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15 GLENDALE ST •t �' U.S.DEPARTMENT OF HOMEIAND SECURITY ELEVATION CERTIFICATE OMB No. 1664-0008 Federai Emergency Management Agency Expires March 31,2012 National F(ood Insurdnce Program Important: Read the instrucGons on pages 1-9. SECTION A-PROPERTY INFORMATION For Insuranoe Company Use: At. Buflding Owners Name VILLAS OF CLEARWATER BEACH CONDO ASSN INC Pollcy Number � A2. Bupding Slreet Address(including Api.,Unit,Suite,andlar Bldg.No.)or P.O.Route and Box No. Company NAIC Numbsr 15 GLENDALE STREET Ciiy CLEARWATER State F4 ZIP Code 33767 A3. Property Descriptlon(Lot and Blodc Numbers,Tax Parcel Number,Legal Descriptfon,etc.) VILLAS OF CLEARWATER BEACH CONDO,CONDO PLAT BOOK 60,PAGE 108 A4. Buflding Use(e.g.,Residential,Non-Residentlal,Addition,Accessory,etcJ BESIDENTIAL A5. LalitudelLangitude:La�27°59'13.7" Long.82'49'3&.9" Horizontai Dalum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 phorographs of the building if the Certifcate is being used to obtain ftood insurance. A7. Building Diagram Number 8 A8. For a buifding wKh a crawispace or enciosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enctosure(s) 1.764 sq ft a} Square footege of attached garage Q sq ft b) No.of perrnanent flood openings in the crawlspace or b) No.of pertnanent flood openings in the attached garage enclosure(s)within 1.0 fool above adjacent grade 0 within 1,0 foot above adjacent grade Q c) Total net area of ftood openings in AB.b Q sq in c) 7ota1 net area of flood openings in A9.b Q sq in d) Engineered ftood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8 Communiry Number 62.County Name B3.State CITY OF CLEARWATER,125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Suffix 66.FIRM Index B7.FIRM Panel 68.Flood B9.Base Flood Elevation(s}(2one 12103C0102 G Date EHectivelRevised Date Zone(s) AO,use base tlood depth) &18-09 9-3-03 VE 13 610. Indlcate the source of the Base Flood Elevation(BFE)data or base flaod depth ente�ed in Item 89. ❑ FIS Profile I� FIRM ❑ Communiry Detertnined � Qther(Describe) B11. Indicate elevation datum used for 8FE in Item 69: ❑ NGVD 1929 � NAVO 1988 ❑ Other(Oescribe) Bt 2. Is the building tocated in a Coastal Barrier Resources System(CBRS)area or Othenxise Protected Area(OPA)7 ❑ Yes � No Des(gnation Date N/A ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INF�RMATION(SURVEY REQUIRED) Ct. Buitding elevations are based on: ❑ Construction Drawings' ❑ Building Under ConsWction'. � Finished Construction `A new Elevation Certificate will be requlred when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE},VE,Vt-V30,V(with BFE),AR,AR/A,ARJAE,AR/At-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building dfagram specifled in Item A7. Use the same datum as the BFE. Benchmark UUlized I-03Vertical Datum 1988 Conversion/Comments dL�l Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)�.� �feet ❑meters(PueAo Rico only) b) Top of the next higher flaor 18.9 �feet ❑meters{Puerto Rico only) c) Bottom of the lowest horizontal struUurat rnember(V Zones only) 3.7 �feet ❑meters(Puerto Rico oniy) d) Attached garage(top of slab) �/A. ❑feet ❑meters{Puerto Riw only) e) Lowest elevation of machinery or equipment servEcing the buitding �.0 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f� lowest ad)acent(finished)grade next to building(LAG) g.Q �feet ❑meters(Puerto Rico anly) g) fiighest adjacent(finished)grade next to building(HAG) 7.0 �feet ❑meters(Puerto Rico oniy) h) Lo�vest adjacent grade at lowest elevation of deck or stairs,including 7.1 �feet ❑meters(Puerto Rico only) structurat support SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or archited authorized by law to certity elevation information. 1 certify that!he rnlormaUon on thrs Certi(�cate represents my best ellorts to Interp�et the dete avaifable. 1 understand Ihat any islse sfatement may be punishabfe by(rne orlmprisonment under 18 U.S.Code,Secffon 100t. � � Chedc here lf comments are provided an badc of torm. Were latRude and longitude in Section A provEded by a �.� . . Ilcensed lend surveyo�'1 � Yes ❑ No •• ��f Certifers Name DAN H. RIZZUTO License Number 5227 ��•'�' �� '� Title PROFESSIONAL LAND SURVEYOR Company Name POLARIS ASSOCIATES.INC. C S �s(i c? _ Address 216 U YDALE VD. Clty CLEARWATER State FL ZIP Code 33765 ' Signalure Date 12-27-11 Telephone 727-461-6113 FEMA Form 81-31,Mar 09 See reverse side for continuation. Replaces all previous editions ' r _ � � IMPORTANT: In these spaces,copy the ccrresponding informatlon from Section A. For Insurance Company Use: Buiiding Street Address(inGuding Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No. Poilcy Number '• � 15 GLENDALE STREET City CLEARWATERState FL ZIP Cade 33767 Company NAIC Humber SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Eleva6on CeRificate for(1)communiry official,(2)insurance agenUcompany,and(3)build(ng owner. Comments 1.SURVEY MAP AND REPORT OR TH COPIES THEREOF ARE NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR A PER. DITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED 2.ITEM C2E DENOTES TRANSFORMER P 3.POLARIS JOB NUMBER 01�4148 Slgnature Date 12-27-11 ❑ Check here if attachments SECTt�N E-BUII.DING ELEVATION INFORM I (SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A{WITHOUT BFE) For Zarses AO and A(without BFE),complete items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F requesl,complete Sections A,B, and C. For items E1-E4,use natural grade,if avaitabte. Chedc the measurement used. tn Puerto Rioo onty,enter meters. E1. Provide elevation informalion for the following end check the appropriate boxes to show whether the elevallon is above or below the highesl edjacent grade{HAG)and lhe lowest adjacent grade(U1G). a)Top of bottom floor(including basement,crawispace,or enGosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor{including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ betow the LAG. E2. For Building Diagrams 6-9 with permanent flood openi�gs provided in SeGion A Items 8 andlor 9(see ages 8-9 of Instructions),the next higher(loor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or �below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑belaw the HAG. E4. Top oi platfortn of machinery and/or equipment servicing the building is C]feet ❑meters ❑above or❑below the NAG. E5. Zone AO only: If no flood depth number is available,is the top of the botiom floor etevated in accordance with the cammunity's floodplain management ordinance? ❑Yes ❑ No ❑ Unknovm. The local afflcial must certify this infortnation in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVEj CERTiFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The stalements in Secttons A,B,and E are corract to 1he best ot my knowledge. Property Owners ar Owners Authorized Representalive's Name Addre�s. Ciiy State ZIP Code Sig nature Date Telephone Cornments fl Chack here H attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The Iccal o�ciat who is authorized by law or ordinance to administer lhe community's @aodplain management ardinance can camplete Sections A,B,C(or E), and G of lhts Elevation Certificate. Complete the applicable item(s)and sign betow. Chedc the measurement used in ltems G8 and G9. G1.❑ The information in Section C was taken fram other documeniation that has been signed and sealed by a Ilcensed surveyor,engineer,or architect who is authorized by law to certiy elevation infortnation. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community o�cial completed Section E for a building iocated 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 floodplain management purposes. G4.Pertn(t Number G5. Date Permit Issued G6. Date Certificate OF Compliance/Occupancy Issued G7 This pemiit has been issued for. ❑New Construction ❑Subsiantial Improvemenl G8. Elevation of as-built lowest eoor{including basement)of the building: �]feet ❑meters(PR)Datum G9. BFE or{in Zone AO}depth of tlooding at the building site: ❑feet ❑meters(PR)natum G10.Communiry's design Oood etevation ❑feet ❑meters(PR)Datum Lacal Otficial's Name Title Cornmuniry Name , Telephone Sf9^a�� Date Cornrnents _`, -- : � ' ❑Check here if attachmants FEMA Fortn 81-31, Mar 09 Replaces all previous editions Bu�ldin� Photogr�phs S�e instruction5 ior It�n1 I�G, �� . .__._... � _.._.__�. S`or Insurancc Gam�any Use; � --—_.. .�_...__ _ ___._�_ _. _.�_.__ Suiid�ng Street Add��ss(incl�ding Apt., Unit,Suite,andlor 81dc�. No.)or p.C7. Rout .._..�_. _ _.____._ i �?�t�d �OX NO. Policy Ni�mber f 5 GIECaDALE STREET � – -..._..____......�._...._�___ � __..__......_................ � Ciry ctEa,RwA'r�� 5tate FL ZIP Code �s�s� . _.. . _.._.._.___...__.._ _... . ___..__comX,aanyt�iCNur�;t�r u � : If using the Elev�tion Certificete to abtain NFIP floo� ins�rance, �ffix at leasi twa f�uiiding photographs belr�w according to ' the instruct�ions for fkem A6. Identify ail photogra�hs witi�: date t�ken, "1=ront Vi�w" and "Rear View`; and, ifi r�quir�d. `�Right Side View' and "Left Side View," !f submitting more photogra{�hs th�n wii(fit on ttiis pac�e, 4ise the Continu�tion Page on the � reverse. FhC1NG SUUTH FACING SOUTH � _ � � . � � �� .. � ,, �� ,r�: � � 'P 6�l :g �� . '' � � ' �+" ,. � � �`�a�� + �..d� ' � 'lllNi��4�� " � � �-�-4 ,: r � �� _ �� r .� � � _. 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No,�ar P_C), Rcrut'e��d �t�x No. Po��Numk�er � ��L�r�r��,��s�r�E�T _ ____._........_... _.. ...._ _.. � � _..._ _..._.. _ �_._.__...___...._....�..�...__._ �_ _..._. _.__ _____ C�ty ��.�nr�wAT��z State �� IP Code s3��r � ��mr�nyru��r�,n,�es If s�i�rr�itting rnore photoc�raphs than will fit on the �receding page. �ffix the �dciitional photogr��t�s k�c�av�. ldenti#y al� � pt�otc�gr�phs��rith: dat�talten;>.�ront Vie�a�"�ntl"Rear Vie�`�; and, if r�quired, ,�Right Side �i��v" and "Left Side�fi��.v." � �, ; , _ �_ �_ ... _ .__.._._� _.._�__ ._..__ _, ._. _____._____.---____._. _ . �� _ —. f�1�Cl�.l� t�7C)i;TH FACItJG WES'T � �.. '� �:� �",� �� rt��"��.� ��. 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TRAi�SFORM�R PA[} �;r`.:�� "'1 � . ;3�" v � , �'"�` ` �� ..�.�„�,,:�: � � A � �:�.�� j. � �: �� ; � � : x� � .,,�� ` 3 pi ., � `��a ��<s I . � � . �i W � � i � � � � �� - . � �. j �� "`� "`�"°�� ;�k3��.��"�� ' I � � t � �� f;= �� , �t� �� v v� �� " ��. � ,v� � r,`+m;s � : � � � % .. ��,��` � - ¢: a.0 ��`�"�-� �' ' . � �,�a '°'� ��, � �� s��, � � a , �� ! x �� ik� � �wA°A• �--.�-�.i �:�.,., �� gi ..`..........w U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name VILLAS OF CLEARWATER BEACH CONDO ASSN INC Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 15 GLENDALE STREET City CLEARWATER State FL ZIP Code 33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.) VILLAS OF CLEARWATER BEACH CONDO,CONDO PLAT BOOK 60,PAGE 108 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude:Lat.27°59'13.7" Long.82°49'38.9" Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building ff the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 6 A8. For a building with a crawlspace or enGosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enGosure(s) 1.764 sq ft a) Square footage of attached garage 0 sq ft b) No.of permanent flood openings in the crawtspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8�Community Number 62.County Name B3.State CITY OF CLEARWATER, 125096 PINELLAS FLORIDA B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel 68.Flood B9 Base Flood Elevation(s)(Zone 12103C0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 8-18-09 9-3-03 VE 13 610. 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) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date N/A ❑ CBRS ❑ OPA 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. 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 building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized I-03Vertical Datum 1988 Conversion/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)7.1 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 16.9 �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) 13.7 �feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) N/A. ❑feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 7.0 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 6.0 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 7.0 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including 7.1 �feet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This ceRification 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 on this Certiflcate represents my best efforts to interpret the data available. . I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 100L , � Check here if comments are provided on badc of form. Were latitude and longitude in Section A provided by a - + �"`¢`� licensed land surveyor? � Yes ❑ No �„ ,�;$^,r � �. ' , Certifier's Name DAN H. RIZZUTO License Number 5227 (p�,y//�,, l � � .+; � I"�_- ,��• uS.. � G. Title PROFESSIONAL LAND SURVEYOR Company Name POLARIS ASSOCIATES,INC. � r' ~� =��-�°-��L� v� ��. Address 21 S NNYDALE LVD. City CLEARWATER State FL ZIP Code 33765 ,��•,� �;;"�"r' " µ,q� , f.. ��`�., �. . Signature Date 12-27-71 Telephone 727-461-6113 �� FEMA Fo 81-31, Mar 0 See reverse side for continuation. Replaces all:previ�us editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Buiiding Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 15 GLENDALE STREET Ciry CLEARWATERState F� ZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments 1.SURVEY MAP AND REPORT OR THE COPIES THEREOF ARE NOT VALID WITHOUT THE SIGNATURE AND THE pRIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER.ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPOR7S BY OTHER THAN THE SIGNING PARTY OR PARTIES IS PROHIBITED. 2.ITEM C2E DEN TES TRANSFORMER PAD. 3. POLARIS JO N MBER 0 148 Signature Date 12-27-11 ❑ Check here if attachments SECTI N E-BUII.DI VATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is ❑feet ❑meters ❑above or�below the HAG. E5. 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 offcial must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or ownePs authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,8,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 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 Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items GS and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by Iaw to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community o�cial completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4-G9)is provided for community floodplain management purposes. G4.Permit Number G5. Date Pertnit Issued G6. Date Certficate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs Continuation Page , For Insurance Company Use: i� Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 15 GLENDAIE STREET Clty CLEARWATER State FL ZIP COd2 33767 Company NAIC Number 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." FACING NORTH FACING WEST ��- ��%' '�'1 ��; � , � ��Illlllli , ,�;�, �f' �-�, i � ,.�. ., tr -- .e�'"�� f� )� rv#kR ` b f : �4 v:r � � � .�, �� ..... � IIII�IIU� � � 4� I ��' � :IIII,IIII!�°�� — �. � �am ; ,, :- � �"• �; �� '� _ ■ � ` � I�'"u;,d ��Il�u�Im i� �H � ', r x i ! I t .:�" � j , IIIIIIIIIIIIIIU � � � � , "'� �� t ' _� �'` t I�, '� � � � �� a • ��._ � c` "�'� __— _ r_, , r: � .,,�.- ., µ. . q . ��, r .� .. .:..� . '. .� ' � , :..� . rv ` .ti � }� ' � ,. •P � t . ��.... ... � gr. i �,.�.; s,/ ' : { � `_ e x .� - . v , . . - -° . � . ... �e ;.f-� . .. � ' . f ,.:/e;^�. . . 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Route and Box No. Poi�cy Number 15 GLENDALE STREET Clty CLEARWATER State FL ZIP COde 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least finro building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear VievW'; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. 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