1091 ELDORADO AVE 1 �' � '
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FEDERA�. EMERGEfJC�MAN�►l3EMEN�'AG�PICY ��+�t,`� s ;, taxt��rb '
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� � � ,�r � ' NATIONAL FLO�d �NSURANCE PROGRA�VI
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TMIs forrtt is io be used lor: 1 New/Emer enc Pr �:� .:' . `� , � ' , •' . „ , .' , J..:.
1 g y ogratn coilstFuclion In�Specia�Flood Naiard'Areas;2�pre-F�Ri�cortstruc{ioij,
September 30, 1982;3) Pos1-FIRM construction;and, 4) Other buildings rafed as Post-FIRM rules. � i'�
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, .. H'Q fY'% y^ �T.�...GL'U�'��� � '� � . � I `;f ilS�i :.,yT1>nn .: �� .. . 1 t � y{1 •,-i� �r. .
BUILDIN(3 OWNER'S ' 'AODRESS '
NAME .�� � „ .i _ -
;'�'�" � 109 I E�Dfl��4 DO � ,.; �V�:�v� , , ,„` • ,
, � r4 E ' c'��AKwi�T�1Z BK�4U-�' �. ����
. PROPERTY LOCATION (Lot and Block numbers and address it available) �
i f . � ` ' Lp.�, � a.� gIA�-S 4�1 M ; �. , . ,� ,.: .�
� � a�,o�► 4 � �s��� ;, K� u-�E � �, ':.:
� 1 certity hat the inlormation on this certificate represents my best eff rts to interpret the data available. I u erstand that any
; statement may be punishable by fine or imprisonment under 18 U.S.code,Section t00L
�j SECTION I EUGIBIUTY CERTIFICATION (Completed by Local Community Permit O(ticial or a Registered Pro(essional�ngi�
Architect,or Surveyor) ' ,
OMMUNITV NO PANEI NO SUFFIX DATE OF FIRM FIRM ZONE OA7E OF CONSTq.• • . BASE FLOOD EIEV. BUIIDINti 1$ I
� 25b ,1 fin AO Zone,use deplh) . '�'
0g d�3 � �O�GJ��3 . H �Z . , , � . O New/Emery
i , j(� �O _ , . �Pn-FINM q=
, � . ❑ Po�t-fIFiM r
YES NO It is intended that Ihe building described above will be constructed in complian�e with the community's floo _ eT"-
❑ O ordinance. The cerUfier may rely on community records. The lowest Iloor(includin$b8ser�eilt)4Yi���k�e�1t�r� g�� :
. o� ft,NGVD. Failure to,construcl the building at this elevaUon may plade,th�bulldjng jn��t�ti�o �
!he community's tlood plain management ordinance.; � •;••:�,�;,r �,�/ �M�
N
YES NO The building described above has been constructed in compliance with the commun't`'§�( od�I�iRrnprrd
� , �7 ordinance based on elevation data and visual inspection or,other reasonabte means.�Y� ��( L (9����
,� � : If NO is checked, ettach copy of variance lssued by the community.!,- �
YES NO The mobile home located at the address describeA above has been tied down.(ancho ed) rr c3in fan" i
O O community's flood plain menagement ordinance,or in compliance with the NFIP Spe IIIc�iSiohs. �i� �1��t�}���
• .. ....__...._._�..._--..--r=-
MOBILE HOME MAKE ; MODEL' YR. OF MANUFACTURE SERIAL NO. ' DIMENSION�
... , r{ �. . .. ., ,.� ; X ' -
� ; ; i� � � , ♦I.
(Community Permit Officlal or Registered Proiessional Engineer,Architect,or Surveyor)
NAME ADDRESS .
TITLE CITY TAT
, _ - - -:
SIGNATURE ' " � DAT
PHONF
SECTION II ELEVATION CERTIFICATION (Certilied by a local Community Permit Ot(icial or a Registered Professional Engin
„ Architect,or Surveyor.)
+ FIRM ZONE At-A30: 1 ce�ti(y that the bull in at the properly locetion described above has the loweat lloor(including baseme
at an elevation of feet, NGVD (mean sea levei) and the average grade at the buitding site i=
an elevation ot -s�� leet, NGVD.
FIRM ZONES V, V1-V30: I certi(y that the building al the property locadon described above has the bot�om ol fhe lowesf floor be=
at an elevetion of leet, NGVD (mean sea level), and the average grade at the building s
is et an elevation of feet,NGVD.
