130 BRIGHTWATER DR UNIT 5 - � ' FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
���/�����/r J��� NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
1�� `
_ 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.5
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brighiwater Drive, UNIT 5
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
61.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096 PINELLAS FLORIDA
B4.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih 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 69:�NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.Is the building located in a Coastal Bamer 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 wili be required when construction of the building is complete.
„2.Bui�ding Diagram Number 7 (Select the buiitling 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,ARIA,AR/AE,ARIA1-A30,AR/AH,ARIAO
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 tlatum to that used for the BFE.Show field measurements and datum conver�ion caiculation. Use the space provitled or the Comments area of
Se:;tion D or Section G,as appropriate,to document the datum conversion.
Datum NAVD 1988 ConversionlComments NIA
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference maric used appear on the FIRM? ❑Yes � °,�s ��,,.�-; +
o a)Top of bottom floor(including basement or endosure) 5.58 FT ft.(m) � ,,�-�„� �. r� � ���#;�
o b)Top of next higher floor 15.12 FT ft.(m) a � ��� �'
o c)Boitom oT lowest horizontai struciural member(V zones only) N/A FT fi.�mj o o , � `4� � '`'° -�
o d)attached garage(top of block) 5.58 . FT ft.(m) �� ; ,_ � `'� p
o e)Lowest elevation of machinery and/or equipment w m ; »"� �`'
� �; �'� °
servicing the building(Descnbe in a Comments area) N/A FT ft.(m) �m �. `', � �� �`'' `
'�*r
o fl Lowest adjacent(finished)grade(LAG) 5.0 FT fl.(m) z� y� � "� �
o g)Highest adjacent(finished)grade(HAG) 5.1 FT fl,(m) � �� , •44/z$19�,5�_R��u
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 � #R� � � �'�'
o i)Total area of all permanent openings(flood vents)in C3.h 1285 sq.in. `t^k=..,.
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 info
I cerfify that fhe informafion in Sections A, B,and C on fhis certificate represenfs my best efforts to interpref the data available. °
I understand that any false statement may be punishable by fine or imprisonmenf under 18 U.S. Code, Secfion 1001.
CERTIFIER'S NAME LICENSE NUMBER �
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME CS
•'RESIDENT KLEIN&STAUBSURVEYING,�NC. C�TY_�.rLEARV�,TEF
ADDRESS CITY STATE ZIP CODE
8016 Old County Road 54 ^ New Port Richey FL 34653
SIGNATURE ,' DATE TELEPHONE
_ 04/28/05 (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 insurance company use: •
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,antl/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Poiicy Number •• � '
130 Bri htwater Drive, UNIT No.5
CITY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) �
Copy both sides of this Elevation Certifcate 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),compiete Items E1 through E4. If the Elevafion Certif�cate is intended for use as suppoRing 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 enciosure)of tfie buiiding 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 ofform.
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,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 owne�s authorized 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-
issued BFE)or Zone AO must sign here. The stafements in Secfions A,8,C,and E are correcf 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
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The Ixal official who is auinonzeo by iaw 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 appiicable item(s)antl sign below.
G1.❑The intorma!�on in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or archiiect who is authorized by state
orlxal law!o certify eleva.'.ion information. Qndicate the source and date of the elevation tlata in the Comments area below.)
G2.❑A corpinuniYy officiai 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(Items G4-G9)is provided for communiiy floodplain management purposes.
64.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
: G7.This permit has been issued for: �New Construction ❑Substantiai Improvemeni
G8.Elevation of as-built lowest floor(including basement)of the buiiding 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
�! 'n������� NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
���J
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.5
BUILDING STREET ADDRESS(InGuding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brighiwater Drive, UNIT 5
C��J�. STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERIY 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):
( ##°-##'-##.##" or ##.#####� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096 PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER � B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIftEVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of fboding)
-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(Desaibe):_
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 Resour�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' ❑Building Under Construction' �Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
.�2.Building Diagram Number 7 (Select the building diagram mast similar to the building for which this certficate 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,AWA,AWAE,AWA1-A30,AWAH,ARIAO
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 mark used LABINS EL=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � �± �
o a)Top of boriom floor(induding basement or endosure) 5.58 FT ft.(m) � ,'-•,,�' � �
o b)Top of next higher floor 15.12 FT ft.(m) � a ,.-��' t v.•
o c)Bottom of lowest honzontal structural member(V zones only) N/A FT ft.�m) o o , --�; :::� r� .�
o d)attached garage(top of bl�k) 5.58 . FT ft.(m) E� ' � %_'' :e ` '
o e)Lowest elevation of machinery and/or equipment W�%''� ' ``�' �
� � ' �,.. ,
serviang the building(Descnbe in a Comments area) N/A . FT ft.(m) �� � � '', �- ,�;-.k�' �4�"'
o fl Lowest adjacent(finished)grade(LAG) 5.0 FT ft.(m) z� • � � �' ,b`� ,��.''
