161 BRIGHTWATER DR UNIT 5 � � �-�'!"" .�I��'�
�. r,,,,,. FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
� � f:�� ...} NATIONAL FLOOD INSURANCE PROGRAM
J'��' �o"':�i���„t'�' Expires December 31, 2005
, � ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7. JOB No.020024.2
SECTION A-PROPERTY OWNER INFORMATION Forinsurance Company Use:
BUILDING OWNER'S NAME Policy Number
CLEARWATERTOWNHOMES, INC. UNIT No.5
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
161 BRIGHTWATER DRIVE
CITY STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 5, ISLAND TOWNHOMES Plat Book 127,Pages 46-47
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):
( ##°-##'-#f#.##" or ##.#�###°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMAT�ON
B1.NFIP COMMUNfTY NAME&CAMMUNITY NUMBER 62.COUNTY NAME B3.STATE
City of Clearwater 125096-0102-G 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 deplh 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 69.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Desaibe):
611.Indicate the elevation datum used for the 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 Certificate will be required when cbnsUuction of the building is complete.
�;2.Builtling 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 photograph,)
C3.Elevations-Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AWA,AWAE,AWA1-A30,AWAH,AWAO
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 fo�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. �'.' �
..�..4.A4Aii4� •:cv.N .
Datum NAVD 1988 ConversionlComments NIA A�
Elevation reference mark used LP-15, EL.=4.191 Dces the elevation reference mark used appear on the FIRM? ❑Yes �No � ��4�e#�x�� II¢f �
o a)Top of bottom floor(induding basement or endasure) 5.50 . FT ft.(m) � ,� �� � _,�- �'
� � -,.� 0i ,s._� .k.;�.. ei�i✓ t�:•
o b)Top of next higher floor 15.67 . FT ft.(m) �.�° . '� ,"° �; •
,� ��'�e-, �a .�- ��.. ,
o c)Bottom of lowest honzontal structural member(V zones only) N/A FT ft.(m) ;o�`' v�' t�. w� � , .
o d)attached garage(top of block) 5.50 . FT ft.(m) �� �^� ;�, ., �'; ."�'., fi
o e)Lowest elevation of machinery andlor equipment ,W� . %• ��X = ��;,,� .
serviang the building(ELEVATOR EQUIPMENT) N/A . FT ft.(m) '�� `* :. ,�;� ' �y�,�
o fl Lowest adjacent(finished)grade(LAG) 4.2 . FT ft.(m) ��P�` � ��LS 5*Q5';�� -
o g)Highest adjacent(finished)grade(HAG) 5.1 . FT ft.(m) � ' �0� ••'[�'�'�a -
rt. -
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 � �%r�A� � ;�� •
o i)Total area of all permanent openings(floal 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 certify that the information in Sections A,8,and C on fhis certificate represents my besf effo�ts to interpref 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.KLEW PLS 5052
TITLE COMPANY NAME
- PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old Coun 54 New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
.. 08/14/05 (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.,Uni�Suite,andlor Bidg.No.)OR P.O.ROUTE AND BOX N0. Policy Number � �
161 BRIGHTWATER DRIVE UNIT No.5 -r '
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 offiaal,(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 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(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 platform of machinery andlor equipment serviang 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 offiaal must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The properry 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�ssued or community-
issued BFE)or Zone AO must sign here. The stafemenfs in Sections A,8,C,and E are corr�ct fo 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
,� 0 ,� SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local o�iraal who is auU�onzed by lauu�r ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Cer6ficate.Cornplete the applicccle itemrs)an�sign below.
G1.❑The inf�r,�ation in,Section C w etaken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state
or local la�to ce,*�fy e�evatio��jnformation. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A cornmunity offiaal completed S�;ti�n�for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.�The follrnuing irafo�ation(Itern:.G�-G�)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(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:_
LOCALOFFICIAL'SNAME c°���-`��°��°���� � TITLE
�, �s� -h
COMMUNITY NAME �,, p�M�''�::�'"�" TELEPHONE
SIGNATURE �`�;� �.,,�i 1 � ��R!�� DATE �
COMMENTS �
� ��`�-=�'���-°��-1�C-
�K: w �
� ��:-�;°-��T�F��f�TER
..��..
