130 BRIGHTWATER DR UNIT 2 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
M ` NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
_ ��i`^�'�3 � ��� ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -7. JOB No.020308.9
SECTION A-PROPERTY OWNER INFORMATION Forinsurance Company Use:
BUILDING OWNER'S NAME Policy Number
BRIGHTWATER COVE, LLC. UNIT No.2
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brightwater Drive, UNIT 2
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 1-9 BRIGHTWATER COVE No.2 P.B.129,PGS.61-62
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):___
� �°_��_�.� o� �.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:____
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNI7Y NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096 PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
� ��-0102 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
B10.Indicate the source of the Base Flood Elevation(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 B9:0 NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.Is the building located in a Coastal Bamer Resources System(CBRS)area or Otherwise Protecied Area(OPA)? ❑Yes �No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:0 Construction Drawings" ❑Building Under Construction` �Finished Constru�ion
. "A new Elevation Certificate will be required when construction of the building is compiete.
2.Building Diagram Number 7 (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 Commenis area of
Se:;tion D or Section G,as appropriate,to document the datum conversion. '
Datum NAVD 1988 Conversion/Comments N/A � x ;6� ^ �w�' '
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � . ' ' ;�,
o a)Top of bottom floor(including basement or enciosure) 5.58 FT ft.(m) � e,+ . ' ' -
o b)Top of next higherfloor 15.12 rT ft.(m) � �, �`� �'� � : �
o c)Bottom of lowesi horizontal siruciural mem�er(V zones only) NIA FT ft.(m) �� � '''� � �.+ � �
�o�� h�= �..p '�. :
o d)attached garage(top of block) 5.58 FT ft.(m) E ,o , ,.
w c�d" : r." .
o e)Lowest elevation of machinery and/or equipment �� 'ayr�, �, � ,,,
servicing the building(Descnbe in a Comments area) N(A FT ft.(m) ���`,- •..¢� '� ,-','�
o fl Lowest adjacent(fnished)grade(LAG) 5.0 FT ft.(m) �� \" �� " .., '�.'R'
o g)Highest adjacent(finished)gratle(HAG) 5.1 FT ft.(m) � ''� 0��/05
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 �
o i)Total area of all permanent openings(flood vents)in C3.h 1285 sq.in.
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 informa
t �..
I cerfify that the information in Sections A,8,and C on this certificate represents my best efforfs fo interpret the data available. � E
I undersfand that any false sfatement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Fe�,�Y ll � ?(1t1�_ <�
CERTIFIER'S NAME LICENSE NUMBER
BRUCEA.KLEIN PLS5052 [��V� 1DIlA����+- ..
�TRESIDENT K�LEIN&NS AUB SURVEYING,INC. C+ITY OF C(.EARW VC``
DDRESS CITY STATE ZIPCODE ATi' t•
8016 Old County Ro ' New Port Richey FL 34653
SIGNATURE � L�ATE TELEPHONE
� _ _ _ 04/28/05 (727)834-8140
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For�nsurance comPany use:
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number � k
130 Brightwater Drive UNIT No.2 „
CITY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) �
Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner.
COMMENTS
N/A
❑Check 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(without BFE),complete Items E1 through E4. If the Elevation Certificate is intentled for use as supporting information for a LOMA or LOMR-F.
Section C must be completed.
E1.Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed—see pages 6 and 7. If no diagram accurately
represents the building,provide a sketch or photograph.)
E2.The top of the bottom floor(including basement or enclosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6�with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4.The top of the platform of machinery andlor equipment servicing the building is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E5.For Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorizetl representative who completes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community-
issuetl BFE)or Zone AO must sign here. The sfatements in Secfions A,8,C,and E are correct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME •
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
i
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local ofriciai who is authonzetl by la�v or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or Ej,and G of this Elevation
Certifcate. Coriiplete the applicable itemjs)and sign below.
G1.❑Tne information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authonzed by staie
or local law to certrfy elevat�o��inforr�ation. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A comm�nity o�'iciai compieted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following in;ormation(Iter;�s G4-G9)is providetl for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
G7.This permit has been issued for: �New Construction ❑Substantial Improvement
G8.Elevation of as-built lowest floor(including basement)of the building is: _._ft.(m) Datum:
G9.BFE or(in Zone AO)depth of Flooding at the building site is: _,_ft.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE •
COMMENTS
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
, FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
V Q NATIONAL FLOOD INSURANCE PROGRAM
�( ���_ ��,�, Expires December 31, 2005
��I`'`� ELEVATION CERTIFICATE
• Important: Read the instructions on pages 1-7. JOB No.02Q308.9
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
BRIGHTWATER COVE, LLC. UNIT No.2
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brightwater Drive, UNIT 2
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Desaiption,etc.)
LOTS 1-9 BRIGHTWATER COVE No.2 P.B.129,PGS.61-62
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):
( ##°-##'-##.##" or ##.#i4�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNIIY NAME&COMMUNITY NUMBER B2.COUNTY NAME 63.STATE
Ciry of Clearwater 125096 PINELLAS FLORIDA
64.MAP AND PANEL 87.FIRM PANEL B9.BASE ROOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE 68.ROOD ZONE(S) (Zone A0,use depih of flooding)
f �y�g�-Q1(�l""' G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
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):_
612.Is the building located in a Coastal Bamer Resoum,es System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:�Construction Drawings' ❑Buiiding Under Construdion' �Finished Construction
"A new Elevation Certificate will be required when consUuction of the building is complete.
��2.Building Diagram Number 7 (Select the buiiding diagram most similar to the building for which this certrflcate is b�ing compleied-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch or phoiograph.)
