130 BRIGHTWATER DR UNIT 3 FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
� ���j ''�� 3� Expires December 31, 2005
. � � ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -7. JOB No.020308.9
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
BRIGHTWATER COVE, LLC. UNIT No.3
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brightwater Drive, UNIT 3
C�n STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Descrip6on,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):__..
( ##°-##'-##.##" or ##.�°) ❑NAD 1927 ❑ NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096 PiNE��,s FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of flooding)
� - 102 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
B10.Indicate the source of the Base Flood Elevation(BFE)data or base Bood 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(Descnbe):
B12.Is the building located in a Coastal Bamer Resources System(CBRS)area or Othenvise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are b2sed on:❑Construction Drawings� ❑Building Under Construction" �Finished Construction
� A new Elevation Certificate will be required when construction of the building is complete.
.Building Diagram Numt�r 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.Elevafions—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AWA1-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 appropnate,to document the datum conversion.
Datum NAVD 1988 Conversion/Comments N/A
Elevation referen�mark used L4BINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � � ', ,;t •',�
�-�;�..
o a)Top of bottom floor(induding basement or enclosure) 5.58 Ff ft.(m) � � y; �a- ,
o b)Top of ne�higherfloor 15.12 FT ft.(m) � t.J • {�V u �
o c)Bottom or low2si horizonta struc[urai member(V zones only) NIA FT fi.(m) o o "`"°�,•"�' �"� � � �x � �
o d)attached garage(top of block) 5.58 FT ft.(m) �-� ``' ��� �"�
W m N
o e)Lowest elevation of machinery and/or equipment - -' _
servicing the buiiding(Descnbe in a Comments area) N/A FT ft.(m) �� � ro c 'r" v
o fl Lowest adjacent(finished)grade(LAG) 5.0 . FT ft.(m) �� �':; ,�} ,�.,� � �` *
o g)Highest adjacent(finished)grade(HAG) 5.1 FT it.(m) � � �o7k�p�-p412gJ�`r.�,`
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 J ° <; -�� �;'-'
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 informat t'f �°•`� ;` `
I certrfy that fhe informafion in Sections A,B, and C on fnis cerfificafe represents my best efforfs to inferpref fhe data available. �� �+ �
I understand fhat any false sfatemenf may be punishable by fine or imprisonmenf under 18 U.S. Code, Section 1001. �
CERTIFIER'S NAME LICENSE NUMBER � x C 3 2�c�5
BRUCE A.KLEIN PLS 5052
�TITLE COMPANYNAME �M�NT �,S'VG`�
RESIDENT KLEIN&STAUB SURVEYING,�NC. CITY—B-F'
ADDRESS CITY STATE ZIP -H�"(wqTEF
8016 Old County Road New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
/r � „ 04/28/05 (727)834-8140
FEMA Form 81-31,January 2003 See reverse side for continuation. Reptaces all previous editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For insurance company use:
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number ' '
130 Bri htwater Drive, UNIT No.3 - ,
s
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)buiiding owner.
COMMENTS
NIA
❑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 intended for use as supporting information for a LOMA or LOMR-F,
Section C must be compieted.
E1.Buiiding 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 boflom 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 6-8 with openings(see page 7),the ne�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 and/or equipment servicing the building is _ft.(m)_in.(cm)�above or ❑tnlow(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 locai 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 completes Sections A,B,C(Items C3.h and C3.i oniy),and E for Zone A(without a FEMA-issuetl or community-
issuetl BFE)or Zone AO must sign here. The statements in Secfions A,8,C,and E are conect to fhe besf of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME •
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local ofFcia!who�s authorized uy lavr or ordinance to adminisier the community's floodplain management ordinance can complete Seciions A,B,C(or E),and G of this Elevation
Certificate. Complete the a�plicabie�tem(s)and sign below.
G1.�The information in Section G was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law to certify elevaiion information. (Intlicaie the source and date of the elevation data in the Commenls area below.)
G2.0 A community ofiicial c����plete�Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�Thc following information;Iter�s G4-G9)is provided 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
, �
- � „�w�-�� ��,
�
���������*�� ��ak C I T Y O F C L E A R W A T E R
� �= �� �.
� �"�� ` ����� � -
�� ��������.� DEVELOPMENT & NEIGHBORH0C7D SERVICES DEPARTMENT
�� ��. .� :
�����?�'., �� ` POST�FFICE BOX 474g� CLEARWATER� FLO�DA 33758-4748
��.,,.
'"f'� y MUN[CIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDn 33756
TELEPHONE�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 flle 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/�ONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:❑GPS(Type):
(##°-##'-##.##" or ##.#!J###°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
84.MAP AND PANEL g5.SUFFIX B6. FIRM INDEX DATE B��FIRM PANEL gg.FLOOD ZONE(S) g9.BASE FLOOD ELEVATION(S)
NUMBER EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
12103C0102
610. 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)
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 Designation 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,AR1A,AR/AE,AR/A1-A30,AR/AH,AR/AO.
