130 BRIGHTWATER DR UNIT 8 . , ' �, FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM
Expires December 31, 2005
; ��,.�3-dJa 3� 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.8
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 8
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 ##.�°) ❑ NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME 8�COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
City of Clearwater 125096 PINELLAS FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX 66.FIRM INDEX DATE EFFECTIVEIREVISED DATE 68.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 FIoa1 Elevation(BFE)data or base flood depth entered in 69.
❑FIS Prof le �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 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 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 photo�raph.)
C3.Elevations—Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,AR/AE,AWA1-A30,AWAH,AWAO
Complete Items C3.-a-i below according to the building diagram specified in Item C2.State the tlatum 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 ConversionlComments N/A ''
«�.
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � _•a 1 ��, j';.�
o a)Top of bottom floor(including basement or enclosure) 5.58 FT ft.(m) � - ����� �� � -
� "".
o b To of next hi herfloor 15.12 FT ft.m `� �i� �
) P 9 � � � �; �,�;" `'
o c)6ottom of lowest horizontal struc[ural member(V zones onlyj N�A rT ft.(m) ti@ 'y '�,� �.� '
0 0 - i
o d)attached garage(top of block) 5.58 FT ft.(m) �� � •� � �r
o e}Lowest elevation of machinery and/or equipment � �; � �cs. �.
servicing the building(Descnbe in a Comments area) N/A . FT ft.(m) � � ,` "�� , � � ,���`�
o �Lowest adjacent(fnished)grade(LAG) 5.0 . FT ft.(m) z� � ��- �"h t `
� � ": :
o g)Highest adjacent(fnishetl)grade(HAG) 5.1 FT ft.(m) � �'' �^� �'°0��
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 infor n
I certify that the informafion in Sections A, B,and C on this cerfificate represents my best efforfs fo inferpref the data available.
I understand that any false stafement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001, ����� �QQS
CERTIFIER'S NAME LICENSE NUMBER
BRUCEA.KLEIN PLS5052 �cvc� n�nncnrr vUCS
TITLE COMPANY NAME
�RESIDENT KLEIN&STAUBSURVEYING,�NC, CITY �F CLFARWATER
ADDRESS CITY STATE ZIP CODE
8016 Old County Ro New PoR 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�nsurance Compa� e:_' , _
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Poiicy Number
130 Bri htwater Drive, UNIT No.8
�� STATE ZIP CODE Company NAIC Number �
CLEARWATER FLORIDA 33767
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) •
Copy both sitles of this Elevation Certificate for(1)community officiai,(2)insurance agenUcompany,antl(3)builtling 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 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 buiiding,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 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�.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorized representafive 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 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
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local ofr�cial whu is auti�onzed rv law or ordinance to adminisier 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)and sign below.
G1.�The information 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 la;al law to ceri;fiy elevation in�ormation. Qndicate the source and date of the elevation data in the Comments area below.)
G2.�A comrnunity official cornpleted Seclion E for a building located in Zone A(without a FEMA-issued or community-issuetl BFE)or Zone A0.
G3.❑The following information�li��ms G4-G9)is provided for community floodplain management purposes.