C3.Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,ARIA1-A30,AR/AH,AR/AO
Complete 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 the BFE in
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G,as appropriate,to document the datum conversion.
Datum NAVD 1988 Conversion/Comments N/A �_ '
Elevation reference mark used LABINS EL=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � �� .
o a)Top of bottom floor(induding basement or endosure) 5.58 . FT ft.(m) � r'
o b)Top of next higher floor 15.12 . Ff fl.(m) � � '.;e�'� �£ r +��,
o c)Bottom of lowest honzonta�struciural member(V zones only) NIA FT ft.(m) �@ �; ; r.� --� �"' ��
o�d ..�.. �: � .i
o d)attached garage(top of block) 5.58 FT ft.(m) W�� ;= ''' �. �, �=r
o e)Lowest elevation of machinery and/or equipment -� �i, ,•, d
a� � �k° r "+� '
serviang the building(Descnbe in a Comments area) N(A FT ft.(m) E�' � ._�,,� , ;.` �+�
o fl Lowest adjacent(finished)grade(LAG) 5.0 FT ft.(m) z�'� �y;- ` �<�"`'
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � � � � 04�L8/05
o h)No.of permanent openings(800d vents)within 1 ft.above adjacent grade 10 �
o i)Total area of all permanent openings(flood vents)in C3.h 1285 sq.in.
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 informa
I cerfify thaf fhe information in Sections A,B,and C on this cerfificate represenfs my best efforts fo interpret fhe data available. � �
I undersfand that any false sfatement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. E�J t�Y R � ��
CERTIFIER'S NAME LICENSE NUMBER
BRUCEA.KLEIN PLS5052 (��VFI t'l�n�c�„- ..
TITLE COMPANY NAME G.'.,.� OF VC.,``,.
,pRESIDENT KLEIN&STAUBSURVEYING,wc. CLEARWATi���
• ADDRESS CITY STATE ZIP CODE
8016 Old County Ro New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
04128105 (727)834�140
FEMA Form 81-31.Januarv 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For�nsurance ComPany use:
BUILDING STREET ADDRESS(Induding Apt,Uni�Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX N0. Policy Number � +
130 Bri htwater Drive, UNIT No.2 ,
�� STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D•SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) / •
l
Copy both sides of this Elevation Certificate for(1)community offiaal,(2)insurance agenV�mpany,and(3)building owner.
COMMENTS
N/A
❑Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WfTHOUT BFE)
For Zone AO and Zone A(without BFE),complefe Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Select the building diagram most similar to the building for which this certificate is being completed—see pages 6 and 7. If no diagram accurately
represents the building,provide a sketch or photograph.)
E2.The top of the bottom floor(induding basement or enclosure)of the building is _ft.(m)_in.(cm)0 above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building is _ft.(m)_in.(cm)above the highest adjacent
gratle. Compleie items C3.h and C3.i on front of form.
E4.The top of the platform of machinery and/or equipment serviang the building is _ft.(m)_in.(cm)�above or ❑below(chedc one)the highest adjacent grade. (Use
natural grade,'rf available).
E5.For Zone AO only: If no Bood depth number is available,is the top of the bottom floor elevated in accordance with the communitys floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorized representative who canpletes Sections A,B,C(flems C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community-
issued BFE)or Zone AO must sign here. The sfatements in Sedions A,8,C,and E are correct to fhe best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME �
ADDRESS CITY STATE ZIP CODE �
�I(;NATI IRF nerE TELE°HONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNfTY INFORMATION(OPTIONAL)
The local offiaahwho is authorized by laev or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete the applicable item�s)and sign below.
G1.❑Tt�e infamatior in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by staie
or local law to cerirfy elevatioii inforr�a6on. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A community offiaal completed'Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following information(Itenis G4-G9)is provided forcommunity floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMff 15SUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
�;G7.T�his pertnit�as�been i§sued�for:'❑New Construdion ❑Substantial Improvement
' �8.Elev�atiori of as-builf lou�est floor(including basement)of the building is: _._ft.(m) Datum:_
_ : f�9:�BFE or(in Zone AO)deptri o�ftooding at the building site is: ._ft.(m) Datum:
�. � � . i._ _ - .
-- LOGAL OFFICIAL'S NAME TITLE
�OMMUNITY NAME TELEPHONE
SIC�IATIJRE DATE t
COMMENTS ' •
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces ail previous editions
<. . �
� �
�4����°�`� �' �; CITY OF CLEARWATER
�� , , � ���-
� �����i ,� ,�� � �
�«� �� �� f� ��� DEVELOPMENT 8r NEIGHBORHOOD SERVICES DEPARTMENT
�,� � i:.Y t ..
�' . POST QFFICE BOX 474g� CLEARWATER� FLO�DA 33758-4748
F `�' � MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDn 33756
TELErxorrE(72� 562-4567 Fnx(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,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
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 B2.COUNTY NAME 63.STATE
64.MAP AND PANEL g5.SUFFIX B6. FIRM INDEX DATE B�•FIRM PANEL gg,FLOOD ZONE(S) B9�BASE FLOOD ELEVATION(S)
NUMBER EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
12103C0102
810. 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 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:
Date of Review: Community Official:
�levation certificates shall be maintained by the community and copies with the attachedmemo made availab/e by 2quest
FRANK HBRARD,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBCR
PAUL F.GIBSON,COUNC[LMEMBER � CARLGN A.PE1'ERSEN,COUNCILMLMBER
��EQUAL EMYLOYMEN'C AND AFFIItMA'1'IVE ACTION EMPLOYER��