�IRM tONES A,A99,AH and EMEfIGENCY PROGRAM: i certlfy that the building et the property Ixatfon described above has the lowr_
floor elevation of feet,NGVD. The elevatlo�of the highest adjscent grede next to the building it feet,NGVD. .
FIRM ZONE AO: I certify thst the building at ths property location delcribed abow has the loweat iloor eleveNon of
feet,NGV�. The elevadon of the highect edjacent grade naxt to the building le feet,NGVD. ,
, SECTION III FLOODPROOFINQ CERTIFICA7'ION (Certitication by a Registered Professional Engineer or Archilect)
• 1 certi(y to the best,of my knowledge, intormation, and belief, that lhe building is designed so that the buliding is watertight, wl
walls substantially imbermeable to the passage bt water and structural components having the capabflity ot resisting hydrostat
a�d hydrodynamic loads and effeCis of buoyancy that would be caused by the flood depths, pressures velocities, impact and upl
torces associated with the base flood.
YES ❑ NO L7 In the event ol tlooding',will this degreA oM tloodprooting be achieved wilh human Interventlon?
, • (Human Intervention means that water witl enter the building when Iloods up to the base Ilood level oc-
cur unless rneasures ere taken prbr to the flood to prevent entry of water(�.g„ boftlng mefal shields over
doors ahd windows�, ( .. ' . . :.�:, � .
YES ❑ NO O Will the 6uilding be occupied as a residence7 i '
�t ira s��;�,�rr°!o boiF�cjuesfions is Y��,the rioodproofing cannot be credited Oor reff�g purposes and the aclua) lowest Hoor must b
completed and ceitilted instead.Complete both the elevation and(loodprooting certi(icates.
FIRM ZONES A,A1-A30.Vt-V30,AO and AH: i� CertiNed Floodproofed Elevation Is.-_��eet,(N(iVD
THfS CERTIFICATION IS FOR O SECTION II O BOTH SECTIONS 11 AND III (Check One)
��+� ° CERTIFIER'S NAME COMPANY NAME UCENSE NO.(or Af(ix Seaij
4A1?IZy L. E�/AiJS EC/A�JS �AiJ� SU��IE�(/�(ar Zs�37 • �
• TITIE , ADDRESS , , , Z�P
S���Ey�(Z • � 178o MAi� S'l''• �U�rr 1� 335� .
SIGNATURE DATE CITY: STATE PHON� ,
, _ ,,; �s �
. ' ( 13�88 • , .1}��ED W � � : �L-, , ,3�3) 73� �382(
e 1 surance eyent:hould attech!he orlginal copy of!he compteted lorm to Ihe flood Insurance policy applicaflon,,
Ihe aecond copy should be supplied to the policyholder and the third copy retalned by the agent
INSURANCE ACiENTS MAY ORDER THIS FOFiM • �
FEMA Fortn 81-31,SEP 83 REPLACES FEMA FORM 81-31,APR 82,WHICH 13 OBSOLETE. • -
___ `��t� ^ ��2•
�A.S.DEI�ARTMENTOFHOMELANDSECURITY ������'ON C�It�I���/^1��
PED�RAL EMEROENCY MANAf3EMENT AGENCY OMB NO. "I6BO-00O8
NatlnnalFlvndlnsurariceProgra�n �n1p01`tc111�: Read the instructions on pages 1-9. Expiration Date: July 31, 2015
'�� _ SEGTION A� PROPERTY IN�ORMATION '��b�F �N�l�l�l`1N��•�:�i�lUli�ANY�iJ��=k ����.'
A1. Building Owner's Name �
A2. Building Street Address in�
►��� l--C� t� F�' _ 1
��..� . �
��� ��
A3, Property Description (Lot a
'�a°�� • �'1�-t!;_.
K c. o v �, �- '��t� �" � � P��' , .
luding Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and 8ox No.
��v �.�► u ��. ,
��,� p„��L �_' State �, ZIP Code
�d 1� � �
d Block Numbers, Tax arcel Number, Legal Desctiption, etc.)
��...��:.�� I71--04�n
����7
A4. Building Use (e.g., Residentlal, Non-Resldenlial �1ddlUon, Aoceseor , etC.) C1 -- j�j�=:�> �.�'C--A�IT{ � E.-�
A5. Latitude/longitude: Lat. � " O� � U� �� Long. Z:.° � ,. `� Horizontal Datum: ❑ NAD 1927 AD 1983
A6. Attaah at least 2 photograph� of the building li he Certiflcate is being used to obta n flood insurencs.