❑Chedc here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
C �� � '� r � FEDERAL EMERGENCY MANAGEMENT AGENCY
� � '�
� � � ''� NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
�a x ;�`=''�"�,�����r'� '` ° � Expires December 31, 2005
,
• ' ' ' ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7. JOB No.020024.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
CLEARWATER TOWNHOMES, INC. UNIT No.5
BUILDING STREET ADDRESS(Induding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. Company NAIC Number
161 BRIGHTWATER DRIVE
CITY STATE ZIP CADE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 5, ISLAND TOWNHOMES Plat Book 127,Pages 46-47
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):
( ##°-##'-##.#1#" or ##.#�#i#°) ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NFIP COMMUNIlY NAME&COMMUNITY NUMBER B2.COUNTY NAME 63.STATE
City of Clearwater 125096-649�" PINELLAS FLORIDA
84.MAP AND PANEL �j / � 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6. RM IN EX D TE EFFECTIVEIREVISED DATE 68.FLOOD ZONE(S) (Zone A0,use depth of fboding)
12103C010 � , SEPTEMBER 03,2IX13 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):_
611.Indicate the elevation datum used for the BFE in B9:�NGVD 1929 �NAVD 1988 ❑Other(Describe):_
B12.Is the building located in a Coastal Barrier Resources System(CBRS)area a Otherwise Protected Area(OPA)? ❑Yes �No Designation Date
SECTION C-BUILDING ELEVATtQN INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Constructi�Drawings" ❑Building Under Construction' �Finished Construction
`A new ElevaGon 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 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,ARIA,ARIAE,AR/A1 A30,ARIAH,AWAO
Complete Items C3.-a-i below according to the building diagram speafied 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
Sec6on D or Section G,as appropriate,to document the datum conversion.
. _. . :
Datum NAVD 1988 ConversionlComments NIA
Elevation reference mark used LP-15, EL.=4.191 Dces the elevation reference ma�C used appear on the FIRM? ❑Yes �No
o a)Top of bottom floor(induding basement or endosure) 5.50 . FT ft.(m) �
o b)Top of next higher floor 15.67 . FT ft.(m) �
o c)Bottom of lowest honzontal structural member(V zones only) N/A . FT ft.(m) ,.o� : . �
o d)attached garage(top of block) 5.50 . FT ft.(m) W� �. `�
o e)Lowest elevation of machinery and/or equipment �,
seNian the buildin ELEVATOR EQUIPMEN N/A . FT ft.m � � � .
9 9� � � ) `�� � � ,
o fl Lowest adjacent(finished)grade(LAG) 4.2 . Ft� ft.(m) z'� `' `� PLS��5Q5� '
o g)Highest adjacent(finished)grade(HAG) 5.1 . FT ft.(m) � � ` �1 Q��i 4/p�
o h)No.of permanent openings(flood vents)within 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 certificate represenfs my best efforts to interpret the data available.
1 undersfand that any false statement may 6e punishable 6y fine or imprisonmenf under 18 U.S.Code,Secfion 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 Coun 54 N�Port Richey FL 34653
SIGNATURE DATE TELEFHONE
.. 08114I05 (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 insuranoe comPany use:
BUILDiNG STREET ADDRESS(Induding Apt,Uni�Sufle,and/or Bidg.No.)OR P.O.ROUTE AND BOX N0. Polic,y Number � ,
161 BRIGHTWATER 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 Certificate for(1)commun'�y oifiaal,(2)insurance agent/company,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 ihis 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 endosure)of the building is _ft.(m)_in.(cm)0 above or ❑below(check 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. Compiete items C3.h and C3.i on front of form.
E4.The top of the platform of machinery andlor equipment serviang 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 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 stafements in Sections 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 •
SIGNATURE DATE TELEPHONE
COMMENTS
❑Check here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local o�i�al who is auU�onzer'by law.er ordinan,e to administer the communitys floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificate. �ornplete the applic�:i�e item�sl and sign below.
G1.❑The infor„�ation in Section C was taken from other documentation that has been signed and embossed by a licensed suroeyor,engineer,or architect who is authorized by state
or Iocai law to ce:5fy e;e��atio;�informati��n. (Indicate the source and date of the elevation data in the Comments area below.)
G2.�A cornmunity offiaat completed S�;tibn E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0.
G3.❑The following in�r�ation(Itern,.i.�1-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 baserr�nt)of the building is: _._ft.(m) Datum:_
G9.BFE or(in Zone AO)depth of flooding at the buiiding site is: _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME �-°-t,�'���� k; �= TITLE
'"'` ;�' �° ��r�� �,
COMMUNITY NAME .�_r�` � ��°w�"°�`� „,� ;� TELEPHONE
SIGNATURE �`� r,��# � 4f ����� DATE
COMMENTS .�� •
�,� .� .F r f�''
�-:�, �.: ;:��� k r e���'�
�::
,_ .�,� �����,��°i'��
:.,�a �
❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
i A
� � ��Nf
�$� c�� CITY OF CLEARWATER
� v ,�I�, �
r�— = �py DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT
99 � `o` POST OFFICE BOX 474H� CLFARWATER� F�o�Dn 33758-4748
�'ATER�v MUNICIPAL SERVICES BUILDING, 100 Sov'rx MYtt�AvErruE,CI.EARWATER,FLO�u�A 33756
TELEPHONE�/2� S6Z-4S67 F.vc(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 63.STATE
City of Clearwater-125096
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 AO,use depth of flooding)
12103C0102 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)
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 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,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 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:
dl�alevation certificates shall be maintained by the community and coPies with the atfached memo made availa6/e 6y request
•
Fwwx H[ssa,xn,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMEMAER JOI IN DORAN,COUNCILMEMBER
PAUL F.GIBSON,COUNCILMEMBER � CARLEN A.PE7'ERSEN,COUNCILMEMBER
��EQUAL EMPLOYMENT AND AFFIRMATIVE ACTION EMPLOYER��
_ _ ,.
