130 BRIGHTWATER DR UNIT 6 FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
, Expires December 31, 2005
��..��,3--�a 3y 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.6
BUILDING STREET ADDRESS(Inciuding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brightwater Drive, UNIT 6
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):___
� �°_��_�.{�^ or #p�.�°) ❑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
City of Clearwater 125096 PINELLAS FLORIDA
B4.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVFJREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depfh of flooding)
� ,�1 -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:❑NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.is the building located in a Coastal Bamer Resources System(CBRS)area or Othenr✓ise Protected Area(OPA)? ❑Yes �No Designation Date_
SECT�ON 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 requiretl when construction of the builtling is complete.
., .Building Diagram Number 7 (Select the building diagram most similar io the building for which this certifcate is being compleied-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,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 tlatum 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 NIA
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference maric used appear on the FIRN? ❑Yes �
�����§ � -�
o a)Top of bottom floor(including basement or enclosure) 5.58 FT ft.(m) � �w��,�;� � ' ;;�
� �+, l. o*� :
o b)Top of next hiqherfloor 15.12 FT ft.(m) � �' ,• � ,_
o c)Bottom oi lowest horizontal structural member(V zones only) NIA FT ft.(m) o�a, ��•;�'�� J � I
o d)attached garage(top of block) 5.58 FT ft.(m) �� q -+� � �'
o e)Lowest elevation of machinery and/or equipment w y"� ~ �,, �
servicing the building(Descnbe in a Comments area) N/A FT ft.(m) � �� q��,r.. �"� -� °"=� � =
o fl Lowest adjacent(finished)grade(LAG) 5.0 FT ft.(m) z� �� �� �: 4,� g�,,� +r'��'
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � ;•.9 "' 04/28/(�5�, "
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 `—' ' �''` � ' k`4
� �; i=;
o i)Total area of all permanent openings(flootl 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 infor
I certify thaf the information in Sections A,B,and C on this certificate represents my best etforfs fo interpret fhe data available.
I undersfand that any false statement may be punishable by fine or imprisonmenf under 18 U.S. Code, Secfion 1001. �;Y C 3 2�5
CERTIFIER'S NAME LICENSE NUMBER
BRUCEA.KLEIN PLS5052 DEVELUPMENT SVCS
•TITLE COMPANYNAME CITY OF �LEARWATER
'RESIDENT KLEIN&STAUB SURVEYING,INC. _
ADDRESS CITY STATE ZIP CODE
8016 Old County Roa New Port Richey FL 34653
SIGNATURE DATE 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 insurance company use:
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
130 Bn hlwater Drive, UNIT No.6 � _ ,
CITY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHfTECT 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(WfTHOUT BFE)
For Zone AO and Zone A(without BFE),cromplete 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 tliagram 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 6-8 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
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,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 communit�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 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 statements in Sections A,B,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 local official who is authonzed b;la��:�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 ihe appli�able item(sl and sign below.
G1.❑The information in Se:;tion 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 local law io certify elevation information. (indicate the source and date of the elevation tlata in the Comments area below.)
G2.�A community onicial u,�mp!E`�d Seciion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.❑The follovring information�item�G�3-G9)is provided for community floodpiain 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
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
����--�'"Ja�y ELEVATION CERTIFICATE Expires December 31, 2005
� 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.6
BUILDING STREET ADDRESS(Induding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
130 Brightwater Drive, UNIT 6
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Blodc 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
LAT(TUDE/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 COMMUNffY NAME&COMMUNIIY NUMBER 62.COUMY NAME B3.STATE
Ciry of Clearwater 125096 PINELLAS RORIDA
B4.MAP AND PANEL B7.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIf2EViSED DATE 68.FLOOD ZONE(S) (Zaie A0,use deptli of floodag)
� ,� G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL11.0
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:�NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.Is the buildng 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 based on:�Constniction Drawings� ❑Buiiding Under Construcfion' �Finished Construction
� A new Elevation Certi6cate will be required when construction of the building is complete.
� Building Diagram Number 7 (Select the building diagram most similar to the building for which this certificate is being compieted-see pages 6 and 7. If no diagram
J accurately represents the building,provide a sketch or photograph.)