CG4.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
Expires December 31, 2005
,��. Y�Y�3-DJa 3� ELEVATION CERTIFICATE
��-���,"
� Important: Read the instructions on pages 1-7. JOB No.020308.9
SECTION A-PROPERTY OWNER INFORMATION For lnsurance Company Use:
BUILDING OWNER'S NAME Policy Number
BRIGHTWATER COVE, LLC. UNIT No.8
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 8
C�N STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcei 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
IATITUDE/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 COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME 63.STATE
City of Clearwater 125096 PINELLAS FLORIDA
64.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/f2EVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depih of fboding)
G SEPTEMBER 03,2b03 SEPTEMBER 03,2003 AE EL 11.0
B10.Indicate the sour�of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe):_
B11.Indicate the eleva6on datum used for the BFE in B9:�NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.ls the building located in a Coastal Bamer Resourczs 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 most similar to the building for which this cert�cate is being completed-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(v✓ith BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,AR/A1-A30,AR/AH,AWAO
Complete Items C3.-a-i below according to the buiiding diagram spec�ed 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 ConversionlComments N/A
Elevation reference mark used LABINS EL.=4.191 Does the elevation reference mark used appear on the FIRM? ❑Yes � 3;.�"<� 1. ,; • ' +r
o a)Top of bottom floor(induding basement or endosure) 5.58 . FT ft.(m) � !��. •` , ' �,. - �
o b)Top of next higherfloor 15.12 FT ft.(m) � � 1�,•''•�, i��`� � ' "�
o c)Bottom of lowest horizontal structural member(V zones only) N/A . FT ft.(m) o o $ i`;� � �r y r ` r� ,��
o d)attached garage(top of biock) 5.58 . FT ft.(m) ��,, °�' � w' ¢. �
o e)Lowest elevation of machinery and/or equipment W;' 9 'f ' �. -
servicing the building(Describe in a Comments area) N/A . FT ft.(m) �� ', '."' ' �+ t��
o fl Lowest adjacent(finished)grade(LAG) 5.0 . FT ft.(m) z� ,V 3„ � ' �, ���s��
o g)Highest adjacent(fi�ished)grade(HAG) 5.1 Fi fl.(m) J �,�'�'� �3 0���/���+ :
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 infor n
I cerfify that the information in Sections A,B,and C on this cerfificate represents my best efforfs fo inferpret the data available,
1 understand that any false statement may be punishable by fine or imprrsonment under 18 U.S. Code,Section 1001. ��y �
CERTIFIER'S NAME LICENSE NUMBER ��-°-��
BRUCEA.KLEIN PLS5052 �c�ici /"1��ACAIT �VCS
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUBSURVEYING,wc. CITY 4F CLEARWATER
• ADDRESS CITY STATE ZIP CODE
8016 Old Counry Ro New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
. 04C18/05 (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�nsurance comPany use: , �� . .
BUILDING STREET ADDRESS(Induding Apt,Unrf,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX N0. Polic,y Number �
130 Bri htwater Drive, UNIT No.8
�m' STATE ZIP CODE Company NAIC Number r
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. l
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 Cerfificate 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 certificale 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(indu�ng basement or endosure}of the building is _ft.(m)_in.(cm)❑above or ❑below(chedc one)the highest adjacent grade. (Use
natural grade,'rfavailable).
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 plafform of machinery and/or equipment senriang 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 bottom floor elevated in accorciance with the communit�s floalplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must cerfify 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 BF�or Zone AO must sign here. The stafemenfs in Sections A,B,C,and E are correct fo the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME J
ADDRESS CITY STATE ZIP CODE
` �
SIrR,q?L�RE QP,?E TELEPNONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL}
The local offiaal who is aut�onzed Gy law or ordinance to administer the communitys floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. Complete ihe appiicable item(s)and sign below.
G1.�The inform2iion in Section C was taken from other documentation that has been signed and embassed by a licensed surveyor,engineer,or architect who is authorized by state
or tocal law to cen,`�y_elevation in�oTnation. (Indicate the source and date of the elevation data in the Comments area below.j
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(It�ns G4-G9)is provided fa community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued for.�New Construction ❑Substantial Improvement
G8.Elevation of as�built[owestfloor(induding basement)of the building is: _._ft.(m) Datum:_
G9rBFE or(in Zone AO)depth af 800ding at the�ilding site is: __ft.(m) Datum:_
LOCAL OFFICIAL'S NAME � � TITLE
COMMUNITY NAME - TEL,EPHONE
SIGNATURE � - DATE �
COMMENTS .
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
, . `. .+�r-
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�Y� �```� °���� CITY OF CLEARWATER
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���a ���; DEVELOPMENT & NEIGHBORHOdD SERVICES DEPARTMENT
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�� � POST�FFICE BOX 474g� CLEARWATER� FLOa�DA 33758-4748
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4���*, �g� MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.EARWATER, FLORIDA 3375�
TELEPHONE �7Z� 562-4567 F�(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 ceRificates 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,Legai 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 B3.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
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)
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. Buiiding Diagram Number (Select tlie 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 equiprnent 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(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�levation certificates shall be maintained by the communi!,and copies with the attached memo made availab/e by request
FRANK HIBAARD,MAYOR
GEORGE N.CRE"1'EKOS,COUNCILMEMA[R JOIIN DORAN,COUNC[LMEMBER
PAUL F.GIBSON,COUNCILMEMBER � CARLEN A.PE1'ERSEN,COUNCIIMEMAER
��EQUAL EMYLOYMENT AND AFFIWNA"PIVE AC'1'ION EMPLOYER��