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
� ' w\�' ��� Expires December 31, 2005
� ELEVATION CERTIFICATE
�SSI�o
Important: Read the instructions on pages 1-7. JOB No.020024.2
SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
• BUILDING OWNER'S NAME Policy Number
CLEARWATER TOWNHOMES, INC. UNIT No.5
BUILDING STREET ADDRESS(InGuding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
161 BRIGHTWATER DRIVE
C�Ty STATE ZIP CODE
CLEARWATER FLORIDA 33767
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number,Legal Desaiption,etc.)
LOT 5, ISLAND TOWNHOMES Plat Book 127,Pages 4647
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 PINELIAS FLORIDA
B4.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX B6.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD 20NE(S) (Zone A0,use depth of flooding)
125096-0102 G SEPTEMBER 03,2003 SEPTEMBER 03,2003 AE EL.11.0
B10.Indicate the source of the B�e 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.Buiiding elevations are based on:0 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 photograph.)
C3.Elevations—Zones A1-A30,AE,AH,A(vvith BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARIAE,ARIA1-A30,ARIAH,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
Secbon D or Section G,as appropnate,to document the datum conversion. ;
Datum NAVD 1988 ConversionlComments NIA .
Elevation reference mark used LP-15, EL.=4.191 Dces the elevation reference mark used appear on the FIRM? ❑Yes �No �,��,��,�� �+
o a)Top of bottom floor(induding basement or endosure) 5.50 . FT ft.(m) � �,���.,., .,,��%,.ti
o b)Top of next higher floor 15.67 . FT ft.(m) �, r`�✓�' " �•,"� `
o c)Bottom of lowest honzontal structural member(V zones only) N/A . FT ft.(m) N�.r �.. ;°��, cti1 �4 y " �
o d)attached garage(top of biock) 5.50 . FT ft.m ��' � � T ' � ��
� ) E c' v ;� ....0 �.5
o e)Lowest elevation of machinery and/or equipment � �;� • �'{{ ` �, , �:
serviang the building(ELEVATOR EQUIPMENT) N/A . F=f ft.(m) �� ;� s�;" }`�,. a,,; � '
o fl Lowest adjacent(finished)grade(LAG) 4.2 . FT ft.(m) z�'� �� � ��� � �~;•'� '
o g)Highest adjacent(finished)grade(HAG) 5.1 . Ff ft.(m) � `,� .�t.�•,,08/12/��0���
o h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 14 � " �
o i)Total area of all permanent openings(flood vents)in C3.h 1280 sq.in. `��„�s 4�. ,..•
SECTION D-SURVEYOR,ENGINEER,OR ARCHfTECT CERTIFICATION " :��
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
I ceRify that the information in Sections A,B,and C on this certificate represents my besf effoRs to interpret the dafa available.
I undersfand that any false stafement may be punishable by fine orimprisonment under 18 U.S. Code,Section 1001.
CERTIFIER'S NAME LICENSE NUMBER
BRUCE A.KLEW PLS 5052
TITLE COMPANY NAME
.� PRESIDENT KLEIN&STAUB SURVEYING,INC.
ADDRESS CITY STATE ZIP CODE
8016 Old County Road 54 New Port Richey FL 34653
SIGNATURE DATE TELEPHONE
� 08112104 (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 com�any use:
BUILDING STREET ADDRESS(Induding Apt,Uni�Suite,and/or BkJg.No.)OR P.O.ROUTE AND BOX N0. Polic,y Number' ` ,
161 BRIGHTWATER DRIVE UNIT No.5 • , ,
�� 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 agenVcompany,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.Buitding 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 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 6-8 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 andlor equipment seroiang the building is _ft.(m)_in.(cm)❑above or ❑below(chec{c 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 communitys 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�ssued or community-
issued BFE)or Zone AO must sign here. The statemenfs 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 loca'official who is?uthorzed by!aw or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation
Certificat�. Camplete the appiirable item(s)and sign below.
G1.�The intormation 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 loczl law to ceR'rfy elevatic�,information. (Indicate the source and date of the elevation data in the Comments area below.)
G2.❑A community offiaal com�let�d Se�ian 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 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(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 ��
❑Chedc here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions