120 BRIGHTWATER DR UNIT 1 t , FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
, NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
' ELEVATION CERTIFICATE
��.p���-- �d►�y
Important; Read the instructions on pa es 1-7.
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use
UILDING OWNER'S NAME Policy Number
MENNA DEVELOPMENT
BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AN�BOX NO. Company NAIC Number
12a1 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CLEARWATER BEACH FL 33767
PROPER7l'DESCRIPTION(Lot and Block Numbers,Tax Paroel Number,Legal Descnption,etc.)
LOT 1,BELLE AQUA VILLAS II
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE. ❑GP5(Type):
( ##°-##'-##.##" or ##.#/�##� ❑NAD 1927 ❑NAD 1983 ❑ USGS Quad Map ❑Other I
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Bt.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2 COUNTY NAME B3.STATE
CLEARWATER 125096 PINELLAS FLORIDA
84.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 85.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE BB.FLOOD ZONE(S) (Zone A0,use depth of flooding)
125(KJCr0102 G 9103ro3 91D3N3 AE 11
B10.Indicate the source of fhe Base Flood Eleva6on(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 ❑Ofher(Describe):_
B12.Is the building located in a Coastal Bartier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Desi na6on Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building eleva6ons are based on:❑Construction Drawings* ❑Building Under ConsUuction' �Finished Construction
� *A new Eleva�on Certificate will be required when construction of the building is complete.
Buiiding Diagram Number 8(Select the building diagram most similar to the building for which this cer6ficate 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,AWA,AR/AE,AWA1-A30,AR/AH,AR/AO
(�mm�lOfP IfPmc(:�-aa Fwlnw a�rrl�nn M}ha h�ijl�inn iiionrom enonifi�l��iiciTi r� C�..�..�ti.,,,,.�,......,.,.a is a�,,,a,.a..�:_ ��___.��.�_ .
••r�-- � ��y w ���y���y������r����wv�u vc.�iaic u ic�owu i uacU.il U ro ualW n IJ UiIICI CI Il uUtl I U IC UdlUl l l UJCII IUI U le D!'C�fl
Section B,convert the datum to that used for the BFE.Show field measurement�and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G,as appropriate,to document the dah�m conversion.
Datum NGVD Conversion/Comments
Elevation reference mark used LP 10 BM#1 Does the elevation reference mark used appear on the FIRM? ❑Yes �No
o a)Top of bottom 800r(induding basement or endosure) 7. 12 ft(m) �
o b)Top of ne�higher floor 11 .02 ft.(m) `�
�
o c)Bottom of lowest horizontal structural member(V zones only) WA._ft.(m)
o d)Attached garage(top of slab) 7. 15 ft.(m) E a
o e)Lowest eleva6on of machinery ancUor equipment W `°
serviang the building(Descnbe in a Comments area) WA._ft.(m) ��
o �Lowest adjacent(finished)grade(LAG) 5.05 ft.(m) Z.m
o g)Highest adjacent(finished)grade(HAG) 5. 08 ft(m) ��
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 7 � zs�z ►a�Rp��f
o i)Total area of all permanent openings(flood vents)in C3.h 1203.29 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 certrfy fhat the information in Sections A,B,and C on this certificate represents my best efforfs to interpret the data available.
1 under�fand that any false stafement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME GEORGE A.SHIMP II LICENSE NUMBER 2512
�TITLE PRESIDENT COMPANY NAME GEORGE A.SHIMP II 8�ASSOC.,INC
ADDRESS CIIY STATE ZIP CODE
3301 DESOT OULEVARD PALM HARBOR FL 34683
SIGNAT DATE TELEPHONE
JOB N0.050738 9102105 727-784-5496
.
FEMA Form 81-31,January 2003 See reverse side for r.�ntm�,atlnn Rcnloroc�u.,.o„�,,,��o,�;r�,,.,�
, � • FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
� , NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
a0b�— �o�� � important: Read the instructions on a es 1-7.
SECTION A-PROPERTY OWNER INFORMATION For Insurance Canpany Use:
BUILDING OWNER'S NAME Policy Number
MENNA DEVELOPMENT
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
120-1 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CIEARWATER FL 34630
PROPERTY DESCRIPI"ION(Lot and Blodc Numbers,Tax Parcel Number,Legal Descrip6on,etc.)
