140 BRIGHTWATER DR UNIT 6 �;. „�� l�I l ��� FEDERAL EMERGENCY MANAGEMENT AGENCY
l�� J n� NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
��,, I � Expires December 31, 2005
ELEVATION CERTIFICATE
• Important: Read the instructions on pages 1-7. JOB No.030094.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
HARBORSIDE TOWNHOMES, LLC UNIT No.6
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
140 Brightwater Drive
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Desaiption,etc.)
Lot 6 OF HarborsideTownhomes (P.B.127,Pgs.80-81
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 B2.COUNTY NAME B3.STATE
City Of CI88fW8fBf �Z5O�-0102 PINELLAS FLOR�DA �
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVAT�ON(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth of flooding)
12103C0102G 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 S stem(CBRS area or Otherwise Protected Area(OPA)? ❑Yes �No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIR
C1.Building elevations are based on:�Construction Drawings` Building Under Construction' Finished Const
�A new Elevation Cerfificate will be required when construction of the building is complete.
•C2.Building Diagram Number 7 (Select the building diagram most similar to the building for which this cert�cate is being co -s�s�a�i 71��diagr
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,ARIAE,AWA1-A30,AR/AH,ARIAO EVELOPM ENT SVCS
Complete Items C3.-a-i below according to the building diagram specified in Item C2.State the datum used,If the datum is d' r �tu�� t F ip�.E�
Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use th rovi or t e �
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 � � �,� _ �
o a)Top of bottom floor(including basement or endosure) 5.49 FT ft.(m) � .,�,� �'� � � t�'�" t �
o b)To p of ne�hi gher floor 15.67 . FT ft.(m) � ' * f � '
o c)Bottom of lowest honzontal structural member(V zones onl y) N/A . FT ft.(m) ��� n"��° � � R '
o Cwar ? '�3'� „^g � . � .
o d)attached garage(top of block) 5.49 . FT ft.(m) ��� ::�a, �
o e)Lowest elevation of machinery andlor equipment "'� .� �^� - +�
serviang the building(Descnbe in a Comments area) 11.2 . FT ft.(m) �m y c� /s- � ;.�`
o fl Lowest adjacent(finished)grade(LAG) 5.0 . FT ft.(m) z' d M,a,�� "`'' '� .•, ;°
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) ;:>�Y'r, _ ,:y 0�/.'l�'� �
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 � +�, �� .�€c , �� ,
o i)Total area of all permanent openings(flood vents)in C3.h 1280 sq.in. '`�a.. ,,,
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 information.
I cerfify that the information in Sections A,B,and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
• PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County R 54 New Port Richey FL 34653
SIGNATURE _,, DATE TELEPHONE
05/18/05 (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 Com�any use: � °
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX N0. Policy Number ,�
140 Bri hiwater Drive UNIT No.6 •
�In' 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 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 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(including basement or endosure)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(chedc 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 owner'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 statements in Sections A,8,C,and E are conect 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 oficial wt��is aut:�nzed�y lav,�r orclinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certifcate. Cumpiete the applica;�e item(�)and sign below.
G1.❑Thr.ii�fornation ir Section C was t^ken?rnm other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authonzed by state
or Ir�cal law to cer�i�y ele+�ation ini�ima�on. (Indicate the source and date of the elevation data in the Comments area below,)
G2.0 A community offiaal comple;e+�Sectio;��for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.❑The followino information(Items Gi-G9)is providetl for 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 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 Repiaces all previous editions
l FEDERAL EMERGENCY MANAGEMENT AGENCY
�aGU,�-�lnf ��� NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
,, Expires December 31, 2005
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7. JOB No.030094.2
SECTION A-PROPERTY OWNER INFORMATION Fa Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
HARBORSIDE TOWNHOMES, 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
140 Brightwater Drive
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Desaiption,etc.)
