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162 DEVON DR n .�,; 7 ,_,.-,�:1 q� `�--�=� ��l °�� L'�`� � �� . F�DERAL EMERGENCY MANAGEMENT AGENCY O.M.B.No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 . ELEVATION CERTIFICATE Im ortant: Read the instructions on a es 1 -7. SECTION A-PROPERTY OWNER INFORMATION Fwr I�urahc��annpan 4Js�; BUILDING OWNER'S NAME -: �Qi.r.�:�uw.. .....::�:::::::.:::::::::::::::::.::::::::::::::::::: 01- L u/Z 61�h1 � L► PP O _� ....mb�r:::-:::::::::::::::-::-:::::::::::::::::::::::::::::::::::::::: BUILD ING 5T _................_.................._......................................,..... ;::::::;:._.::::::::::::::.::::::::::::::::::.:s:_::::::::::::::::::::.=:::::::::::::::::::: R ETADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. ;;:�om:��Y::NAIG.Nur�iber�:::::::::=�:::: :::�:::::::: 1�Z DE�/on.► Dr�ivE _........................_._.._...................................:..:.._.......... ...._....._....... cir�r -:.......::::::::_:::::::-_ :::::::::::::::::::::-::::::-:::-::::,:::::--::::::::::- _............_..:.......:.._:........_:_....::.._..::...:.. .... .. . .. LE�(� �"("�,� E (' ZIP CODE 33 � 7-� ' 7 7 PROPERTY DESCRIPTION(Lo and Block N mbers,Tax Parcel Number,Legal Description,etc.) C, 4S_ bf� 1.07' zc� � y�, 35' l�T 2� , (Z�P�/�T o�. BA`(��D,E SuBr>>vis �o�.l BUILDWG USE e g Residen8al,Non-residential,Addition,A cessory,etc. Use a Comments erea,If necessary.) R��n�T�,4 V LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: ( ##°-##'-##.##" or ##.###�#°) �_�NAD 1927 �_�NAD 1983 SOURCE: �_�GPS(TYPe):_ .__r �_�USGS puad Map �_�Other ____'— ___ SECTION B-FLOOD INSURANCE RAT�MAP(FIRM)INFORMA710N 61.NFIP COMMUNITY NAME 8-COMMUNITY NUMBER g2.COUNN NAME 83.STATE ��E�RwaT�r� / �2509� ��NE�y-�S �C., B4.MAP AND PANEL B5.SUFFIX 66.FIRM INDEX B7.FIRM PANEL Be.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBEf2 DATE EFFEC7IVE/REVISED DATE ZONE S �21��j G D I OZ. � �-03_o?� ,� �,� O (Zone AO,use depth of flooding) �- 3` AE 11..a' 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 ihe elevation datum used for the BFE in B9:�__�NGVD 1929 �NAVD 1988 �__�Other(Describe):____ � 812, Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? �_�Yes � �No Qesignation Date:_____ SECTION C-BUILDING ELEVATIOfV INFORMATION(SURVEY REQUIREQ) C1. Building elevations are based on: �__�Construct(on Drawings' �__�Building Und�r CQnstruction' ��Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number��(Select the building diagram most similar to the building for which this ceRificate is being completed-see pages 6 and 7. if no diagram accurately represents the building,provide a sketch or phatograph.) 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 diffarent from the datum used for the BFE in Section B,conve�t the datum to that used for khe BFE.Show field measurements and daturn conversion calculation. Use the space provided or the Comments area of Section D qr Section G,as apprapriate,to dncument the datum conversion. Datum�1�VQ�� Conversion/Comments__ '�'79� C-sVD 19�-9 Tti �AVP � B8 �---- --�--------------�— Elevation reference mark used_�I��0.$N]_.,_[�Z Does the elevation refer nce mark used appear on the FIRM1 �__�Yes �,� No 0 a)7op of bottom floor(including basement or enclosure) ______ �,�_�,�m� � ❑ b)Top of next higher floor ��,o_ft.(m) � ❑ c)Bottom of lowest horizontal structural membar(V zones only) ____A _, ft.(m) �� L.S. 4� .�937 ❑ d)A t t a c h e d g a r a g e(t op o f s la b) __�•_B ft.(m) E� ,,. O e)Lowest elevation of machinery and/or equipment W � � �� ' servicing the building(Describe in a Comments area.) _____�_ � �, m d � � � � �� -zr-�4 ❑ fl Lowest adjacent(finished)grade(LAG) _, I _ff,�m� Z� O g)Highest adjacent(finished)grade(HAG) ,�ft.