125 BRIGHTWATER DR UNIT 3 t
. '. . FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
�,,�Qp3-- �11c� y ELEVATION CERTIFICATE
Important: Read the instructions on pa es 1-7.
SECTION A-PROPERTY OWNER INFORMATION Fa�nsurance Caripany Use:
BUILDING OWNER'S NAME Policy Number
MENNA DEVELOPMENT
BUILDING STREETADDRESS(Including Apt.,Unft,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
12�3 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CLEARWATER BEACH FL 33767
PROPERIY DESCRIPTION(Lot and Block Numbers,Tax Parczl Number,Legal Description,etc.)
LOT 4,BELLE AQUA VILLAS I
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 ##.�� ❑NAD 1927 ❑NAD 1983 ❑ USGS Quad Map ❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNITY NAME$COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
CLEARWATER 125095 PINELL4S FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
1250960007 D 8119/91 81t951 AE 11
B10.Indicate the source of the Base Flood Elevation(BFE)data or base 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 located in a Coastal Bamer Resources System(CBRS)area or Otherwise ProtecGed Area(OPA)? ❑Yes �No Desi nation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Buiiding elevations are based on:�Construc6on Drawings* ❑Building Under Conshuction* �Finished ConsUuction
� 'A new Elevation Certificate will be required when consVuction of the building is complete.
2.Building Diagram Number 8(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.Eleva6ons—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,AR/AE,ARIA1-A30,AR/AH,AR/AO
Complete Items C3.-a-i below accorcling to the building diagram specified in Item C2.State the datum used.If the datum is di8erent from the datum used for the BFE in
Section B,convert the datum to that used for the BFE.Show field measuremenls and datum oonversion calcula6on. Use the space provided or Ihe Comments area of
Sec�on D or Sectibn G,as appropriate,to document ihe dah�m conversion.
Datum NGVD ConversioNCommenls
Elevation reference mark used LP 10 BAA�1 Does the elevation reference ma�C used appear on the FIRM? ❑Yes �No ,,,
o a)Top of both�m floor(induding basement or endosure) 7. 09 R(m) � ��'`•� `?
�, >�._
o b)Top of next higherfloor 11.01 ft.(m) � � . �,``: ,�,J � ,
o c)Bottom of lowest honzontal struclurai member(V zones only) WA._ft.(m) y ,� �y � r
o d)Attached garage(top of slab) 7. 09 ft(m) E� � a �� � ;:.
o e)Lowest elevation of machinery andlor equipment w 1° �'" ° +
serviang the building(Describe in a Comments area) WA._ft.(m) E� ' ;� '' '��� ,�� "
o �Lowest adjacent(finished)grade(LAG) 5.42 R(m) z'.� „ �,`�'�`�
o g)Highest adjacent(finished)grade(HAG) 5. 64 ft(m) �� �b'>�`�'
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 7 J i i �„�o�o,�
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 certify that the information in Sections A,B,and C on this certificate represents my best efforts to inferpret the dafa available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code Secfion 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
SIGNAT DATE TELEPHONE
JOB N0.050242 7128/05 727-784-5496
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
• .` .
IMPOR�ANT: fn these spaces,copythe corresponding intormation rrom Section A. ' =orinsuanceC.omoanyus�. -
9UIL;ING S�E=i,�DCRESS(Incuding Ant,i�n�4�ui�,and/or 31dc.No.j OR P.O.RG�'T�?,NC o0X NQ Poiicl Numher
125-� BRIGn;�N,4 i_R DRIVE
c� sra i� z�����_ �
C:=ARWA i cri 3�,CH �� .,omPanyNAIC NumDer
�- 33767 �
SECTION D-SURVEYOR,ENGINE�R,OR ARCHITECT CERTIFICATIQN(CONTINUED)
�opy�tt;sides or fiis�levaaon�erQncate Tor,'1 j rammunm omdal,;2;insuran�agent/ccmpar��,and;3)buiiding�wrpr.
COMMEN i S ��
❑Check here if attachmen'ts
SECTION E•BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
�or Zone AG and Zone A(without BF�;,c�mplete Items E1 througn�4. If the�ievauon Certmcate is intend�for use as supporiing inrormauon ror a LOMA or LOMR-F,
Secvon�must be completed.