Lot 6 OF Harborside Townhomes (P.B.127,Pgs.80-81
BUILDING USE(e.g.,Residentiai,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 ❑Ofher.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNIY NAME B3.STATE
CI�Of CI88fW8L01' 125096-11a$�-'-- PINELLAS FLORIDA
B4.MAP AND PANEL 87.FIRM PANEL 69.BASE ROOD ELEVATION(S)
NUMBER 65.SUFFIX . INDIX TE EFFECTIVEIREVISED DATE 68.FLOOD ZONE(S) (ZoneAO,use depth of flooding)
12103C010?� G SEPTEMBER93;z'�803 SEPTEMBER 03,2003 AE EL.11.0
610.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 89:❑NGVD 1929 �NAVD 1988 ❑Other(Desaibe):_
B12.Is the building located in a Coastal Bamer Resourc.es System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIR
C1.Building elevations are based on:❑Construction Drav�ings' Building Under Construction' Finished Cons
'A new Elevation Certificate will be required when construction of the building is complete.
•C2.Building Diagram Number 7 (Select the building diagram most similar to the building for which this certificate is being co -s�s�a�i 7��dag
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,AWAE,AR/A1-A30,AWAH,ARIA EV E LO P M E NT SV CS
Complete Items C3.-a-i below aa:ording to the building diagram specified in Item C2.State the datum used.If the datum is d' r �u�����F �.r�R
Section B,conveR the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use th ov� or th e f
Secfion 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 bottan floor(induding basement or endosure) 5.49 FT ft.(m) �
o b)Top of next higherfloor 15.67 . FT ft.(m) `�
o c)Bottom of lowest honzontal stnictural member(V zones only) NIA . FT ft.(m) �:�_ I �� ��
��`.
o d)attached garage(top of block) 5.49 . FT ft.(m) �� . -
o e)Lowest elevation of machinery and/or equipment W��' °
serviang the building(Describe in a Comments area) 11.2 . FT ft.(m) �c - � `
o fl L o w e s t a d j a c e n t(fi n i s h e d)g r a d e(L A G) 5.0 . F T ft.(m) z�� �
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � 05/1$(05
o h)No.of permanent openings(flood vents)uvithin 1 ft.above adjacent grade 14 � -
o i)Total area of all permanent openings(flood vents)in C3.h 1280 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 information.
1 certify that the information in Sections A,B,and C on this ceRificate represents my best efforfs to inferpret the data available.
1 undersfand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County R 54 New Port Richey FL 34653
SIGNATURE _., DATE TELEPHONE
05118/05 (72�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: ' ' J
BUILDING STREET ADDRESS(Induding Apt,Unik Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX N0. Polic,y Number �
140 Bri htwater Drive UNIT No.6 r
CITY STATE ZIP CODE Company NAIC Number
CLEARWATER FLORIDA 33767
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 Certi6cate 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 canpleted—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 endosure)of the building is _ft.(m)_in.(cm)❑above or ❑below(chedc one)the highest adjacent grade. (Use
natural grade,'rf available).
E3.For Building Diagrams 6�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 plafform of machinery andlor equipment servidng 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 availabie,is the top of the bottom floor elevated in accordance with the communitys floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local official must oertify this information in Section 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 statemer�s in Sections A,8,C,and E are corred to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CIIY STATE ZJP CODE �
CIrNATI IRF f1ATF TFI FPHQNF
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local offia�wh�is auti:�nzed by lav,�r ordinance to administer the communit�s floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificaie. Compiete the applica�le item(��and sign below.
G1.❑The ir�orm�tion ir Section C was:�ken rrnrn other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or Ixal law to certify elevztion in�orma5on. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A community offiaal comple;ed Sectic��E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.❑The followi�o information(Items C}S�9)is provided for 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.Elevation of as-built lowest 800r(induding 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
i
�� � �My` CITY OF CLEARWATER
� » 4
�r� . .
� �� �� .
DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
; POST�FFICE BOX 474g� CI.FARWATER� FLO�DA 33758-4748
MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�unn 33756
TEi.ErxorrE(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 Bidg.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 62.COUNTY NAME 63.STATE
City of Clearwater 125096
64.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER g5.SUFFIX 66.FIRM INDEX DATE EFFECTIVE/REVISED DATE B$•FLOOD ZONE(S) �Zone AO,use depth of flooding)
12103C-0102 5/17/2005
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 buildin located in a Coastal Barrier Resources S stem(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.
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:
�evation ce�tificates shall be maintained by the community and copies with the attached memo made availab/e by request
FRANK H[BRARD,MAYOR
GEORGE N.CRE'1'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBER
PAUL F.GIfiSON,COUNCILMEMBER � CARLEN A.PE1'ERSEN,COUNCILMEMAGR
��EQUAL EMYLOYMEN'1'AND Af�FIKMATIVE ACTION EMPLOYER�
��GP ZD�3 '«��� FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM
Expires December 31, 2005
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7. JOB No.030094.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
HARBORSIDE TOWNHOMES, LLC UNIT No.6
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
140 Brightwater Drive
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number,Legai Description,etc.)
Lot 6 OF Harborside Townhomes (P.B.127,Pgs.80-81
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 63.STATE
City of Clearwater 125096 PINELLAS FLORIDA
64.MAP AND PANEL B;.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE 68.FLOOD ZONE(S) (Zone A0,use depth of Booding)
125096-0102 G SEPTEMBER 03,2003 SEP"fEMBER 03,2003 AE EL.11.0
610,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 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' inished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2.Builtling Diagram Number 7 (Select the building diagram most similar to the building for which this certificate is being completetl-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 tlatum 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 tlocument 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 � . �a}� ;>�.T� � ,f ,:
o a)Top of bottom floor(including basement or endosure) 5.49 . FT ft.(m) � '������ �_* � , �a�,�;
J •
o b)Top of ne�higher floor 15.67 . FT ft.(m) "�
� 'd ,°�<.
o c)Bottom of lowest horizontal structural member(V zones only) NIA FT ft.(m) o o , � 0-- �� � _ _
o d)attached gara ge(to p of block) 5.49 FT ft.(m) �� „ ° '--.� � c�
o e)Lowest elevation of machinery and/or equipment W� ;�J •� .
servicin the buildin Descnbe in a Comments area 11.2 . Ff ft.m � � ' i' ~ /. �q �
9 9� ) � ) �� •.�. ,.
o fl Lowest adjacent(finished)grade(LAG) 5.0 . Ff ft.(m) �z'� ,�� � ' ,��`' ' "° �1s'•,,�
o g)Highest adjacent(finished)grade(HAG) 5.1 FT ft.(m) � �, ,,,r^f?,�'•,D�/1 C/A`�t_��
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 ; ' � "� �'' S
o i)Total area of all permanent openings(flood vents)in C3.h 1280 sq.in. "ti=..<.,.
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 information.
1 cerfify that the information in Secfions A,B,and C on this certificate represents my best efforfs to interpret fhe data available.
1 undersfand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEIN PLS 5052
TITLE COMPANY NAME
PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County, d 54 New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
_ 08/16/04 (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 com�any use: ' ' '
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Policy Number
140 Bri htwater Drive UNIT No.6
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
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 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 enclosure)of the builtling is _ft.(m)_in.(cm)❑above or ❑below(check one)the highest adjacent grade. (Use
natural grade,if available).
E3.For Builtling Diagrams 6�with openings(see page 7),the next higher floor or elevated floer(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 representative who completes Sections A,B,C(Items C3.h antl 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 corrnct 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 loca!offcial who i�auth���zed by law or or�inance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certifcate. Complete the apolicable item(s)and sign below.
G1.�The informatiun 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 state
or local law tc certrf��eleva��ori infc-rn�tion. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A commu��ity official compie[ed Se�;tion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.❑The following information(!tei��s G4-G9)is provided for 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 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