LOT 1,BELLE AQUA VILLAS II
BUILDING USE(e.g.,Residential,Non-residentiai,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
(##°-##'-##.�l#" or ##.#!#�ft#� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 82.COUNTY NAME 63.STATE
CITY OF CLEARWATER 125096 PINELLAS FLORIDA
64.MAP AND PANEL ' � 87.FIRM PANEL 89.BASE FLOOD ELEVATION(S)
NUMBER 85.SUFFIX 86.FIRM IND DATE EFFECTIVFJREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
125096-0007 D � 8119191 G�a' 8J19/91 AE 11
B10.Indicate the source of 1he Base Flood Eleva6on(BFE)dataor ase flood depth entered in 69.
❑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 locatetl in a Coastal Bamer Resources System(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 Construc�on' ❑Finished Construction
� 'A new EJevation Certificate will be required when construc6on of the building is complete.
2.Buiiding Diagram Number 8(Select the building diagram most similar to the building for which this certificate is being c�mpleted-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(w'rfh BFE),AR,ARIA,AWAE,AWA1-A30,AR1AH,ARIAO
Complete Items C3.-a-i below according to the building diagram specified in Item C2.State ihe datum used.If the datum is different from the datum used f�r th.e�FE in
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calcula6on, Use the space provided or fhe Comments area of
Section D or Seclion G,as appropoate,to document the datum conversion.
Datum ConversioNComments
ElevaUon reference mark used LP 10 BM#1 Does the elevation reference mark used appear on the FIRM? ❑Yes �No
o a)Top of bottom floor(induding basement or endasure) 7. 15 ft.(m) �
o b)Top of ne�higher floor 11.01 ft.(m) �
o c)Bottom of lowest horizontai structural member(V zones only) NA._ft.(m) o 0
o d)Attached garage(top of slab) 7, �5{�,�m� W� /
o e)Lowest elevation of machinery andlor equipment .�
serviang the buiiding(Describe in a Comments area) NA._ft.(m) ��
o fl Lowest atljacent(finished)grade(LAG) 5.05 ft.(m) z'.m
o g)Highest adjacent(finished)grade(HAG) 5. 08 ft.(m) �N #2512 5/02/05
o h)No.of permanent openings(flood vents)wifhin 1 ft.above adjacent grade 7 J
o i)Total area of all permanent openings(flood vents)in C3.h 1203.29 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.
1 cerfrfy that the information in Sections A,B,and C on this cerfificate represents my best eiforfs to interpref 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 GEORGE A.SHIMP II LICENSE NUMBER 2512
� TITLE PRESIDENT COMPANY NAME GEORGE A.SHIMP ii&ASSOC.,INC
ADDRESS CITY STATE ZIP CODE
3301 DESOTO BOULEVARD PALM HARBOR FL 34683
SIG DATE TELEPHONE
�- JOB N0. 050242-A 5102/05 727-784-54g6
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all qrevious editions
IMPORTANT: ia these s aces,copy the corresponding(nformation from Section A. `'For insuranoe ca�any usa "'`
BUILDING STREET ADDRESS(Indudir�g Apt,Unit„Suite,and/a BkJg.No,)OR P.O.ROUTE AND BOX N0. ''PoGcy Nurr�b�'
120-1 BRIGHTWATER ORIVE
Cf�Y STATE ZIP CODE Cof[y�y W+IC M�Ink� . �+
CLEARWATER FL 34630 : ti�l'.,� , �.:, :�
SECTION D•SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUEO �
y both sides of this EJeva�on Certlficate for(1)canmuniiy offidal,(2)insurar�ce agenVcompany,and(3)bu�ding owner.
COMMENTS
_ ❑Chedc 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{wifhout BFE),complete Items E1 ttuough E4. If ihe Elevafion CeNflcate is iniended for use as supporUng info►maUon for a LOMA or LOMR•F,
Section C must be completed.
Ei.Building Diagram Number_(Seled the building diagram most siRWar to ihe building for which�is cerfificate is being campleted—see pages 6 and 7. If no diagram accurately
represents ihe building,provide a sketch a photograph.)
E2.The top�the bottom floa(induding basement or endosure)of the bullcAng is _ft(m)_in.(cm)�above or ❑below(check one)ihe highest adjac;enl grade. (Use
naturai grade,if available).