�1.Building Diagram Number_(Select the building diagram mest simifar tc'�he building ror wnich this certincate is b2ing campleted—s2e pages 6 and 7 If no diagram accurately
repres2nts the building,provide a sketch or photograph.j
E2.The top or the bottom floor(including basement or enclesure)of the building is _ft.(m)_in.(cmi 0 above or ❑below jcheck onel the nianesi adjacent grade. (Use
natural grade,R availaole).
E3.For Buiiding Diagrams 6�with openings(see page 7),the ne�hianer floor or elevatecl800r(eieva6on bj of the buiiding is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front or form.
E4.The toe of the olatform of machinery and/or equipmerlt SeNiGng the huilding ig _ff.(rn;_in.l�ml(�a�nyF nr [,I�i���,i�hack nnai tho hinhagr�riiarnnt���,�o n�S�
,.. ,....,,..�.. ..,...,.,... . ,..
naturai grade,if availabie).
E5.!=or Zone AO only: If no flood depth number is availaole,is the top of the bottom floor elevated in aG;ordance with the community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offidal must certify this information in Seciion G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE�CERTIFIGATION
The properry owner or owne�s authonzed representative who completes Sections A,B,C(ItQms C3.h and C3.i oNy),and E for Zone A(without a F�MA-issued or community-
issued BFF;or Zone AO must sign here. The sratements in Sech'ons A,B, C,and E are correci to the best of my knowledge. •
PROPERT`!OWNER'S QR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRE�S CiTY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
_ � SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local o"c�al,.��o is_.c.onze�^y la or ordinance to administer the communiry's floodplain management ordinance can complete Sections A,B,C(or E�,and G of this Elevafion
Cerfmcate. �om�;late C.:� �oplicauia item(s)and sign below.
G1,0 The inrorma�o�,;n�r-,��n C �s taken from other dc�umentation that has oeen sianed and embossed by a iicensed surveyor,engineer,or ar�hitect who is authorzed by state
or fcca� a4��?o certify elevafion inrormation. (Indicate the sourr,e and daie of the eievation data in the Comments area beiow.j
G2.[I A communiry��ficai a�moleted Seclion�ror a buiiding loca'ted in Zone,4(without a F�MA,-issued or communiry-issued 3FE)or Zone A0.
G3.[]The following inmrmaiion(Items G4-G9)is provided for community floodplain management purp�ses,
' G4.PERMIT NUMBER G5. DATE PERMIT ISSUEC I vo. DATE CEKTIFICATE OF COMPWLNCJQCCUPANCY ISSUED
� � I
G�.This permi[has beAn issued for. �New C,onstruttion ❑Subs'tantial Improvemeni
G8.Eievavon of as-built lowest floor(induding basement)or the building is; _.__ft.(mj Datum:
G9.BF_or(in Zone A01 depth of flooding at the building site is: _ _ft,(m) Datum:
LOCAL OF=!CIAL'S NAME I ITL�
COMMUNI i Y NAME ?ELEPHONE �
SIGNATURE DA�E
COMMENTS
❑ �heck here if attachments
, =UIP.=orm 81-3?. .;anuarv 2�G3 �,._�---- -°--- ..-.— - ,_
• ' � FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
��3� ���j � ELEVATION CERTIFICATE
Important: Read the instructions on p es 1-7.
SECTION A-PROPERTY OWNER INFORMATION Fa Insurance Carpany use:
UILDING OWNER'S NAME Policy Numbec
MENNA DEVELOPMENT
BUILDING STREET ADDRESS(InGuding Apt.,Unit,Suite,ancUor Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
1253 BRIGHIWATER DRNE
CITY STATE ZIP CODE
CLEARWATE6i�B�, FL 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Pamzl Number,Legai Descnption,etc.)