C3.Elevations-Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(wiUi BFE),AR,AWA,ARIAE,AWA1-A30,ARIAH,AR/AO
Complete Items C3.-a-i below aa;ording to the building diagram specified in Item C2.Sta1e 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 Secfion G,as appropnate,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 � ��+,'.,f , <,:,
o a)Topofbottomfloor(indudingbasementorenclosure) 5.58 F=f ft.(m) � rs'�,`,• �� "`' �`�
o b)Top of next higherfloor 15.12 FT ft.(m) � .1,��`�`,�°}}'" � f
� �
o c)Bottom of lowest honzontal structural member(V zones only) N/A FT ft.(m) N�: �� .'�� �;, ' ` � ; '
o d)attached garage(top of block) 5.58 FT ft.(m) W� ;, v+�.� a � � i�
o e)Lowest eleva6on of machinery and/or equipment -� �' � �
servicing the building(Describe in a Comments area) N/A FT ft.(m) �� � ;t. s' �t ' �,
� � , _� �,.r � ,� �;;'
o fl Lowest adjacent(finished)grade(LAG) 5.0 Ff ft.(m) z� � '�y t : ��, qv` R>
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � � ,,` 04/28Jp$�'� '�
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 10 `-' ' ���i'
J �i }�
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 info
1 ceRify that the information in Sections A,B,and C on fhis cerfificafe represents my best efforfs to interpret the dafa available.
1 undersfand fhat any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Secfion 1001. �nY � 3 ��i 5
CERTIFIER'S NAME LICENSE NUMBER
BRUCEA.KLEIN PLS5052 DEVELOPMENT SVCS
TITLE COMPANYNAME CITY OF CLEARWATER
�'RESIDENT KLEIN&STAUB SURVEYING,INC.
. ADDRESS CITY STATE ZIP CODE
8016 Old County Roa New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
,, 04CZ8/05 (727)834�140
FEMA Form 81-31.Januarv 2003 See reverse side for continuation. Reolaces all�revious editions
IMPORTANT: In these spaces,copy the corresponding information from Section A. For�nsurance Company use:
BUILDIN�STREET ADDRESS(Induding Apt.,Uni�Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
130 Bri htwater Drive, UNIT No.6 " � - .
CRY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 337g7
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) � �
Copy both sides of this Elevation Certficate 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 suppoRing information for a LOMA or LOMR-F,
Secfion 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. It no diagram accurately
represents the buildng,provide a sketch or photograph.)
E2.The top of the bottom floor(induding basement or endasure)of the 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�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 plafform 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 flood depth number is available,is the top of the bottom floor elevated in accordance with the communit�s floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offiaal must cerfify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESEM'ATIVE)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-issued or community-
issued BF�or Zone AO must sign here. The statemenfs in Sections 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 �
cirniqri iRE DATE TELEDL����C
COMMENTS
❑Check here if attachments
SECTION G-COMMUNfTY INFORMATION(OPTIONAL)
The local offiaal who is authorizecJ�;�lar�or ordinance to administer the communitys floodplain management ordinance can complete Sections A,B,C(or E),and G of this Eleva6on
Certificate. Complete ihe appli!;able item(sl and sign below.
G1.�The information in Se�on C was taken fran other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local law to cerfrfyelevatior information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A community offidal�mp!eted Secfion E for a buildng located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The foilan�ng information(items G4-G9)is provided fa community floodplain management purposes.
G4.PERMIT NUMBEft G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
G7.This peRnit has 6een issued fo�:❑New Construdion ❑Substantial Improvement
G8.Elevation of as-builtlowestfloor�irrduding basement)of the building is: _._ft.(m) Datum:_
G9.BFE or(in Zone AO)depth of flQod�ng 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
. • ` � .� �
a
,{�F ,�,y�,��,� �rid•�;£,,.
�4��.� � , �� � CITY OF CLEARWATER
� ���. ,,�, �t� � , �..
�'��° � �` �Y"y DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
� .��
:,.��� �.,�,,�
��;�:�;, _,. "~'''� PosT OFFrcE Box 4748, Cr.�wn�x, Fco�u�n 33758-4748
x MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.FARWATER, FLO�unn 33756
TELErxorrE(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 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 83.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
610. 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)
B12. 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 CeRificate 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(witli 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 tl�e 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) 1 ft.above adjencent grade
i) Total area of all permanent openings(fiood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community O�cial:
��e/evation certificates shall be maintained by the communi!y anU copies with the attachedmemo made available by request
FRANK HIRBAW),MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMGMRLR
PAUL F.G(BSON,COUNCILMEMBBR � CARI.GN A.PG7'ERSEN,COUNCILM6MBER
��EQUAL EMPLOYMEN'I'AND E�FIRMA'I'IVE AC'PION EMPLOYER��