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � �t ` �.` ,Q�/�$l8,��°;�
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 `-' '�� �t �`�'.�'l-'�
�
o i Total area of all rmanent o nin s flood vents in C3.h 1285 s .in. `'``
) Pe Pe 9 � )� q �t.'�' '
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 info
I cerfify fhat the informafion in Secfions A,B,and C on this cerfificafe represents my besf efforfs to inferpret fhe data available.
1 understand fhat any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Secfion 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME CS
I�RESIDENT KLEIN&STAUBSURVEYING,�NC. rITY C1F CLEARW�TEF
• ADDRESS CITY STATE ZIP CODE
8016 Old County Road 54 Nevu Port Richey FL 34653
SIGNATURE DATE TELEPHONE
_ 04f28ro5 (727)834�140
FFMA Fnrm R1-31 .lanuarv 2003 See reverse side for continuation. Replaces 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 Bidg.No.)OR P.O.ROUTE AND BOX N0. Pdicy Number •
130 Bri htwater Drive, UNIT No.5
�� STATE ZIP CODE Company NAIC Number -
CLEARWATER FLORIDA 337g7
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) / �
t
Copy both sides of this Elevation Certificate for(1)community offiaal,(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 Certficate 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 dagram most similar to the building for which this certificate is being completed—see pages 6 and 7. If no diagram accurately
represents the buildng,provide a sketch or photograph.)
E2.The top of the bottom floa(induding basement or endosure)of tfie building is _ft.(m)_in.(cm)�above or ❑below(checic 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(eleva6on b)of the building is _ft.(m)_in.(cm)above the highest adjacent
grade. Complete items C3.h and C3.i on front of fam.
E4.The top of the platform of machinery andlor equipment servidng 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 accordance with the communitys floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offiaal must certify this information in Seclion G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFICATION
The property owner or owners authorized 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-
issued BFE�or Zone AO must sign here. The sfafements in Secfions A,B,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 �
�I(vNATI IRE per� r`�`ou�NE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local offiaal wh�is au�norize9 by iaw or ordinance to administer the community's floodpiain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete the applicable item(s)and sign below.
G1.0 The information in Section C was ta_{�en fran other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law#o certify eleva#�n information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A comrnunity offiaai co�lefe�Sedion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The fdlowing infamation(Ilems G4-G9)is provided fa 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(induding basement}of the building is: _._fl.(m) Datum:
G9.BFE or(n Zone AO)dept�ofllodtling at the building site is: __ft.(m) Datum:_
�tOCAL OFFICIAL'S NAME ••- -- TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE �
COMMENTS •
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
,..; e}9'�n�'"v tt Lr.°.
" CITY OF CLEARWATER
� � ��
� k � � �e �� 4 � ��.
� �� DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
���� r-. - PosT OFFicE Box 4748, C►.�wn�R, F�o�u�n 33758-4748
i" MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDn 33756
TELEPHONE �7Z� 5�2-4567 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 Parcei 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
B4.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 Eievation(BFE)data or base flood depth entered in Item 69.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑Other(Describe)
611. indicate elevation datum used for BFE in B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
612. Is the building located in a Coastal Barrier Resources 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 ceRificate 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 fieid 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 buiiding(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents) 1 ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�levation certificates shall be mainfained by the community and copies with the attached memo made availab/e by requesf
FRANK H[RRARD,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMBBR J011N DORAN,COUNCILMEMBGR
PAUL F.GIRSON,COUNCILMEMRGR � CARI.EN A.PE7'ERSEN,COUNCILMEMBER
��EQUAL EMYLOYMENT AND AFFIItMA'fIVE ACI'ION EMPLOYER