LOT 4,BELLE AQUA VILLAS I
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 ##.#l�##� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
CLEARWATER 125095 PINELLAS FLORIDA
B4.MAP AND PANEL — B7.FIRM PANEL 89.BASE FLOOD ELEVATION(S)
NUMBER 85.SUFFIX 86.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.F100D ZONE(S) (Zone A0,use deplh of flood�g)
125096-0007 D '�t919'r' 8/19i91 AE 11
810.Indicate the source of the Base Flood Eleva6on(BFE)data or base flood depth en0ered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
B11.Indicate the elevation datum used for the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe):_
612.Is the building located in a Coastai Bamer Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑Yes �No Desiqnation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Construc6on Drawings* ❑Building Under Construction' �Finished Construction
! 'A new Elevation Certificate will be required when construction of the building is complete.
.Building Diagram Number 8(Select tlie building diagram most similar to the building for which this certificate is being comple6ed-see pages 6 and 7. If no diagr�n
aa;urately represents the buiiding,provide a sketch or photograph.}
C3.Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AR/AE,ARIA1-A30,ARIAH,ARIAO
CompleVe Items C3.-a-i below according to the buiiding diagram specified in Item C2.State the datum used.If the datum is different from the datum used for ihe BFE in
Sec�on B,convert the datum to that used for the BFE.Show field measurements and datum conver�ion calcula6on. Use the space provided or ihe Comments area of
Sec6on D or Sec:tibn G,as appropriate,to document the dah�m conversion.
Datum NGVD ConversioNComments
Elevation reference maric used LP 10 BNF�1 Does the elevation reference mark used appear on the FIRM? ❑Yes �No
o a)Top of botD�m floor(induding basement or endasure) 7. 09 ft(m) � ' '
�
o b)Top of ne�higher floor 11.01 R(m) �' '-?' <:
o c)Bottom of lowest horizontal struch�ral member(V zones only) WA._ft.(m) °�' .��°�J
o d)Attached garage(top of slab) 7. 09 ft(m} �a � � { ; .
o e)Lowest elevation of mac;hinery andlor equipment E � ��
W �0 ,r"
senriang ihe building(Describe in a Comments area) WA._ft.(m) E�'� _ .,� °
o �Lowest adjacent(6nished)grade(L4G) 5.42 R(m) z'.�; . '-"
�
o g)Highest adjacent(finished)grade(HAG) 5. 64 ft(m) � �, '=- . �
o h)No.of permanent openings(flood venLs)within 1 ft.above adjacent grade 7 J i i. �„��Jo;�
o i)Total area of all permanent 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 efevation information.
1 certi(y that the information in Sections A,B,and C on this cerfificate represents my best efforts to inferpret 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
�ITLE PRESIDENT COMPANY NAME GEORGE A.SHIMP II&ASSOC.,INC
DRESS CITY STATE ZIP CODE
3301 DESOTO BOULEVARD PALM HARBOR FL 34683
SIGNAT DATE TELEPHONE
JOB N0.050242 7/28I05 727-784-5496
GG�AA Cn.m R�.74 1.,..��.,...7nn�] n__ "_"_'__ 'u_�_____.:___.:__ .-. � .� . ....
IMPOR�ANT: in these spaces,copythe corresponding inrorrr�aiion Trom Section A � '=orinsuaneeComaanyuse: -
BUILDING S� �=i ADDRESS Qnduding,4pt,Unr�,Sui�,ancllor 31dc.No.i OR P.O.ROIIfE ANC BOX N0. ooiic�NurriLer
�2�?BRIGn�N�T�R DRIVE
r,� STA i c ZJP CvD� „ompanyNAIC tvumbe,
.=AR'NA i cR�cACH FL 3"s767 �
SECTION D-SURVEYOR.ENG{NEER,OR ARCHITECT CERTIFICATIQN(CONTINUED) �
:;opy�th sides of fiis�levaoon Cerun�te ror('j commun�}�omdal,,2)insuran�agenUcompany;and;3)buiiding own�r.
COMMCI�S ..
❑Checic here if attachmenis
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(W[THOUT BFE)
�or Zone AO and Zone A(without BFE),c�mpleie Items E1 through�4. If the Eievation C2rtmcate is intend�for use as suppor[ing iniormauon for a LOMA or LOMR-F,
Section C mus�be completed.
E1.Buildina Diagram Numoer_(Select the buiiding�iagram mest similar to the building ror which this ceruficate is being compleied–see pages 6 and 7. If no diagram accura[ely
represenis the building,provide a sketch or phoiograph.)