E3.Fw BuGding Diagrarns 6�8 with openings(see page 7),fhe next higherfloor w elevated floor(elevaUon b)of fhe buiiding is _tt.(m)_in.(cm)above fhe highest adjacent
grade. Complete items C3.h and C3�ai front of fam.
E4.The top of the pia�ortn of machlnery andlor equipment servidng fhe building is _ft.(m)_in.(cm)�above or ❑below(chedc one}lhe highesl adjacent grade, (Usa
natural grade,if avaitable�.
E5.For Zone AO oniy: If no flood depfh number is available,is ihe iop af the bottan floor elevated in aocordar�ce with the communitys�oodplain management ordinance7
❑Yes ❑No ❑Unknown. The local offi�dal must certify this infortnation in SecGon G.
_ 3ECTION F•PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
rna propeny owner or owne�s aufhorized represenlaUve who completes Seqions A,B,C(Items C3.h and C3.1 oNy),and E for Zone A(without a FEMA�{ssued or oommuNly-
issued BFE)or Zone AO must sign here. The sfatemenfs!n Sections A,8,C,and E are conact to the besf of my knowledge.
�ROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME �
ADORESS CITY STATE 7JP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Chedc he�e if a�achments
SECTION G•COMMUNITY INFORMATION(OPTIONAL)
7he bcal offidal who is authorized by law or ordinar�ce to administer the canmunity's floodplain management ordinance can complete SecUons A,B,C(a E),and G of U�is ElevaUon
Certf�ate. complete fhe ap�icab�e iter��(sj and sign below.
Gi.0 The infortr�alion in Secfion C was taken from oihe�documentation that has been signed and embossed by a 4censed surveyor,engineer,or arohitect who is aulhorized by state
a local law to cerfify elevaiion information. (In�ipte the sou�e and date of the elevaUon data in ihe Comments area below,)
G2.�A cwnmunity offidal compleied Section E for a buildiny Iocated(n Zone A(without a FEDAA-issued or commuNryassued BFE)or Zone A0.
G3•�]The foUowing informaGon(Ilems G4-G9)is provided for oommunity floodplain management purposes,
G4.PERMIT NUMBER G5,pq'IE pERMIT�SSUEp G6,pq7E CERTIFICATE OF COMPUANCFJOCCUPANCY ISSUEO
G7.This perrNt has been issued fw:[J New ConsUud(ai• ❑Substantlal Improvement
G8.FJevation of as-buGt lowest floor Qnduding basement)of ihe buikling is: __ft.(m) Datum:
G9.BFE or(in ZoneAO)depfh of flooding at ihe building sile is: �_fl,(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
� �
COMMUNITY NAME TELEPHONE
SIGNATURE �� �
�� � � OATE �
COMMENTS
— �"�i`�f�f t���v� ��$T S�
�fTY �F �L�A�WATE�
-- ❑Chedc here if attachments
' � FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
(jC�li�.�- ��;�¢y ELEVATION CERTIFICATE
Im �tarrt: Read the instructions on es 1-7.
SECTION A•PROPERTY OWNER INFORMATION For Inswarroe Canpany Use:
BUILDING OWNER'S NAME Pdicy Number
MENNA DEVELOPMENT
BUIIDING STREET ADDRESS(InGuding Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
120i1 BRIGHTWATER DRIVE ,n -� �
CITY STATE ZIP CODE
CLEARWATER�. FL 33767
PROPERTY DE i.riir=Tiviv(Loi and ciocic ivumi�ers,i au NarCel Number,Legal Descnption,etc.)
LOT 1,BELLE AQUA VILLAS II
BUILDING USE(e.g.,Residen6al,Non-residential,Addition,Aocessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
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
81.NFIP COMMUNITY NAME&COMMUNIN NUMBER B2.COUNN NAME 83.STATE
CLEARWAiER 125096 PINELLAS FLORIDA
B4.MAPAND PANEL 87.FIRM PANEL B9.BASE FL000 ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTI�31SED DATE 88.FL000 ZONE(S) (Zaie A0,use1dep�of lboding)
( 102 G "�'� I
B10.Indicate tl�e souroe of the Base Flood ElevaGon(BFE)data a base flood depfh entered in B9.
