniniste�the canmunity's flooc�lain management orcinance can canplete Sections A,B,C(or E�,and G of this Elevation
Certificate. Canplete the�pp�Cable itan(s)and�gn below.
G 1.�The infu�nation ir�Section C was faken`an�her docunerrtation that has been signed and ar�ssed by a licer�sed s�veyor,engineer,or architect who is aulhor¢ed by state
or locai lawto certify elevation i�cxmztion. (Ind�cate the source and date of ihe elevation data�the Cmunenis area below.)
G2.�A cunmunifj off�ial rxrnple�a.ci Sectien E for a bud�ng located in Zone A(without a FEMA-issued or conmunity-issued BF�or Zone A0.
G3.�The foliowing infamation(Items G4-G9)is prwided fa carrnunity floo�lain manag�nent pur�oses.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED C-�. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
G7.This pe►mit has been ssued for�New Construction ❑Substantial Im{xwement
G8.Elevation�as-buift low�st floa(induding basemen��the buil�ng is: _._it{m) Dahm:_
G9.BFE or(n Zone AO)depth of flooding at the builcing site is:
—_ft{m) Dahm:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY�IAA�tE TELEPHONE
SIGNATURE DATE �
COMMEt�lTS
U � v I, FEDERALEMERGENCYINANAGEMENTAGENCY O.M.B. No. 3067-0077
� , .,��L -�.,4 t003 v NATfONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
��pp�tENT SERVICES �JEPT Importartt: Readtheinstructionsonpages1-7.
SEC110N A-PROPERIY OWNER INFORMATION Foi.lnsuranoe Gompary Use:
BUILDING OWNER'S NAME Policy Number
BUILDING STREET ADDRESS(Inciuding?�,Unit Sude,and/w Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
a��� BRIGHTWATER DRIVE �/,t���
CITY STATE ZIP CODE
CLEARWATER, FLORIDA �7�
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tau Parcel Number,Legal Description,etc.)
LOT � OF THE PLAT OF"BRIGHTWATER TOWNHOMES" PAT BOOK 126 PAGES 65&66
BUILDING USE(e.g.,Residerrtiai,Norxesidential,Addfion,Accessory,etc. Use a Comments area,rf necessary.)
RESIDENTIAL
LATITUDEJLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.#�X' or ##.##�F#� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑��
SEC710N B-FLOOD INSURANCE RATE MAP(FlRIV�INFORMATION �
B1.NFIP COMMUNffY NAME&COMNAJ�UTY f�A�ABER B2.COlA�1TY NAME B3.STATE (")
CffY OF CLEARWATER 12`.�096 -� LLASCOt..NTY FLORIDA '�
B4.MAP At�PANEL , vsC B7.FIRM PANEL 89.BASE FLOOD ELEVATION(S) C)
NlRv1BER 85.SUFFIX B6.FIRM IPIDEX DATE �, EFFECTNFIREVISED DATE B8.FLOOD ZONE(S) (Za�e A0,use depih offloodng) �5
125096-0007 D AUGUST _� � AlK3UST 19,1991 AE EL.11.0 (�)
610.Incicate the soia�e�the Base Fiood Elevation(BF depth entered in B9. �'j
❑Fis�o�� x�oc Fiw� ❑c�,�„u�ty��,��d ❑�(��)�— J
61 t.Ind�cate the eledation dahm used for the BFE in B9:0 NGVD 1929 ❑NAVD 1988 ❑Other(Desa�e):— W
612.is the bud�ng loca�d in a Coas�ai B�ri�R�Systan(CBRS)area a Otherwise Proteded Ar�a{OPA)? ❑Yes ❑No Desi�ation Date_ �
SECTION C-BUILDING ELE1/AT10N INFORMATION(SURVEY RE4UIRED) �
C1.Buik�ng ele�rations are based on:❑Constructior�Drav,engs'` ❑Buik�ng Under Caistuc6on' XXX Finished Constrix�on
'A new Ele�ration Certificate wia be requ�ed when ca�struction of the bu�ng is complete.
• 2.Buii�ng Diag�n Nuriber_ (Select ttie buiking dagam most sin�ar to fhe buiking fa uktidi this certificate is being corripleted-see pages 6 and 7. if no dagam
accwatey represenls the buacf�g,provide a ske�h or photograph.}
C3.�evations-Zones A1-A30,AE.AH,A(v�th BFE),VE,V1 V30,V(wifh BF�.AR,AWP4 AR/AE,AR/A1-A'i0,AR/AH.AR/AO
Corr�plete Items C3.-a-i below accordug to the b��c5ng�agam specfied in Item C2.State tl�e dahun used.If ihe dahim is cifferent fran ihe dahan used fa�e BFE in
Section B,convert ihe dahim to that used fa the BFE.Sha�v field measurements and dahm corrversion caiculation. tJse fhe space pranded or the Carmer�area of
Section D a Section G,as apprnpriate.h�docunent ihe dahen conversion.