A7. Building Diagram Number - �
Af3. For a building with a crawlspace or enclosure(s): '� � 4-� A9. For a building wilh an attached garage: � `
a) Square footage of crawispace or enclosure(s) � sq ft a) Square footage of atteched garage �� sq ft
b) Number of permanent Ilood openings fn the crawl�pace b) Number of permanent tlood open(ngs ln the attached garage
or enclosure(s) within 1 A foot above adjacent grade �S�Q: f�DO`rtYil�.r1�'�� within 1.0 foot above adJacent grade
o) Totai net area of Flood openings in Ae.b ��j sq in c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings7 ❑ Yes L`� No d) Engineered flood openings7 ❑ Yea ❑ No '
SEGTION �- FL.00ID INSURANGE RATE MAR (FIRM) INFQRMATION
B1. NFIP Community Name & Community Number 82. County Name 83. 5tate �(�
f ^ �, � /� F� W/4 T" �. I� I � � a? � � �' � N E l,.t._.� .S � � ,�
64. Map/Panel Number 65. Sufflx 86. FIRM Index Dafe 67. FIRM Panel 68. Flood B9. Base Flood ElevaBon(s) (Zone
(? � ,��? � � � �,�, �'.,�. �_ � �_ �� Effe�tive�_!� vis�d� ate ne�(s) A0,1 � base flood depth)
' 131�. Indic�t� the source of the,,_B,/ase Flood Elevatlon (BFE) data or base flood depth entered in Item B9.
❑ FIS Proflle iN FIRM ❑ CommuNty Determined [] OtheNSource:
811. Indicate elevation datum used for BFE In Item B9: � NOVD 1929 [�NAVD 1988 ❑ Qther/Source:
812. Is the building Iocated in a Coastal Berrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Deslgnation Date: ❑ CBR$ ❑ OPA
SECTION G- 6UILDINC3 ELEVA'�IC�N INFORMATIQN (BURVEY REGlUIRED)
❑ Yes Q No
C1. Building elevations are based on: ❑ Constructfon brawings"' [] Building Under Construction' Finished Constructfon
"A new Elevation Certiflcate will be required when construction of the buildfng la complete.
G2. 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 C2.a-h
below according to the �\uilding dfagram specitied in Item A7. In Puertb Rtco only; enter eters.
6enchmerk Utilized: CIU:�a�-- �,�, J Vertical Datum: 5� �
Indicate elevatfon datum used for the elevatlons In ftems a) through h)' beipw: ❑ NGVD 1929 NAVD 1988 ❑ Other/Source:
Datum used for building elevaiions must be the same as that used for;the BFE.
a) Top of bottom floor (inciuding basement, crawlspeoe, or enclvsure (loor)
b) Tap of the next higher tioar
c) Bottom of the lowest horizontai structural member (V Zanes only)
d) Attached garage (top of siab)
e) Lowest eisvation of machinery or equfpment servicing the building
(Deacribe type of eqitlpment and location in Commenta)
� Lowest adJacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) lowest adjacent grade at lowest elevatlon ot deck or stafrs, Inciuding str
(p , �.
2 �
� �._
NL�A,
-�Z-S��
3, P,
�'�--
f� N/�.
Cheak the measurement used.
p ieet O meters
[_�''�eet I] meters
C] feet ❑ meters
p feet p meters
(�]'�eet ❑ metera
I�teet ❑ meters
L�'%et ❑ meters
.. - �-fe�t•;`: � C] meters
's
SEGT�CIN p- gURVEYpR, ENGIN�ER, Oa ARCHITECT C�R7IFICATION .
Th(s certification is to be signed and sealed by a land surveyor, engineer, or erchitect authoriz2d by faw to cerHfy elevation
information. I cerfil'y thaf the lnformafion on fhis Certlf/cate represenfs my best effoNs to interrvret-.fl�e.data ava!!able: --��,
I un ersfand that any fa/se stafemeni may be punisl�aBle by �ine or Imp�lsonmenf under 18 U.S. Code, SecNo� 1001. ;
Check here if comments are provided on back of form. Were letftude and longitude in Se;�tion A provided by 8
[�Check here if attachments. flcensed land surveyor� C�Yes ❑ No
CertiFler's Name LARRY L. EVANS Lioense Number PLS # 2937
�
Title LAND SURVFYOR Company Name EVANS LAND SURVEYING, INC. �� ,
Address 1460 BELTREE ST STE. 9 City DUNEDIN, State FL ZIP Code 34698
51�nature �� �^�a� r �(;�..�� Date � � _ ! �' � � Telephone (727} 7343821
;
;
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�iL�VA� i Iun1 c:�Ft � ir-��� i t, page x ,
�a.
IMwQRTA�IT: In these apaces, aopy the corresponding Infattilatic�n frnrii Sec�tion A. i��{�.�� ���� �����j�fj� �j��'�,� ��'
BuildingN1Street Address (inciuding Apt., Unit, Suite, andlor Bidg. No.) or P:O. Raute and Box No: �'��i�� Ntii��Ai�P 'fi'' " `''�' F '
� I �� ��R ��� -v���u�- , ,
r�:J� �.« � � o���x'.�n� ri ,4rti � �-�s ° �� �y�.i �' ,,�
��ry C'_.�.-�. p %� StAte ZIP ('ode /�� �
, }
/� �`,. �/�i "[r�-R, � ��.�:.� c . • �j � /�'O7 ��i�1f�i���l� ���ry �i_!��l��i�'�i�}y�f��1a��� rh{+r�x �r � ,
.��: � .. . - . . / . ��r�l , �..-0,,,£�7 'F'��Jr �,;? p" `X }la {i�,�lJ.°y(M1^ � .i � 'S; �,.
3EC710N D- 3UR1[EY(3R, ENfdINEER, OR AF�GHI'TECT C�RTIFICATIf')N (CONTINUED) ,.
Copy both side9 of this Elevation Certiftcete for (1) oornmUhity offlclai, (2) lnsutan�e ��ent/campany, and (3) bufiding owner.
� Comments ��%�) �T�u��"'��� pR�csi���L �uic.T 11�1 ���rj�
��.�� ; n��-r,a��e-��� �r��. `�� �r���-�-' a-� ��c��iN�- a�r�y. :
�. � a �. ) a 1 S �� �.XT°�r�r a (�. �/c. cb.M,{��,���a �. o ►J �i..�.v��r"� � P�� �
.— .
Signature �� _ ` DAEe,
, ,,w
O i-- i q...-> � L�,
�ECTION — B IL;DIIVO ELEVATION INF(7RMATION (SURVEY NOT ItEqUIR�I�) FOR �('�NE AO ANLI ZONE A(WITHOU'[ BFE) .
..,:.,�
For Zones AO and A(wilhaut BFE); complete Items �1-E5. If the Certlflcate is IntendAd to suppolt a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items Ei-�4, use natural g�ede, If aV�ilable: Cheok the measurement used. In Pue�to Rico oniy, enter metars. ,
E1. Provide elevation inCormation for the following anci check the approprlate boXe� io ehow whether the elevatinn is above orbelow the h(ghest adjaceM
grade (HAG) and the lowest adjacent grade (LAG),
a) Top of boftom floor (including basement, crawispaoe, or enclosure) fs � feet ❑ meters ❑ above nr [] below the HAG.
b) Top oF bottom floar (including basement, crawlspace, or enciosure) is .:';. � feet ❑ meters ❑ abova or ❑ helow the LAG.
L2. For �uliding Diagrams 6-9 with permaneM Plood openinga provided In 3ectlon A Items 8 andlor 9(ae_e,,pagea 8-9 of Inetructions), the next higher tloor
(elevation C2.b in the diagrams) of the bUilding is 0 feet [_j metern ❑ above or �] below the HAG.
E3. Attached garage (lop of slab) is [;j leet ❑ meters [] above or ❑ below the HAG.
: E�. Top of platform of machinery and/or equipment aervicfng the building is " ,_ ❑ feet ❑ metera ❑ above or C] below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bcikfohi tlo6r elevated in accbrdanoe with the community's floodplain management �
ordinance? I] Yes ❑ No ❑ llnknown. The local oiflciai must oertify this)riformation In Seclion a,
�
SECTION F-- pROP�RTY OWNER (OR.OWN�R'3 REPREB�NTA'TIVE) CERTI�ICATION
.i _
The property owner or owner's authorized representattve who completes Sectlons A, �; end E ior Zone A(Without a FEMA-issued or community-issued BFE)
j or Zone AO must sign here. The statementa in Secflons A, B, and E are cdr�ect to the beat of my knowledge.
Praperty Owner's or Owner'sAuthorized Representative's Neme
ii �
-�-
��A�Idress City Sfete ZIP Code
_,�
' Signature � bate Telephane
: Comments
; _
�
G] Check here if attachments.
a� S�G"�ION �3 - COMMUN�7Y IN�C�F�MATION (4PTIONAL)
1;he local official who is aulhorized by law or ordinahce to edministeP the comrri�unity's iioodpiafn management ordinance can cnmplete Sect ons A, B, C(or E), and o
o,f this Elevation Gertiflcate. Complete the applicable Item(s) and sign below. �hebk the measurement u�ed in ftems G8-d10. in Puerto Rico oniy, enter met�rs.
C^�1. ❑ The In(ormation in Section C was taken frotn other documentation �hat has be�n signed and sealed by e Iicensed surveyor, enginesr, or archltect who
is author(zed by law to certify elevatton informat�on. (Indicate the �;outce and date of the elevatlon det� (n the Coinments area below.),
f'�2: I] A community offfcial completed Sectlon E for a buliding loaated in �ione A(witliout a FEM1i1A-fasued or commun(ty-lssued BFE) or Zone AO:
(�3. C1 The followin0 information (Iteme GA-d10j is provided for aommurtity tloodplain ma�agement purpoa�s:
(G�4. Permit Number G5. nate Permit (saued G6. Date Certificate Of Compliance/Occupancy Issued ,
L
Ci7. This ermit has been Is � �' e4►�et#err— tantial Irtiprovement
P
C�8: Elevation of as-built low s r t� �I e�il �. [� feet [] meters Datum
C310: Communit s desi n flo d elevet I,`� LnJ
C�9. BFE or (In 2one AO) de th o 00 ��sit�� D Cj fe�t C] meters Datum
y' g ►: V ❑ feet 0 meters Datum
. Lacal Qfflcial's Name Title
JAN 1 5 2014
Community Name Telephone
s��nature PIANNING 8� DEVELOPMENTDEPT ' D�te
Cvmmenta
- ❑ Cheak her�, ff attachmenta
�IL�V,ATION CERTIFICAT�, page 3 ��ilding Phofiographs
See instructions for Item A6.
IMPOFtTANT: in these spaces, copy the corresponding informatian from Section A. �01� INSUf�ANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
—t�.'� I�:�.. D c� (L/-� �__�__'� ir-,---C �.% u�.
City � State ZIP Code Cohipahy NAI� Number:
G L I,/`� i� ��v �`� `T L- t�, � 71=j�c., �-� , [`" 7' 3%� f�
If using the Elevation Certificate to obtain NFIP flood insurance, a�x at least 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must shaw the foundation with representative examples of the fiood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
�LEV/�TION CERTIFICATE, page 4 g�����ng Phofiographs
Continuation Page
IIVIPORTANT: In these spaces, copy the corresponding information from Sectien A. FOR INSURANCE COMPANY US�
Building Street Address (including Apt., Unit, Suite, nd/orrBld�q. No.) or P.O. Route and Box Na Policy Number.
i��) I E �- l� E� 1=� � l�C' ,-�} V�. Y.► �.J � �� �
Ciky State ZIP Code Company NAIC Number.
�-�-��! K ��+��tT� �. � �,4 �+�i �� . Y�� � �..
if submitting more photographs than will fit on the prec ding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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�LEVATION CERTIFICATE, page 4 ��ailcling Phcatographs
Continuation Page
IN�PORTEI,NT: (n these spaces, copy the corresponding information from Sectic�n A. FOR INSURANCE COMPANY USE
Ruildin Street Address (includin Apt., Unit, Suit an /or 51 g. No.) or P.O. Route and Box No. Policy Number.
—�-I � Li� t► /�� I c.� �V�� !�� �� L� � � � � �
���Y � � ' State �., ZIP Code Company NAIC Number.
�:. � E,� �` ��% i4 T�� .t� t/-�c:� L, �-� ��> 7
if submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front VievW' and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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�LEVATION CERTIFICATE, page 4 �uilding Photographs
Continuation Page
IIVwPORT�NT: In these spaces, copy the correspanding information from Section A. FOR INSURANCE COMPANY USE
Ruilding Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Policy Number.
��y�� E�G��t�A�ca -��'�,��L � � �
G��Y State ,_ ZIP Code Cbmpany NAIC Number.`
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if submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
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