(m) �y 0 hj No.of permanent openings(flood vents)within 1 ft.above adjacent grade 2�,__ � ❑ i)Total area of all permanent openings(flood vents)in C3.h Z�O�� sq,in.(sq.cm) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERtIFICATION This certification is to be signed and sealed by a land surveyor,engineer,nr architect authorized by law to certify elevation information. I certify fhat fhe informatipn in Secfions A,B,and C on fhis certificate represenfs my best efforts fo interpref fhe data available, 1 undersfand fhat any false stafement may be punishable by fine or imprisonment under 18 U S Code, SecBon 1001 CERTIFIER S NAME LICENSE NUMBER Larry L. Evans - L.S. �� 2937 TITLE surveyor COMPANY NAME Evans Land Surveying, Inc. ADDRESS 1460 Beltrees Street, Ste. 9 CITY Dunedin, 3TATE F . ZIPCOD� 34698 SIGNATURE - DATE TELEPHONE a �a-2�-o� (727) 734-3821 FEMA Form 81-31, �nu 2003 See reverse side for continuation. Replaces all pravious editions IMPORTANT: In 4hese spaces, copy the corresponding informatiqn from Section A. F.ar Insuca�ce Co[npa�Use BUILDING STREET ADDRESS Qnciuding Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Pollcy I�umber CITY STATE ZIP CODE Gnmpany;NlalC Numis�r SECTION D-SURVEYOR,ENGINEER,bR ARCHITECT CERTIFICAtION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community o�cial,(2)insu�ance agenUcompany,and(3)building owner. COMMENTS _ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZON�AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(without BFE),complete items E1,through E5. If the Elevation Certfft�ate is intended for use as supportfng information for a LOMA or LOMR-F,Section C must be completed. E1. Building Diagr�m Number____(Select the building diagram most similar to the building for which thls 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)I--I--I 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 I--I--I ft•�m)I--I--Iin.(cm)above ths highast adjacent grade. Complete Itsms C3.h and C3.i on front of fOrm. E�.The top of the platform of machinery and/or equipment serviCing the building(s �__I--I ft•�m)I--I--I in.(cm)�__�above or�__�below (check one)the highest adjacent grade. (Use naturat 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 menaqement ordinance?I I Yes I__I No � �Unknown The Iocal official must certifv this information in Section(i. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFIC�►TIpN —^ �----T The property owner or owner's authorized representative who completes Sections A,B,C(Items C3.h and C3.i only),and E far Zone A (without a FEMA-issued or community-issued BF�)or Zone AO must sign here. The statements in Sections A,B, C,end E are correct to the best of my knowled e. PROPERTY OWNER 3 OR OWNER 5 AUTHORIZ�D REPRESENTATIVE S NAME ADDRESB CITY STA7E �IP CODE SIGNATURE DATE TELEPHONE COMMENTS Check here(f attachments S�CTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinanae to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certiflcate. Complete the applicable 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 local law to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.) G2. �__� A community oificiai completed Section�for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zane AO. G3.�__�Tne following information(Items G4-G9)is provided for 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 towest flaor(including basementj of the building is: __ft.