❑FIS Profile �FIRM ❑Community Detertnined ❑p��(p���:_
B11.Indicate the eleva6on datum used for ihe BFE in B9:�NGVD 1929 �N,q�/p�ggg �p�����:_
B12.I�ihe building located in a Coastal Bartier Resources Sysdem(CBRS)area or Ofhervvise Protec�ed Area(OPA)� ❑Yes �No Desiqnation Da�e
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
uilding etevations are based on:�ConsU�x:tion Orawings' ❑Building Under Conshuction' �Finished Consbuction
'A new Elevation Certificate will be required when construc6on of ihe building is complete.
�.Bu�ding Diagram Number 8(Select fhe building diagram most similar to fhe building for which fhis certifipte is being comple6ed-see pages 6 and 7. If no diagram
��Y�PresenLs the buil�ng,Provide a sketch or photo9raph•)
C3.Elevadons—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(wifh BFE),AR,ARIA,AR/AE,AR/A1-A30,AR/AH,AR/AO
Comple�e Items C3:a-i below aocording b the building diagram speafied in Item C2.Sfate the datum used.if the datum is di�erent from the datum used for the BFE in
Section B,convert fhe datum to fhat used for fhe BFE.Show 6eld measuremenLs and datum conversion p�ulation. Use fhe space provided or fhe Comments area of
SecUon D or Section G,as appropriate,to document Ihe dalum conversion.
Dalum NGVD ConversioNComments
Elevation referenoe m�k used LP 10 BN1�1 Does the elevation reference mark used appear on Ihe FIRM? ❑Yes �No
o a)Top of botbm floor(induding basement or endosure) 7. 12 ft(m) �;
o b)Top of next higher floor 11.02 R(m) �
o c)eotlari of lowest horizontal struclural member N zones onlY) WA._ft(m) y A
° �Alfadied garage(top of slab) 7. 15 ft.(m) E�
o e)Lowest elevation of machinery andlor equipment w "
serviang fhe building(Describe in a Comments area) WA._ft(m) n'
o �Lowest a�aoent(finished)grade(LAG) 5.05 ft.(m) z'�
o g)Highest adjacent(finished)grade(HAG) 5. 08 ft(m) �N
o h)No.of permanent openings(flood vents)wilhin 1 ft.above adjacent grade 7 � ,�S ii 1�����r
o i)Total ar�a of all pemianent openings(flood venls)in C3.h 1203.29 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 information in Secfions A,8,and C on this certificate represents my best efforts to interp►et the data available.
1 undersfand that any false statement may be punishable by fine or impnsonmenf under 18 U S Code Section 1001
CERTIFlER S NAME GEORGE A.SHIMP II LICENSE NUMBER 2512
_�
PRESIDENT COMPANY NAME GEORGE A.SHIMP II 8�ASSOC.,INC
ADDRESS CIN STATE ZIP CODE
3301 DESOT OULEVARD PALM HARBOR FL 34683
SIGNA DATE TELEPHONE
JOB N0.050738 9/02/05 727-784-5496
, �' �'� CITYOFCLEARWATER
�. �
'�ti�*i
• �� i, 2
��;�
,��-;�i ` DEVELOPMENT & NEIGHBORHOdD SERVICES DEPARTMENT
�..��
"''� .F. POST�FFICE BOX 4748� CLEARWATER� FLOa�DA 33758-4748
3 .x
*� �* � �� MUN[CIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.FARWATER,FLO�uDn 33756
`•��r$,;°: :
° TELErxorrE(72� 562-4567 F.vc(72� 562-4576
MEMO OF REVIEW FOR CORRECTNESS 8� 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 Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
120 BRIGHTWATER DRIVE-UNIT 1
CITY CLEARWATER 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 B2.COUNTY NAME B3.STATE
B4.MAP AND PANEL g5.SUFFIX 66.FIRM INDEX DATE B��FIRM PANEL gg,FLOOD ZONE(S) B9�BASE FLOOD ELEVATION(S)
NUMBER 5/17/05 EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
12103C0102
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 System(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 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,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)1ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments: PLEASE SEE ATTACHED DOCUMENTS FROM MDM MENNA DEVELOPMENT&MNGT,INC.ADORESSING ELEVATION FOR THE PROJECT.
Date of Review: Community Official:
�vation ce�tificafes shall be maintained by the community and copies wifh the attached memo made available by request
FRANK HIBRARD,MAYOR
GEORGE N.CRE'1'EKOS,COUNCILMEMRCR JOIIN DORAN,COUNCILMEMBGR
PAUL F.G[RSON,COUNCtLMEMAER � CARI.@N A.PE'I'ERSEN,COUNCILMEMRGR
��EQLIAL EMYLOYMENT AND Af�FIRMA'I'IVE ACTION EMPLOYEN��
FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
- � NATiONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
� ' ELEVATION CERTIFICATE
� �. �; (c� important: Read the instructions on pa es 1•7.
SECTION A•PROPERTY OWNER INFORMATION Farins�irance Company Use:'
• BUILDING OWNER'S NAME Policy Number
MENNA DEVELOPMENT
BUILDING STREET ADDRESS(InGuding ApL,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
120-1 BRIGHTWATER DRIVE
C�N STATE ZIP CODE
CLEARWATER FL 34630
PROPER7Y DESCRIPTION(Lot and Bbck Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 1,BELLE AQUA VILLAS II
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,'rf necessary.)
RESIDENTIAL . -- _ _ _ _- - -- _ . . ____ _ __ _
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type):
( ��-�'-#�•�#" o� �•�� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
81.NFIP COMMUNITY NAME&CO�NNUNITY NUMBER 62.COUMY NAME B3.STATE
CITY OF CLEARWATER 125096 PINELLAS FLORIDA
84.MAP AND PANEL B7.FIRM PANEL 69.BASE FL000 ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE 88.FLOOD ZONE(S) (Zone A0,use depth of floodirx�)
125096�0007 D 8119�91 9/19191 AE 11
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile ❑FIRM ❑Community Determined ❑Other(Oesaibe):
811.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 Resou�es System(CBRS)area or Othervuise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:�Construction Drawings* �Building Under ConsUuction' ❑Fnished ConsUuction
*A new Elevation Certificate will be required when construction of the buiiding is wmplete.
•C2.Buiiding Diagram Number 8(Select the buiiding diagram most similar to the buiiding 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.ElevaGons—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AWA1-A30,AWAH,AR1A0
Complete Items C3:�i below aa;ording to the building diagram speafied in Item C2.State 1he datum used.If the datum is different from the datum used forthe BFE in
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculafion. Use the space provided or the Comrr�nts area of
Sectlon D or Section G,as appropriate,to document the datum conversion.
Datum ConversioNComments
Elevation reference mark used LP 10 BM#1 Does the eleva6on reference mark used appear on the FIRM? ❑Yes �No (--
o aj Top of bottom floor(induding basement or endasure) 7. 15 ft.(m) �
o b)Top of next higher floor 11 ,01 ft.(m) �'
41 4/ 1
o c)Bottom of lowest horizontal structural member(V zones only) NA,_ft,(m) N;� -
o d)Attached garage(top of slab) �. �5{�.�m� E°�
o e)Lowest elevation of machinery andlor equipment W �°
servidng the building(Descnbe in a Comments area) NA._ft.(m) �_`_
o fl Lowest adjacent(finished)grade(LAGj 5.05 ft.(m) z.�
o g)Highest adjacent(finished)grade(HAG) 5. 08 ft.(m) N N
_ #2512 5/02/05
o h)No.of permanent openings(flood vents)�ithin 1 ft.above adjacent grade 7 �
o i)Total area of all permanent openings(flood vents)in C3.h 1203.29 sq.in.(sq.cm) J
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect aufhorized by law to certify elevafion information,
1 certify that the information in Secfions A,B,and C on this cerfificafe represents my best efforfs to inte�pret the data available.
