881 ELDORADO AVE i-� i� � I ii � I 11I I
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ao2 � ���' O M B.No 3067�0077
� ����, �'��� � � � � � ELEVATION CERTIFICATE ExpiresMay31, �993;
r-�--�m""'°"' RAL EMERGENCY MANAGEMENT AGENCY
� p�VELOPMkN�' S�NVIGES ��
� �����yy,�a�E��,�„ ATIONAL FLOOD INSURANCE PROGRAM
��E � �cate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
ovide elevation information necessary to ensure compliance with applicable community tloodplain management ordinances,to
determine the proper insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision(LOMA or LOMR).
instructions for completing this form can be tound on the following pages.
, SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUtLDING OWNER'S NAME POLICY NUMBER
Edward Ao Singer
STREE7 ADDRESS(Incluo;ng Apt..Unit.Surte and;or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
881 Eldorado
OTHER DESCRIPTION(LOt and Block Numbers,etc.)
Lot 2, Blk 19, GEORGILAS REPLAT OF BLOCK 19 MANDALAY
ciTV C 1 ea rwa te r, F 1 0 34630 sTATE ZIP CODE
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SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the following from the proper FIRM (See Instructions):
1 C0�.1MUNITY NUh10_R 2 PANEL NUMBER 3 SUPFIX 4.DATE OF FIRM{pFDEX 5 FIRM ZONE 6.BA5E FLOOD ELEVATION
125096 0007 D 8/1�/�f� A-E 11 o O Zones,use depth)
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): XXNGVD'29 _Other (describe on back)
8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site, indicate
the community's BFE: ____—___ .— teet NGVD (or other FIRM datum–see Section B, Item 7). �
SECTION C BUILDING ELEVATION INFORMATION �
1 Using the Elevation Certificate Instructions,indicate the diagram number from the diagrams found on Pages 5 and 6 that best
• describes the subject building's reference level�_ .
2(a). FIRM Zones A1-A30,AE,AH, and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation
of ' ' '' ''��feet NGVD (or other FIRM datum–see Section B, Item 7). ^^ F 10o r a t foye r 6.18; F i n i s hed F 10,o r
Livin�
(b). FIRM Zones V1-V30, VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reterence level from a rea,
the selected diagram, is at an elevation of i � ' �N .'A feet NGVD(or other FIRM datum–see Section B, Item 7y. ' ' ���= �
wh��h
(c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is !�;.A�teet above❑ or 2nd F 1
below� (check one) the highest grade adjacent to the building. has an
lev.o
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is �.��feet above� or below n(checl� �4.9
one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reterence
level) elevated in accordance with the community's floodplain management ordinance? L' Yes �_J No � Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:L�,� NGVD'29 ❑ Other(describe
undar Comnents on Page 2). (NOTE: If t;e elavafior,dafum used in measuring the elevations is diff2rant than thaf used on
the F1RM jsee Section B, Item 7J. then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.) _
� 4. Elevation reference mark used appears on FIRM: _ Yes X_ No (See Instructions on Page 4)
5.The reference level elevation is based on: X actual construction r� construction drawings
(NOTE: Use ol construction drawings is only valid if the burlding does not yet have the reference leve/floor in p/ace, in which
case this certificate will only be valid for the building durrng the course ol construction. A post-construction Elevation Certificate
wil!be required once consfruction is complete.)
6.The elevation of the lowest grade immediately adjacent to the building is: '4 6 et NG •(o r FIRM�m-s
Section B, Item 7).
., c ►
`� SECTION D COMMUNITY INFORMATION
•' If the community ofticial responsible for verifying building elevations speCifies that the ref rence vel indicateci in Section , It m 1
is not the"lowest floor"as defined in the community's iloodplain management ordinance the e vation of the building's" wes
floor"as defined by the ordinance is: ' �.'� feet NGVD{or other FIRM datum Section B, Item 7).
2. Date of the start of construction or substantial improvement �
FEMA Form 81-31�MAY 90 REPLACES ALl PREVIUUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
. .., .� . ,.. _ _ _ . _ __ ___ _ ___ __
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SECTION E CERTIFICATION
This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones A1—A30,AE,AH,A(with BFE),V1—V30,VE,and V(with BFE)is required.
Community officials who are authorized by tocal law or ordinance to provide tloodplain management information, may also sign the
certification. In the case of Zones AO and A(without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8- Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not
included in the certification under Comments below. The.diagram number,Section C, ttem 1,must still be entered.
l certily that the information in Sections B and C on this certificate represents my best elforts to interpret the data available.
1 understand that any lalse statement may be punishable by/ine or imprisonment under 18 U.S. Code,Section f 001.
Edward J. Langton, Jr. �3�54
CERTIFIER'S NAME . `{��Ep�
President � LANGTON SURVErIIVl�SE1�l�8EFi(orAHixSeal)
TITLE C MPA NAME
6285 Park Blvd. , Pinellas Par9c, �1 . 34665
ADDRESS ___`y—\ �-- CITY —
3/ot/93 (8t3) 545 5900 Z1P
SIGNATURE
DATE PHONE '
Copies should be de i this Certificate i r: 1) ommunity official,2)insurance agenUcompany,and 3)building owner.
COMMENTS: Pinellas Count Eng. Dept. benchmark �{152; Elev. .6. 19; N.G.V.D.
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MAR . 0 �
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DEVEI.(7PM��t�r SERVICES UE�T�
ON WtTM ON PILES,
SLAB BASEMENT PIERS,OR COLUMNS
A v � A V
ZONES ZONES ZONES ZONES ZONES
AEFERENGE pECERENCE
IEVEL BASE �E�E� REFERENCE
FIOOD . \ .EVEI
ELEVATION
�4::"� �. y:
�' 1 `�R1.
B�SE � .: �:;:..�::.,. .::'�`.
FLOOD � '� �AQIACENT��:°•'"�+`� REFERENCE B�SE
GRADE � ��t( FLOOD
ELEVA7�ON REFERENCE AQI�CENT ��::rr LEVEL ELEVAT�pN
LEVEL GRADE ' '�°
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^t�.:
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., � �}7 o0:n.c'•:*
-..�T1/� � IT/n uF>'�E
The diagrams abo�e illustrate the points at which the elevations shoutd be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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