Compiete 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 equipinent 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 aIl permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community O�cial:
�levation cerfificates sNall be maintained by the community and copies with the attached memo made availab/e by request
FRANK HIBAARD,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMBER JOIIN DORAN,COUNC[LMEMBCR
PAUL F.GIBSON,COUNCILMEMBER � CARI.EN A.PE7'ERSEN,COUNCILMEMBER
��EQUAL EMYLOYMENT AND AFFIItMA'1'IVE ACTION EMPLOYER��
FEDERAL EMERGENCY MANAGEMENT AGENCY
�'aUV� r b5a 3� NATIONAL FLOOD INSURANCE PROGRAM �•M.B. No. 3067-0077
� Expires December 31, 2005
� ELEVATION CERTIFICATE
Important: Read the instructions on pages 1•7. JOB No.020308.9
. � SECTION A-PROPERTY OWNER INFORMATION Fa Insurance Canpany Use:
BUILDING OWNER'S NAME Policy Number
BRIGHTWATER COVE, LLG UNIT No.3
BUILDING STREET ADDRESS(lnduding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Company NAIC Number
130 Brightwater Drive, UNIT 3
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax ParcelNumber,Legal Desaiption,etc.) �
LOTS'I-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 ##.�°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2 COUMY NAME 63.STATE
City of Clearwater 125096 PiNEU�s FLORIDA
64.MAP AND PANEL B7.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER 85.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE 68.FLOOD ZONE(S) (Zone A0,use depih of floodirg)
e - G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL11.0
B10.Indicate the source of the Base Flood Elevafion(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 Protecied Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:�Construction Drawings' ❑Building Under Construction' �Finished Construction
`A new Elevation Cerlificate will be required when construction of the building is complete.
� � Building Diagram Number 7 (Select the buildng diagram most similar to the building for which this certficate is being compleied-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,ARIA,AWAE,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 NAVD 1988 Conversion/Comments N/A
Elevation reference maric used LABINS EL.=4.191 Does the elevation reference maric used appear on the FIRM? ❑Yes �
,r ' � -
o a)Top of bottom floor(including basement or endosure) 5.58 . FT ft.(m) � �`;'�
o b)Top of ne�higherfloor 15.12 . FT ft.(m) � <s,�' �' `f;, '.
o c)Bottom oi low2si horizontai structural member(V zones only) NIA FT ft.(m) y m `~� »�'�° r� - �"��
o d)attached garage(top of block) 5.58 FT ft.(m) E� ' '"'`' ;�r,; r. ;-� � a � �.r{'
o e)Lowest elevation of machinery andlor equipment w; ' y :� ' ' 7`::3`''
seroicing the building(Descnbe in a Comments area) N/A FT ft.(m) E� `��' �� �'" .�� ;`'
o �Lowest adjacent(finished)grade(LAG) 5.0 Fi ft.(m) z�'� ' ..��,`: t �'�' '^� '
o g)Highest adjacent(finished)grade(HAG) 5.1 Fr ft.(m) � � ` 0.4J28/Q5'• �
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 J 4 r' �•yp ����j, ,
�- 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 informat `
1 certify that fhe informafion in Secfions A,B,and C on fhis cerfificate represents my besf efforfs to interpret fhe data available. �, � , ��� �
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ��
CERTIFIER'S NAME LICENSE NUMBER X 0 3 2�5 ��
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME �MENT
�'RESIDENT KLEIN&STAUB SURVEYING,INC. CIT1/ �1c n� .�... __ SVCS
• ADDRESS CITY STATE ZIP ATEF'
8016 Oltl County Road New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
� 041�8105 (727)834�140
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:
BUItDING STREE7 ADDRESS(Induding Apt.,Uni�Suite,and/or BkJg.No.)OR P.O.ROUTE AND BOX N0. Policy Number + , .
130 Bri htwater Drive, UNIT No.3
CITY STATE ZIP CODE Company NAIC Number _
CLEFlRWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) / •
t
Copy both sides of this Elevation Certficate for(1)community offiaal,(2)insurance agenUcompany,and(3)building owner.
COMMENTS
N1A
❑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 Certficate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be compieted.
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)❑above or ❑below(check one)the highest adjacent grade. (Use
nafural grade,rf avaitable).
E3.For Building Diagrams 6 S with openings(see page�,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 and/or equipment servicing the building is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
natural grade,'rf available).
E5.For Zone AO only: If no flood depth number is available,is the top of the bottan floor elevated in acxordance with the communii�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 propeRy owner or owners authorized representative who c�mpletes Sections A,B,C(items 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 statements in Sections A,B,C,and E are conect to fhe best of my knowledge. '
PROPERIY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME /
� �ADDRESS CITY STATE ZIP CODE
cirniqri iRF np,TE TELFpupnlE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local ofiicial who is authonzed Ly lav,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 applicabie item(s)and sign below.
G1.�]The inform�tion 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 state
or Ic�cai law to certify elevotion informa6on. (Indicaie the source and date of the elevation data in the Gomments area below.)
G2.�A community offiaai c�r;��letec Seclion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The following information(Items G4-G9)is provided fa community floodplain management purposes.
G4.PERMff NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for.�New Construction ❑Substantial Improvement
G8.Eleva(ion of as-built lowe�4 floor(induding basement)of the building is: __ft.(m) Datum:_
G9.BFE or(in Zone�1U)depth of flc�oding 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 Repfaces all previous editions