(m) Datum: G9.BFE or(in Znne AO)depth of flooding at the building site is: _�_____ __ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS -- - I I Check here ii attachments FEMA Form 81-31,January 2003 Replaces all previous editions �} ,�� %,�:r? �^-�'✓ ? _--,��=`-� � � FEDERAL EMERGENCY NiANAGEMENT AGENCY <ff� NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 � � � `r� ELEVATION CEfiTIFICATE EXpires oecembe�s�, 2oos , ,�,, ' � Ct" � � Im ortant: Read the instructions on a es 1 -7. SECTION A-PROPER7Y OWNER INFORMATION Fo�.lnsu�ance Com�any us�' BUILDING OWNER'S NAME —s�0�-�tJ � L�U IZ/-� G I/�IJ-F�L I PP 0 Policy Numtit�r ; BUILDING STREET ADDRESS(Including Apt.,Unit,Suife,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. G�mpany hIA�C Nurri[�r 1�Z DE�/on.r D�iv� ,. CITMCLE/�R W�T�P-� STATE �L ZIPCODE 33 � PROPERTY DESCRIPTION(Lo and Block Numbers,Tax Parcel Number,Legal Description,etc.) 7 � C, 45 ' o-F I,o7' zc� � V�/, 35' �-1" z� �EP��T o�- BAY��D�. S�gt�avi$ �o�.l BUILDING USE(e g Residential Non-residential,Addition,AccessoryJetc. Use a Comments area,if necessary.) (�E�I D�NT1,41,- LATITUDElLONGITUb�(OPTIONAL.) HORIZONTAL DATUM: ( ##°-##'-##.##" or ##.##t�#°) �_�NAD 1927 �_�NAD 1983 SOURCE: �_�GPS(TYPe):--------------- �._�USGS Quad Map �_�Other ____`____ SECTION B-FLOOD INSURANCE RAT�MAP(FIRM)INFORMATION 61.NFIP COMMUNITY NAME 8�COMMUNITY NUMBER 62.COUNN NAME 83.STATE c�E��wa�r��: / �25�9� ��NE�y�S ��, B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL 68.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVEJREVISED DATE ZONE S �2�0 3 G O I�Z. � �-o a^,,_0 3 � ��( ) (Zone A�.O�use.�depth of flooding) �-+��o B10. Ind'ICate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 89. �__�FIS Profile ��FIRM �__� Community DeteRnined �__�Other(Describe):_____ 811. Indicate the elevation datum used for the BFE in 89:�__�NGVD 1929 �NAVD 1988 �__�Otber(Describej:___ ___ B12, is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)7 �_�Yes ��No Designation Date:_____ / � SECTiON C-BUILDING ELEVATIOIV INFORMATION(SURVEY REQUIRED) • C1. Building elevations are based on: �__�Construction Drawings` �__�Building Und�r Construction' ��Finished Construction 'A new Elevation Certificate will be required wheri�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 8 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,AWAH,AR/AO Compiete Items C3.a-i below according to the building diagram specified in Item C2.5tate 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 daturn conversion calculation. Use the space provided or the Comme�ts area of Section D qr Section G,as apprapriate,to document the datum conversion. Datum N(f'�D�� Conversion/Comments_ ('�'79� C-�V�7 (�2.t) �""a ►.1/�V� � 8� - k---- —�---------------�------- Elevation reference mark used_�il��f.�3_$Il�]TQ E 2. Does the elevation refer nce mark used appear on the FIRM? �__�Yes �� No C] a)Top of bottom floor(including basement or enclosure) ______�,�_ft.(m) � ❑ b}Top of next higher floor G� p � � u� � ❑ c)Bottom of lowest horizontal structural member V zones onl 1�`,___ft, m � ( Y) --__A -.--ft. m �� L.S. 4� .�9 3 7 ❑ d)Attached garage(top of slab) --� �_Fj �•�m) E'� � ❑ e)Lowest elevation of machinery andlor equipment �� ,"�� servicing the building(Describe in a Comments area.j ____ _ � ft. m �� r � � ❑ fl Lowest ad'acent finished rade LAG , ► � � � � �'-21 �°� 1 ( )9 ( ) ft.(m) z m ❑ g)Highest adjacent(finished)grade(HAG) _____ _,� ft.(m) �� h j No.o f permanent openings(flood vents}within 1 ft.above adjacent grade_ Z�__ � > ❑ i}Total area of all permanent openings(flood vents)in C3.h Z�� sq,in.(sq,cm) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CER?IFICATION This certificafion is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify thaf the informafion in Sections A,B, a�d C on fhis certificafe represents my best efforts to interpret the data available. l undersfand thaf any false stafemenf may be punishable by fine or imprisonment under 18 U S Code, Ssction 1001 CERTIFIERS NAME UCENSE NUMBER Larry L. Evans -_ L.S. �� 2937 TITLE surveyor CQMPANY NAME Evans Land Surveying, Inc. • ADDRESS 1460 Beltrees Street: Ste. 9 CITY Dunedin, 3TATE F . ZIPCODE 34698 SIGNATURE , DATE TELEPHONE � �-2� -0�- (727� 734-3821 FEMA Form 81-31, anu 2003 See reverse side for continuation. Repiaces all previous editions IMPORTANT: In these spaces, copy the cor�esponding informatiot�from Section A. � Far tnsuranc�Carr�?any Us� BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. pol[cy Nurrober - . CITY = r „�::r STA';E ZIP CODE Company N/�IC Numb�r SECTION D-SURVEYOR,ENGINEER,dR ARCHITECT CERTIFICAt10N(CONTINUED) � Copy both sides of this Elevation Certificate for(1)community o�cial,(2)insu�ance agenUcompany,and(3)building owner. COMMENTS SECTION E-BUILDING ELEVl�TION INFORMATIOPI(SURVEY NOT REQUIRED)FOR�ONE AO AND ZONE A(WI HrOUTtBFE)�nts For Zone AO and Zone A(without BFE),complete items E1.through E5. If the Elevation Certifioate 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 similarfo 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)�__I—_I 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 e�evated 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. E�4.The top of the platform of machinery and/or equipment serviCing the building Is �__�__�ft,(m)I--I--I in.(cm)�__�above or�__�below (check one)the highest adjacant grade. (Use naturai 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 floodpiain management ordinance7�_�Yes I I No I I Unknpwn The locai official must certifv this information in Section Ci SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION �� The property owner or owner's authorized representative who completes Sectio�s A,B,C(Items C3.h and C3.i only),and E for Zone A (without a FEMA-issued or community-issued BFEj or Zone AO must sign here. The stafements in Sectrons A, B, C,and E are corrr��t tn f�o uesi oi�ri- k�ivwieti e. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE • SIGNATURE DATE TELEPHONE COMMENTS Check here ff attaChmerits S�CTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordirlance to administer the community's floodplain management ordinance can complete Sections A,B,C (or E),and G of this Elevation Certiflcate. Complete the applicable 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 local law to certify elevation information, (Indicate the sour�ce and date of the elevation data in the Comments area beiow.) G2. �__�A community officiai completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. �__�Tne foliowing information{Items G4-G9)is provided for community floodplain management purposes. G4.PERMIT NUMBER G5. OATE PERMIT ISSUED � G6. DATE CERTIFICAT6 OF COMPLIANC6/OCCUPANCY ISSUED G7.This permit has been issued for: (__� New Construction �__� Substantial Improvement � G8. Elevation of as-built lowest fiaor(including basement)of the building is: __ft.(m) Qatum: G9. BFE or(in Zone AO)depth of flooding at the building aite is: _�_____ __ft.(m) Datum: LOCAL OFF'ICIAL'S NAME TiTLE COMMUNIIY NAME TELEPHONE SIGNATURE OATE COMMENTS • I I�eak here ii attachments FEMA Form 81-31,January 2003 Replaces all previous editions .. ae7v�� i^'"i c�yif;� /`./t / � . � . . . t FEDERAL EMERGENCY MANAGEMENT AGENCY • NATIONAL FLOOD INSURpNCE PROGRAM �•M.B. No.3067-0077 _ ELEVATION CERTIFICATE �xp�res December 31, 2oos .,_�l_. Im ortant: Read the instructions on a es 1 -7, SECTIONA-PROPERTY OWNER INFORMATION �_.............._..........._....._..........._._....................................._...................._......... BUILDING OWNER'S NAME Fo:r�l�Gfafi�::C.si�»p�ir�::::U�`::�:=::::=_�:: � _ _sPo .'.; ._..... ......::._.:-_::�::::::::::::�::�:.-:.:._:_�.-.:::_::::::: —�ToNnl � LA�l�A 61Atil.�i�� PPO i.t�:��c.....::.......:::::::::..::.:.�::-:::-:-: _,�.............. �:..:____:.,. ............._...__...._...,_....._...._ _.... .........._........._......._.._..._�_._..__.-------._....._.. UILDINGSTR ETADDRESS InrJudi ,—:::=:-:::::::��::::�-::�::-_::�-::-_:::--�_--:::::_-::.::._.:�:_-�_=;;;: ( ng ApL,Urnt,3uite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. ' - •::��'►f��k,.MA!�Ntirrtt�er��°::":_:::-: :::::::::::;� Z DE�/Ol�! D ivE �..._.. _ -_:-;:=�:::.��::: ;�:.._:_:.�__.: ... ...._. ..,...,.........,__:........:......::.... GLEA R V✓�'rE STATE ZIP CODE , �L , 337�7 PROPERTY DESCRIPTION(Lo and B ock mbe�Tax Parcel�i�r,�I Description,etc.) C� 45` aF f,fl-7- z �� ' 6oT , Iz 1' AT�o.F. BAYs�DE suBV�v�S �o�.l BUILDING USE(e. .,Restdentlal,Non-resldential Addition,A c�ssory,etc Use a Comments erea,If necesssry.) RE�i DEN�Iq I.- LATITUDFJLONGITUDE(OPTIONAL) HORIZONTAL DATUM: ( ##°-##'-##.##" or ##.##i!##°) �--�NAD 1927 I_I NAD 1983 ;' SOURCE: �_�GPS(Type).---__ �_�USGS Quad Map �_�Other SECTION B-FLOOD INSURANCE RA7�MAP(�IRM)INFORMATION , B1.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER b2.COUNTY NAME C LEA R wAT�K. / 125 0 9�, }�I NE 1�[�j B3.STATE �L� 64.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER �_`D�E J EFFECTIV�REVISED DATE �ES) (Zone 1� O epth of flooding) 12io3c oio2. -G o� 9- 3-Q3 B 1 0. I n d i c a t e t h e s o u r c e o f t he Base F l o o d E levation(BFE)data or base flood depth entered in B9. �__�FIS Profile ��FIRM �__�Community Detertnined �__�Other(Describe):_ 611.Indicate the elevation datum used for the BFE in B9:��NGVD 1929 �NAVD 1988 �_�OtFier(Describe): B12,Is the building located in a Coastal Barrier Resources System(CBRS) rea or Otherwise Protected Area(OPA)? ��Yes No Designation Date:_____y_______ � 5ECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED1 C1.Building elevations are based on: ��Construcdon Drawings' �__(Building Und9r Cqnstruction• ��Finished ConstrucUon "A new Elevation Cerfificate will be required whe►i�onstruction of the building is compiete. • C2.Building Diagram Number�_(Select the building diagram most similar to the buiiding for which this certificate is being completed-see pages 8 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) C3.Efevations-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 daturn conversion calculation. Use the space provided or the Comments area of Section D or Section G,as to document the datum cornersion. appropriate, Datum N,��Q I�L� ConversioNComments__ '�'79�) ��UVD (9Z� T�� 1�AVp � 98 �------v��-'------ -_� Elevatfon reference mark used��.U.$�TQ� 2. Does the elevation refer ncs mark used appear on the FIRM? �__�Yes ��No ❑ a)Top of bottom floor(inctuding basement or enclosure) ____�,�_ft.(m) a ❑ b)Top of next higher floor �,—� o_ft.(m) � D c)Bottom of lowest horizontal structural member(V zones only) ____N%A � I_n,�rp� �� L.S. 4� 937 O d)Attached garage(top of slab) B ft. m �•_� ( ) e� O e)Lowest elevation of machinery and/or equipment W� �j��v� servicing the building(Describe in a Comme n t s a r e a.) ___�,_ � � m $,� � ❑ fl Lowest adjacent(finished)grade(LAt3) _______ � .j ft�m� Z� . �0'2�'°4' ❑ g)Highest adjacent(finished)grade(HAG) .�ft.(m) � 0 h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade 2�_ ❑ i)Totai area of all permanent openings(flood vents)in C3.h Z�O 2� sq,in.(sq.cm) SECTION D-SURVEYOFt,ENGINEER,OR ARCHII'ECT CER't7FICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. !certity that fhe informafion in Sections A,B,artd C on this ce�tificate�presenfs my best efforts to interpret fhe data evaflable. !undersfand thaf any false sfatement ma be unishable b fine or im risonment under 18 U.5. Code, Sectfon 1001. CERTIFIER'S NAME LiCENSE NUMBER Larr L. Evans - L.S. �� 2937 TITLE surveyor C�MPANY NAME ' Evans Land Surveying, Inc. ADDRESS 1460 Beltrees Street Ste. 9 ��n' Dunedin, 3TATE . ZIPC�DE 34698 SIGNATURE DATE TELEPHONE � �"Z -o�- (727) 734-3821 FEMA Form 81-31, anu 2003 See reverse side for continuation. Replacea all previous editions •r�9�S•�A'� ��a C OF�1Hg�t �4"��`�`��,�� CITY OF CLEARWATER � ��"�`;�,\ y �� -� .�� °°x �_ �� DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT `�,,,��',,��'rr��y�� POST OFFICE BOX 474H� CLEARWATER� FLORIDA 337SH-474H ��',.�aQ�� " �� MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.F.ARWATER,FLORIDA 33756 ��``��'�� TELEPHONE �72� 562-4567 Fax(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 X The attached elevation certificate is complete and correct 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 B2.COUNTY NAME B3.STATE B4.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S) NUMBER g5.SUFFIX 66.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8•FLOOD ZONE(S) �Zone AO,use depth of flooding) 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) B12. Is the building located in a Coastal Barrier Resources S stem(CBRS)area or Otherwise Protected Area OPA)? ❑Yes ❑No Desi nation 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)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 O�cial: �vation certificates shall be maintained by the community and copies with the attached memo made available by request FRANK HIBBARI),MAYOR GEORGE N.CRE7'EKOS,COUNCILMEMA[R JOIIN DORAN,COUNCILMEMBER PAUL F.GIBSON,COUNCILMEMAER � CARLEN A.PE7'ERSEN,COUNCILMGMRER ��EQUAL EMYLOYMENI'AND AFFI}tMA"f1VE ACI'lON EMYLOYER�� v�'��"✓�� ;. F�DERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM O.M.B.No. 3067-0077 � °��' Expires December 31, 2005 ��°�` � � ELEVATION CERTIFICATE � � � Im ortant: Read the instructions on a es 1 -7. SECTION A-PROPERTY OWNER INFORMATION Fo�1n�Ur�nce CampanY�a�:.:.... BUILDING C�WtJ�R�S NAME PtillcyNi�mifiAr : �To i-I�i � l-A u l�A 61 A�1-F� �► PP O ; BUILDING STR �, r,vunt55�mcwamg apt.,Urnt,Su�te,andfor Bldg.No.)OR P.O.ROUTE AND BOX NO. Gomp�ny(UAIG Numkier 1�Z DE�/on...� D tv� ' -: , CITYG��R ��T�� STATE r ZIP CODE 33 � PROPERTY DESCRIPTION(Lo and Block N mbers,Tax Parcel Number,Legal Description,etc.) j rL 7 � i C, 4S bf I.fl7' zc� � � 35 !�o T Z► , RE-P�-/�T o.�. BA`��D� S vB��v i S I o nl BUILDING USE e g ResidenUal,Non residential,Addition,A cessory,etc. Use a Comments area,If necessgry.) -' R E��v�n�T�q�- LATITUDEIIONGITUDE(OPTIONAL) HORIZONTAL DATUM: ( ##°-##'-##.##" or ##.##�###°) �_.�NAD 1927 ��NAD 1983 SOURCE: �_�GPS(TYPe):----------------- �—�USGS Quad Map �_�Other _________ SECTION B-FLOOD INSURANCE RAT�MAP(FIRM)INFORMA710N B1.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER g2.COUNN NAME B3.STATE CLE�lR�/AT�K / 125o9Co ��NEL.ys,s �'L � B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL B8.FLOOD 69.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE S I 2►0 3� o i o 2 � � � ) (Zone AO,use depth of flooding) �-03 °�' �-"`''_ o AE 11.a� B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 89. �__�FIS Profile ��FIRM �__�Community Determined �__�Other(Describe):_____ 811. Indicate the elevation datum used for the BFE in B9:�__�NGVD 1929 ��NAVD 1988 �__�Other(Describe):______ 812, Is the building located in a Coastal Barrier Resources System(CBRS)�rea or Otherwise Protected Area(OPA)? ��Yes � �No Designation Date:____________`_____ � SECTION C-BUILDING ELEVATION iNFORMATION(SURVEY REQUIRED) C1.Buiiding elevations are based on: �__�Construction Drawings* �__�Building Und9r Construction* ��Finished Construction 'A new Elevation Certificate will be�equired wheti construotion of the building is complete. 2.Buiiding 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,ARlA1-A30,AWAH,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 daturn conversion calculation, Use the space provided or the Comments area of Section D qr Sectinn G,as apprapriate,to dncument the datum conversion. �atum N�/p � 2 - , ' t � __�� Conversion/Comments__ �,_�_79��(�Vj� 19�-) Tn�AV P_��'��a Elevation reference mark used_�I�,GO_$�TQ� �.. Does the elevation refer nce mark used appear on the FIRM�? � _��Yes ��No ❑ a)Top of bottom floor(including basement or enclosure) ______ �,Q,_�,�m� � ❑ b)Top of next higher floor ��,o_ft.(m) .� :�•-� r y;: _� ❑ c)Bottom of lowest horizontal structural member(V zones onlyj ____A _, fL(m) � �;`g�'�° � �3�•-'f Q d)Attached garage(top of slab) g �° . � --��---ft•(m) e b �; w r;• ❑ ej Lowest elevation of machinery and/or equipment W � xr � , , �'+��'``` �� ,. servicing the building(Describe in a Commenls area.) _____� , �_ft,(m) , . ,� Gj�'��( i' /�, ❑ fl Lowest adjacent{finished)grade(LAO) _, I_�,�m� Z� ! : „ ,� `i',� 0 g)Highest adjacent(finished)grade(HAG) `� �' {°„ ��°+ �a �r.� " ,�ft.(m) � ' � s �� ❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade_ 2�__ � s �= f,, ❑ i)Total area of all permanent openings(flood vents)in C3.h Z�2� sq.in.(sq.cm) ` f ,�f�,� `�``� SECTION D-SURVEYOF2,ENGINEER,OR ARCHITECT CERTIFICATION This ce�tification is to be signed and sealed by a land surveyor,engineer,or architect authqrized by law to certify elevation information. 1 certify that the informatipn in Secfions A,8,and C on this certificafe represents my besf efforts fo interpret the data available. 1 understand thaf any false stafement may be punishable by fine or impnsonment under 18 U 5 Code, Seotion 1001 CERTIFIERS NAME UCENSE NUMBER Larry L. Evans - L.S. �� 2937 TITLE surveyor COMPANY NAME - Evans Land Surveying, Inc. �DDRESS 1460 Beltrees Street: Ste. 9 ��T�' Dunedin, 3TATE F . 21PCODE 34698 SIGNATURE DATE TELEPHONE a (�-2�-0�- (727) 734-3821 FEMA Form 81-31, anu 2003 See reverse side for continuation. Replaces all previous editions y . .r,�. IMPORTANT: In these spaces,copy the correaponding information from Section A BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Poiicn Numtier��,,�� fl cirv v . STATE ZIP CODE Cotw�p�r�y Mj�11 rrSls�r . SECTION D-SURVEYOR,ENGINEER,dR ARCHITECT CERTIFICAtION(CONTiNUED) Copy both sides of this Elevation Certificate for(1)community o�cial,(2)insurance agent/company,and(3)building owner. COMMENTS _ SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NbT REQUIRED)FOR ZON�AO AND ZONE A(WI HOUTtBFE) nts For Zone AO and Zone A(without BFE),complete Items E1,through E5. If the Elevatiorr Certiflcate is intended for use as supporting information for a LOMA or LOMR-F,Section C must be completed. E1. Buiiding Diagr�m 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 rep�esents the building,provide a sketch or photograph.) E2.The top of the bottom floor(including basement or enclosure of the buildin is (check one)the highest adjacent grade. (Use natural grade,,if available.) 9 I--I—I��m)I-_I-�I in.(cm)�__�above or�_�below E3.For Building Diagrams 6-8 with npenings(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 Itpms C3.h and C3.i on front of fOrm. E4.The top of the platform of machinery and/or equipment servicing the buiiding is �--�--�ft•(m)I__�__�in.(cm)� � � �below (check one)the highest adjacent grade. (Use natural grade,if available.) __ above or __ 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 manaqement ordinance7� I Yes � �No I I Unknqwn the local official must�ertifv this information in Section Ci SECTION F-PROPERTY OWNE(�(OR OWNER'S REPRESENTATIVE)CERTIFICATION � �T The property owner or owner's authorized representative who completes Sections A,B,C(Items C3.h and C3.i oniy),and E far Zone A (withnut a FEMA-issued or community-issued BF�)or Zone AO must sign here. The statements in Sections A,B, C,and E are correct to the best of m knawled e. PROPERTY OWNER'3 OR OWNER'S AUTHORIZ�D REPRESENTATIVE'S NAME ADDRESS CITY STAl'E ZIP CODE . SIGNATURE DATE TELEPHONE COMMENTS Check here ff attachmerits S�CTION G-COMMUNITY INFORMATION(OPTIONAL) The Iqcal official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevafion Certificate. Complete the applicable item(s)and sign below. G1.�__�The information in Section C was taken from other documentation that has been signed and embassed by a licensed surveyor, angineer,or architect who is authorized by state or locai law to certify elevation information, (Indicate the source and date of the elevation data in the Comments area below.) G2•�--�A community officiai compieted Section�for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zane AO. G3. �__�Tne following inforrnatiorr{Items G4-G9)is provided for 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: 4__1 New Construction �__� Substantial Improvement �� G8. Elevation of as-built fawest flaor(inciuding basement)of the building is: __ft.(m) patum: G9.BFE or(in Znne A�)depth of flooding at the building site is: _�_�___ __ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE GOMMUNITY NAME TELEPHONE SIGNATURE bATE COMMENTS , • _ Check here if attachments FEMA Form 81-31,January 2003 Replaces ail previous editions . � , �y'rzrr.��i �,`,��'�t�',��'j� �a`�\�, %�r� CITY OF CLEARWATER � v�'��'^`' k w �9 h'---�- �� DEVELOPMENT & NEIGHBORH0C7D SERVICES DEPARTMENT s ,,, �'r,ae W �1��4� POST�FFICE BOX 474g� CLEARWATER� FLOa�DA 33758-4748 ,�, >f,ga� ��, � .,, y MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CI.FARWATER,FLO�uDn 33756 ��k a NE 2 2-4 6 Fnx 2 6 2-4 7 6 TELEPHO (7 � 56 S 7 �7 � S S 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 X The attached elevation certificate is complete and correct Minor corrections have been made in the below marked sections by Community O�cial 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 ##.##i/##°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION .NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE 64.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S) NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8•FLOOD ZONE(S) �Zone AO,use depth of flooding) 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 69:❑ NGVD 1929 ❑NAVD 1988 ❑ Other(Describe) B12. Is the buildin located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction" ❑ Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number (Select the building diagram most similar to the building for which this 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,conveR 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: Cl��Y_�� Community Official: � �evation cerfificates shall be maintained by the community and copies with the attached memo made available by request FRANK HBRARI),MAYOR GEORGE N.CRB'1'EKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBBR PAUL F.GIBSON,COUNCILMEMRER � CARLEN A.PE7'GRSEN,COUNCILMGMBER ��EQUAL EMYLOYMEN'I'AND l�FIWNA"I'IVE ACTION EMPLOYER