Datun NGVD 1929 Cornrersior�Canmerds N!A
Elevation reference mark used No.155.EL.4.981 Does fhe elevation r�erEnce mark used appear on the FIRM? ❑Yes XX No
a)Top of bottan floor(ndudng basanerrt a enclos�e) 6. 50 ft(m) m
b)Top of next hi�er floor 15. 90 ft(m) � � ; , : _
c)Bottan of lowest hor¢ordal structural rr�nb�(Vzones onfy) WA.—R(m) o o� ' �'. "•
�Attached 9ara9e�toP of slab) 6. 50 ft.(m) E a.
e)Lowest elz✓ation of machinery andlor equ4ment �'� , � h � -
servicing the bu�dmg(Descnbe in a Carurienis area) wa._�(m) E� ��RUCE�:`KL
� �:
fl Lowest adjacent(finis�gade(LA�) 6. 0 ft(m) .. z�� ',,.� .,;�: ��_
9)�9��nt(finist�9ade(I-IAG) 6. 2 it(m) m; ':�- ; �, � '� 07/'!2l03
h)No.of pamanent openings(flood ven�)wittun 1 it abwe ac�acent grade 14 `� � _,r; ��; '`,'-
)Total area of aa pertn�ent openings(flood vents)in C3.h 632 sq.in. r,
SEC110N D-SURVEYOR,ENGINEER,ORARCHITECT CERnFiCAT10N
This certification is to be signed and sealed by a land surveyor,engineer,or architect author¢ed by law to certify elevation information.
- 1 cettify thaf the informafion in Sections A,8,and C on fhis cerfificate represenfs my best eff�rts fo inferpret the data available.
1 understand that any ialse sfafemenf may be punishable by fine or impnsonmenf under 18 U.S.Code,Secfion 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A KLEIN PLS 5052
71TLE COMPANY NAME
PROFESSIONAL SURVEYOR�MAPPER KIFIN&STAUB SURVEYING,INC.
qpp�� CIT`( STATE ZIP CODE
8016 Old County R New Pat Riche�r FLORIQA 34653
• SIGNATURE � DATE TELEPHONE
, 07/12/.03 (12�834-8140
IMPORTANT: In these spaces,copy the corresponding information from Section A F«�r�i,rance comPary use: �
BUILDING STREET ADDFtESS Qncludng Apt.,Unit,Suite,andlor Bkk�.No.)OR P.O.ROIiiE AND BOX N0. Polwy Number
BRIGHTWATER DRIVE ,. . •
CITY STATE ZIPCODE ComparryNAlCNumber
CLEARWATER FLORIDA 33763
_
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED}
C both sides�ttHS Elevation Certificate for 1 canmun offiaal, 2 insurarxe a ntl � •
oPY () i�' () 9e cornpanY,and(3)buildng owner.
COMMENTS
WA
❑Chedc here'rf attachments
SEC110N E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(IM7HOUT BFE�
Fa Zone AO and Zone A(wiUiout BFE�,canple�I�ns E1 it�ough E4. If fhe Elevation Certificate is in�nded for use as supporting infarnation for a LOMA or LOMR-F,
Section C must be campieted
E1.B�king D�n N�_(Select the buiking d�n most sintilar to the building fa which this certificate is being corrpided–see pages 6 and 7. If no�ac�n accuratety
reExesen�the bu�ng,prwide a sketch a photogaph.)
E2.The bp of the bot�rn floor(mduding baserient or endosure)of ihe builcing is _ft(m)_in.(an)0 above a ❑�ow��r,�c or,e�n,�rn�„�ad�nt�de. �
r���,�����.
E3.For BuikSng Diagams 6-S with openings(see page�,the next hi�er floor or ele�rated Aoor(ele�ation b)of the buddng is _it(m)_in.(an)abwe the highest adpcent
gade. Cmiplde itans C3.h and C3.i on front of form.
E4.The t�p of the platf�orm of machinery arxYor equiprnent servicing the budd�ng is _ft(m)_in.(an)�abae a ❑below(chedc one)the hi�est adacent gade. {l.)se
rtahual gade,rf available).
E5.For Zaie AO ordy: If no flood depth nunber is av�lable,is ihe top of the boitom floor elevated in�nce wifh the carurwnihr's floodpla�marnagement or�ronce?
❑Yes ❑No ❑Ur�cno�rm.The bc�ofiaai mustcertify tltis infamation in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFlCATION
The property anmer a awners aufha¢ed represer�ative who corripletes Sections A,B,C(I�-xns C3.h arxi C3.i only),and E for Zone A(without a FEMA-'ssued or carmunity-
iss��ed BFE�a Zone AO must s�h�e. The stafemenCs in Sec�orrs A,B,C,aod E�e coiracf to the best ofmy knou7edge.
PROPERTY OWf�R'S OR OWNER'S AUTHORIZ�D REPRESEMATNE'S�IAME
I �ADDRESS CIIY STATE ZIP CODE
SIGNATURE f�A7F 7Fi,�puNp��
COMMEI�tTS
❑Check here rf attaachments
SECTiON G-CONRVIUNITY INFORMATION(OPTIONAL)
The local offk:al who is auLhor¢ed by k>:v or adin�ce to a�nir�ster the commuraty's flooc�lain ma�gement orcinance can corr�Sections q B,C(or�,and G of tlris Elevation
C�tificate. Car�lete the�p6caUle itan(s)and sign below.
G1.�The infcrmation ir Section C wasiaken`om�cbcuner�tation that has been sir�ed arxi e�nbossed by a licensed surveyor,engineer,a�hi�ct who is aufhor¢ed try state
or local ww to catify elevation ir;4xrr�z�tion. {Indcate the soiuce and�te of the elevation data in the Cmxnenis�ea bebw.)
G2.�A corrgn�if,�odi�ial car�le�i�i Section E for a bu�g located in Zone A(without a fEMA�sued or corrrnuniiy�ssued BF�or Zone A0.
G3.�The fo9owing ir�amation(Items C4-G9)is praided ftx cormiunity flooc�lain managemerrt p�uposes.
G4.PERMIT NUMBER C�.DATE PERMIT ISSUED G6.DATE CERTiFICATE OF COMPLIANCE/OCCUPANCY ISSUED
G7.This pertr�t has been ssued for:❑New Cor�truction ❑s�►,�i imExw�n�,t
G8.Elevation of as-bt�lt lowest floor(nduckng���ihe buiking is: _—it(m) Dahm:_
G9.SFE a(n Zone AO)depth of floodng at the builcing site is: __ft.(m} Dahm:_
LOCAL OFFICIAL'S NAME TfTLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
•
' .
z� � �,
s ;��4, ;� � �t. CITY OF CLEARWATER
� � .:. .
DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
POST OFFICE BOX 474g� CLEARWATER� F�.oa�DA 33758-4748
MUNICIPAL SERVICES BUILDING, ZOO SOUTH MYRTLE AVENUE,CLEARWATER,Fco�uDn 33756
TELEPxoNE(72� 562-4567 Fnx(72� 562-4576
MEMO OF REVIEW FOR CORRECTNESS & COMPLETION
In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
The attached elevation certificate is complete and correct
X Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. BUILDING OWNER'S NAME BRIGHTWATER TOWNHOMES LLC Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
200 BRIGHTWATER DRIVE-UNIT 9
CITY STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:�GPS(Type):
(##°_##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 82.COUNTY NAME 63.STATE
64.MAP AND PANEL g5.SUFFIX 66.FIRM INDEX DATE B�•FIRM PANEL gg.FLOOD ZONE(S) B9•BASE FLOOD ELEVATION(S)
NUMBER $�18�1992 EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ❑ FIRM ❑Community Determined ❑Other(Describe)
611. Indicate elevation datum used for BFE in B9:� NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe)
612. Is the building located in a Coastal Barrier Resources S stem(CBRS)area or Otherwise Protected Area(OPA? ❑Yes ❑No Desi nation Date
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction' ❑ Finished Construction
"A new Elevation Certificate will be required when construction of the building is complete.
C2. 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 accuratefy represents the building,provide a sketch or photograph.)
C3. Elevations—Zones Ai-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 C3.-a-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 G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1 ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�levation ceRificates sha/l be maintained by the community and copies with the attached memo made availab/e by request ,
FRANK HIBAARI�,MAYOR
G80RGE N.CRB'1'EKOS,COUNCILMGMRGR JOIIN DORAN,COUNCILMGMBER
PAUL F.GIHSON,COUNCILMEMRER � CARLGN A.PE'I'ERSGN,COUNCILMGMBER
��EQUAL EMYLOYMEN'1'AND Af�FIf2MA'f7VE AC'PION EMNLOYER��