�2.The top of the bottom floor(including basement or enclasure)of the buiiding is _ft.(m)_in.(cm)�ab�ve or ❑below(check one)the hianesi adja�nt grade. (Use
natural grade,R available).
E3.=or Buiiding Diagrams 6�with openings(see page 7),the next hianerT�oor or elevated floor(elevauon b)of the building is _ft.(m)_in.(cm)�bove the highes�adjacent
g2de. Compleie items C3.h and C3.i on front of form.
E4.The too of the platform of machinery andlor equipment sa�vicing the buii�ing is _ft.(m1_�n.(�ml(—I?Sr,�P�� [,I�i�,y«,a.k nngti tho hi�hA„ct�r�i1�n��,r-��� �I Ig�
naturai grade,if available).
�5.!=or Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in aG;ordance with the cammuniry's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offidal must certiffy this ir�ormation in Secuon G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorized representative who e�mpletes Sections A,B,C(Ite.ms C3.h and C3.i oniy),and E for Zone A(without a FEMA,-issued or community-
issued BF�or Zone AO must sign here. The srafements in Secfions A,E,C,and E are cbrrea to fhe best of my knowledge. •
PROPERTY OWNER'S OR OWNER'S AUTHORIZED P.EPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNfTY INFORMATION(OPTIONAL)
The iccal o;n�al.o;�o.is:.u::orizeo�y la-,or ordinance to administer the communi'ry's floodplain management ordinance can compie'te Secbons A,B,C(or�,and G of this�evafion
Certmcate. ComFlete�:.- �opfica�a item(s)and sign below.
G1.❑The inrormatio��in�e;:��n C ti�talcen rrom other documentation tha't nas been sioned and embossed by a iicensed surveyor,engineer,or architect who is authonzed by state
or Ic�i ia��c?o cerafy elevation information. (Indicate the sourr,e and date of the eievation data in the Comments area�low.)
G2.[l A community��5ca�m�leted Szction E for a buifding located in Zone A(without a FEMA�ssued or communify�ssued BFE}or Zone A0.
G3.❑The following inmrma�on(Items G4-G9)is provided for communiry floodplain management purposes.
G4.PERMI'i NIJMBER G5. DATE PERMfi ISSUED Go. DATE CERTIFICATE OF COlV1PLIANCJOCCUPANCY ISSUED
I
G�.This permi't has been issued for. ❑New Construction ❑Substantial Improvement
G8.Efevaiion of as-built lowest flwr�nduding basement)or the buiiding is: _._ft.�m� p�m:
G9.BF�or(in Zone AOj depth o�flooding at the building site is: _ _ft.(m) Datum:
LOCAL OFi=1CIAL'S NAME I fTL=
COMMUNITY NAME rCLE?HONE �
SIGNATURE DATE
COMMENTS
_ i I r;hPnk harF if ahachmanic
ry���;."-.���.
2 �
rF q
�F�� ` '� ` C ITY O F LEARWATE R
� �`�� �r:�.�� _.
�~`�` � " DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
s���. ' `
"�� . POST�FFICE BOX 474g� CLEARWATER� F�.oa�oA 33758-4748
� y �m»V # MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLF.AVENUE,CI.EARWATER, FLORIDA 33756
TECEPxorrE (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 Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
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-Residentiai,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 B2.COUNTY NAME B3.STATE
B4.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER g5.SUFFIX 66.FIRM INDEX DATE EFFECTIVE/REVISED DATE B$•FLOOD ZONE(S) �Zone AO,use depth of flooding)
8/18/1992
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)
B11. 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' ❑ Buiiding 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:
�levation certi(icates shall be maintained by the community and copies with the attached memo made available by request
FRANK HIF36ARD,MAYOR
GGORGE N.CRE7'EKOS,COUNCILMEMBGR JOIIN DORAN,COUNCILMEMBGR
PAUL F.GIBSON,COUNCILMEMBGR � CARLCN A. PE7'ERSEN,COUNCILMEMRGR
��EQUAL EMPLOYMENI'AND AFFIItMA'fIVE AC1'ION EMPLOYEK�
. FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
' • ' NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
� � ELEVATION CERTIFICATE
�✓"1''a�� "�"�' �a � � 7 Im ortant: Read the instructions on a es 1-7.
SECTION A-PROPERTY OWNER INFORMATION Foclnsu�anceCompeny Use: ''
BUILDING OWNER'S NAME Policy!Number
MENNA DEVELOPMENT
BUILDWG STREET ADDRESS pncluding Apt.,Unit,Suite,andlor Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
125-3 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CLEARWATER FL 34630
PROPERTY�ESCRIPI'ION(Lot and Block Numbers,Tax Parcel Number,Legai Description,etc.)
LOT 3,BELLE AQUA VILLAS I
BUILDING USE(e.g.,Residential,Non-residential,Addition,Acxessory,eta Use a Commenb area,if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type):
��'"�''�•�" °r �•�� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B•FL000 INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNIIY NAME&COMMUNITY NUMBER B2.COUNTy NAME gg,�q�
CITY OF CLEARWATER 125096 PINEU.AS FLORIDA
�•���PA�- 87.FiRM PANEL B9.BASE F100D ELEVATION(S)
NUMBER B5.SUFFUC B6.FIRM INDEX DATE EFFECTIVEJREVISED DATE 88.FLOOD ZONE(S) (Zone A0,use depth of flooding)
125096�0007 D 8119/91 8119/91 AE ��
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 69.
❑FIS Profile ❑FIRM ❑Community Determined ❑Other(Describe);_
B11.Indicate the elevation datum used for the BFE in 89:� NGVD 1929 ❑NAVD 1988 ❑Other(Describe):
B12,Is the building located in a Coastal Bartier Resou�ces System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Desiqnation Date
SECTION C•BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Buiiding elevations are based on:�Construction Drawings* �Building Under Construction' ❑Fnished ConstrucUon
"A new Elevation Cerfificate wiU be required when construction of the building is complete.
�C2.Building Diagram Number 8(Select the building diagram most similar to fhe building for which ihis certificate is being completed-see pages 6 and 7, if no diagram
accurately represents the building,provide a sketch a photograph.)
C3.ElevaGons—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with 8FE),AR,AR/A,AWAE,AWA1-A30,AWAH,AWAO
Complete Items C3.-ai below according to the bu�ding diagram specified in Item C2.State the datum used.If the datum is different from fhe datum used for fhe BFE in
Section B,convett ihe 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 Sec6on G,as appropnate,to document the datum conversion.
Datum ConversionJComments
Elevation reference madc used LP 10 BM#1 Does fhe elevation reference mark used appear on the FIRM? []Yes �No
o a)Top of bottom floor(including basement or endosure) 7. 09 ft.(m) � ;r
o b)Top of next higher flaor 11 .01 ft.(m) �'
o c)Bottom of lowest horizontal structural member(V zones only) NA._ft.(m) N�
o d)Attached garage(top of slab) 7 pg� m °° /
( ) w o
o e)Lowest elevation of machinery and/or equipment �
serviang the buildng(Describe in a Comments area) NA._ft.(m) ��
o�Lowest adjacent(finished)grade(LAG) 5.42 ft,(m) z�
o Hi hest ad'acent finished rade HAG °'�'
9) 9 1 ( )9 ( ) 5. 64 ft.(m) � #2512 5/02/05
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 7 �
o i)Total area of all permanent c�penings(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 authorized by law to certify elevation information,
!certify that the information in Sections A,8,and C on this certificate represents my best efforts to interpret fhe data available.
f understand that any false stafement may be punishable by fine or imprisonment under 18 U S Code, Secfion 100?
CERTIFIER'S NAME GEORGEA.SHIMP II LICENSE NUMBER 2512
TiTLE PRESIDENT COMPANY NAME GEORGE A,SHIMPII&ASSOC,,INC
DDRESS CITY STATE Z!P CODE
3301 DESOT OULEVARD PALM HARBOR FL 346g3
SIGNAT � DATE TELEPHONE
N0.050242�P, 5I0?J05 727-784-5496
FEMA Form 81-31,January 2003 See reverse side for continuation. Ranlar.we al1 nravfn���A��tin��
_ _ _
IMPORTANT: In these s aces,co the corres ondin (nformation from Section A. Forinsur�ncaCompenyuse: "
BUILDWG STREETApDRESS(Indudiryg Apt,Unrt,Suite,andla 81dg.No.)OR P.O.R011fElWD BOX N0. PoUcy Nurribet :: � .
125-3 BRIGHTWATER DRIVE
C� STATE ZIP CODE Con�pHnY I!�AlC I�u�(, `
CLEARWATER FL 34630 ;�� •;��
; _:
SECTION D•SURVEYOR,ENGINEER,OR ARCHITECT CERTlFiCATION(CONTINUED)
CopY both s�des of ihls pevation Ceitificate for(1)carununity oifidal,(2)insurance agenUcompany,and(3)bu�ding owner, �
COMMENTS
❑Chedc here ff a�achments
SECTION E•BUILt�ING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BF�
For Zone AO and Zone A(without BF�,complete Items E1 fhrough E4. If the ElevaUon Certifipie is intended for use as supporUng informaUon for a IOMA or LOMR-F,
Section C must be comqeted.
E1.B�IcGng Dlagram Nurt�ber_(Seled the building diagram rtrost sirtu7ar to ihe building for wluch this certifi�ta is baing canpleted—see pages 6 and 7. if no dlagrmn acauately
r�epresents ihe bullding,provide a sketch a photograph.)
E2.The top of ihe bouom floa Qndumng basement or endosure)of 1he bu0ding is _it(m)_in•(«n)O above or p�ow�c�ecx one�u,e r��nesc a�acent 9rade. (use
naturai grade,if available).
E3.For B�Iding D(agrarns 6-8 with openings(see page 7),the next higherfloor or elevated flow(elevaUon b)of the buil�ng is _ft,(m)�in,(cm)above the highest adjacent
grada Compiete iterris C3.h and C3.f on fro�t of fortn.
E4.The top of the pla�ortn of machinery and/or equipment servidng the twilding is _f4(m)_in,(cm1�above or ❑below(chedc one)ihe highest adJacent grade. (Use
natural grade,if av�lable),
E5.ForZone AO only: If noflood depih number is avaGa�e,is 1he top of ihe boitom floor�eyated in accordance wifh fhe communiiy's noodpiain manapement ordinance7
❑Yes ❑No ❑Unknown. The bcal offidal musice�tify ihis informa�on in Section G
SECTION F•PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The prope�ty owner o�owners author¢ed representaUve who campletes Seqions A,B,C(items C3.h and C3.!only),and E for Zone A(without a FEh�A-issued or canmunfiy-
Lssued BFE}or Zone AO must sign here. The sfatements in Sections A,B,C,and E are correct to the 6est o(my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESEMATIVE'S NAME
ADDRESS CITY STATE Z!P CODE �
SIGNATURE DATE TELEPHONE
COMMENTS
❑Chedc here if attachments
SECTION G•COMMUNtTY INFORMATION(OPTIONAL)
The local offid�who�s authaued by law or ordinance to admruste�the carmund�s floodplain management ordnance can complete SecUons A,B,C(or E),and G of ihis Elevalion
Certl6caie. Complete fhe aPPlicable item(s)and sign below.
G1.[�The Infamation in Section C was talcen from other da;umentabon that has been signed and em�ossed by a ucensed surveyor,engineer,or archiied who(s authotized by slate
or la�i law to certity elevation infamaUon. (indiqte ihA source and date of the elevaUon data in ihe Commenis area below.)
G2.�A conmunity offiaal completed Section E fora building locaied in ZAne A(witiwut a FEMA-issued orcommunity-issued BFE)or ZoneAO.
G3.�The folbwing infortnaUon(Items G4�9)is provided for community ibodplain management purposes.
�P����� �' ��P���E� G6.DATE CERTIFICATE OF COMPIUWCEIOCCUPANCY ISSUED
G7,This permit has been issued fa:[]New ConsUuc�ion ❑Substantlal Improvement
G8.�evaUon of as-buat Iowestfloo�(indu�ing basement)of fhe lw�ding is: _,,_ft.(m) Datum:
G9.BFE or(in Zone AO)c�pth of flooding at the bu�ding site is: __�,(m) DaG�m
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SlGNATURE DATE •
COMMENTS
❑Chedc here if aitachments