!understand that any false statement may be punishable by fine or imprisonment under 18 U S Code,Section 1001
CERTIFIER'S NAME GEORGE A.SHIMP II LICENSE NUMBER 2512
TITLE PRESIDENT COMPANY NAME GEORGE A.SHIMP II&ASSOC.,INC
•ADDRESS CITY STATE Z1P CODE
3301 DESOTO BOULEVARD PALM HARBOR FL 34gg3
SIG � ; DATE TELEPHONE
JOB N0. 050242-A 5/02J05 727_784.5496
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
�
IMPORTANT: In these s aces,copy the corresponding(nformatlon from Section A "Fw InsuranoaCo ` ' `
�Y Use: ,
BUILDWG STREETADORESS(Indudir�g Apt,Unrt,Suile,and/a Bldg.No.)OR P.O.ROUTE AN�80X N0. ` Po�C}!Nwnber
120-1 BRIGHTWATER DRIVE
CITY STATE Z!P CODE CorC�pany NAIC Nlui�f �:
CLEARWATER FL 34630 � ,�,,�;: � � " .::+
SECTION D•SURVEYOR,EiVGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy boih sides of this Elevation CerU�Cate for(1)canmunity offldal,(2)insurance agenVcompany,and(3)lw�ding owner. •
COMMENTS •
❑Chedc here if attachments
SECTION E•BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
Far Zone AO and Zone A(without BF�,complete Items E1 Uuough E4. If the FJevaUon Certificate Is intended for use as supporUng Infortnatlon for a LOMA or LOMR F,
Sedion C must be c�mpleted.
E1.Build(ng Olagram Number_(Seled the buiiding diagram mast sirrWar to fhe buikiing fa'whicti this certlficate is being c�omple�ed—see pages 6 and 7. If no diagram acwrately
represents ihe bulkling�Provide a sketch or photograph,)
E2.The top of the bottan floor pnduding baserr�nt or endosu�e)of the buUdin9 is _ft(m)_In.(cm)0 above or ❑below(check one}ihe high�t ad�acent grade. (Use
natural grade,if available).
E3.For BuU�ng Diagrarns 6-8 wilh opeNn9s(see page 7),the next highe�floa or elevated floor(eleva6on b)of the building is _ft.(m)_in.(cm)above the highest adJacent
grade. Complete iiems C3.h and C3.i on front ofi fam.
E4.The top of ihe pla�oRn of ma�diinery andlw equipment servidng fhe twilding is _ft(m)_in,(cm)�above or ❑below(chedc one)1he highest adJacent grade, (Usa
natural grade,if available).
E5.For Zone AO oniy: If no flood c�pih number is available,is the top of the bottom floor elevated in accordance with the communily's tloodplain management ordinance?
❑Yes ❑No ❑Unknown. The bcal offidai must ce�ify this infomiation in SecUon G
3ECTION F•PROPERTY OWNER(OR OWNER'S REPRESEM'ATIVE)CERTIFICATION
The propedy owner or owne�'s authorized represeniatNe who canpletes SecBons A,B,C(Items C3.h and C3.1 oNy),and E tor Zone A(wifhout a FEMAassued or commuNty-
issued BFE�or Zaie AO must sign hera The staternents in Sections A,B,�and E are cortec�,t to the best of my knowledge.
PROPERTY OWNEf�S OR OWNEi�'S AUTHOWZEO REPRESENTATIVE'S NAME
ADDRESS CITY STATE IJP CODE •
SIGNATURE pATE TELEPHONE
COMMENTS
❑Cheac here if a�achments
_ SECTION G•COMMUNITY INFORMATION(OPTIONAL)
The laxl oi�aal who is authonzed by law w ordinance to admiruster the carmurut�s floodpl�n management ordinance can wmplete Sectlons A,B,C(a E),and G of lhis EJevafion
Ceitlficaie. Complete fhe app�cable iieri�(s)and sign below.
G1.[]The infonnafio�in Section C was taken from oiher documentaUon fhat has t�een signed and embossed by a ticensed surveyor,engineer,or architect who�aufhorized by siate
or local law io cer�y elevation infortnation, (indipte the°s�r�and date of the elevafion data in ihe Cornments area bebw.)
�'�A���Y°���np�eted S�ion E fa a building located in Zone A(w(U�out a FENIA-issued o�community-issued BFE)or Zona A0.
G3.[]The foUowing fnfortna�on(Items G4�9)is provided for community floodpiain rnanagement purposes.
G4.PF.RMIT NUMBER G5.DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCEJOCCUPANCY ISSUED
G7.This permit has been issued for:�New Consiruc�(on� ❑Substantlal Improvement
G8.Devation of as-bu�t lowest floor pnduding basement)of the building is: �_ft.(m) Datum:
G9.BFE or(in Zone AD)depth of floaling at the building site is; _ _ft�m� ���;
LOCAL OFFICIAL'S NAME TITIE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE •
COMMENTS
❑Chedc here if a�achments
FFML1 Fnrm A1 Z� ie..�,a.,,o�na