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1060 GULF BLVD;. _ U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 F�ederal Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program -� ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building owner. SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Policy Number: PINELLAS COUNTY A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 1060 GULF BOLEVARD City State ZIP Code CLEARWATER Florida 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PINELLAS COUNTY PROPERTY APPRAISER ID# 17-29-15-00000-320-0000 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) NON-RESIDENTIAL ACCESSORY A5. Latitude/Longitude: Lat. 27.95895 Long. -82.82971 Horizontal Datum: � NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in AS.b N/A sq in d) Engineered flood openings? ❑ Yes � No A9. For a building with an attached garage: a) Square footage of attached garage N�A sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b IV/A sq in d) Engineered flood openings? � Yes � No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State CITY OF CLEARWATER - 125096 PINELLAS Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel 68. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 12103C0104 G 05/17/2005 09/03/2003 VE 12 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile ❑x FIRM � Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 �x NAVD 1988 � Other/Source: 612. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? � Yes � No Designation Date: � CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 � kLEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30. 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1060 GULF BOLEVARD City State ZIP Code Company NAIC Number CLEARWATER Florida 33767 SECTION C— BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction" �x 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, ARlAO. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: "PCDSM GPS 78" EL=4.78 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 9 2 Ox feet ❑ meters b) Top of the next higher floor N�A. ❑x feet � meters c) Bottom of the lowest horizontal structural member (V Zones only) N�A. � feet ❑ meters d) Attached garage (top of slab) N�A. � feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building N�A. � feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 5 6 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 6 � ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 5 6 �x feet � meters structural support 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 on this Certificate represents my best efforts to interpret the data avai/able. l understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number JONATHAN S. BRANSON FL PLS 6845 \`�� i�� i r �� Title �,�`�1`PN. S:;BRq�''�,, PRESIDENT ` � .•\GQ�se N4,nb '!!i�'� Company Name = �_� � Place @� ��, Z = ACROMIC, INC. LB 8094 = � Seal _ Address = o ��• Here 1116 NEEDLEWOOD LOOP J��s+� ��'-. FLORIDA ,.'� tS`��` City State ZIP Code ,��,°'��S�rVeyo`�a��\` OVIEDO Florida 32765 Signature � Date Telephone 05/10/2016 (321) 312-0787 Copy all pag of this Elev ' n Certificate and all attachments for (1) communiry official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) A4. BUILDING IS A BATHROOM / CHANGING ROOM A5. COORDINATES WERE DETERMINED USING GEO-REFERENCED AERIAL IMAGERY. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 � FLEVATION CERTIFICATE a OMB No. 1660-0008 � - Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1060 GULF BOLEVARD City State ZIP Code Company NAIC Number CLEARWATER Florida 33767 SECTION E- BUILDING ELEVATION 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 1-2 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 ara e to of slab is 9 9� P )� . ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or 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 o�cial must certify this information in Section G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) 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 statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 � 1=LEVATION CERTIFICATE OMB No. 1660-0008 Ex iration Date� Novemb 30 2018 � , p . er IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Policy Number: 1060 GULF BOLEVARD City State ZIP Code Company NAIC Number CLEARWATER Florida 33767 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 G8—G10. In Puerto Rico only, enter meters. 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 law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official 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—G10) 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 lowest floor (including basement) of the building: . ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: , ❑ feet ❑ meters Datum G10. Community's design flood elevation: . ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 � BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE See Instructions tor Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. -' Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No 1060 GULF BOLEVARD City State ZIP Code CLEARWATER Florida 33767 OMB No. 1660-0008 Expiration Date: November 30, 2018 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix 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 show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. �n, �r_ _ _ _ _ _ _ - ---- Photo One Caption FRON1 � r �"u - G ;�_016 �., ,. Photo Two Photo Two Caption REAR VIEW - 05/04/2016 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 . BUILDING PHOTOGRAPHS OMB No. 1660-0008 ��LEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE '" Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 1060 GULF BOLEVARD City State ZIP Code Company NAIC Number CLEARWATER Florida 33767 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. �� 1 V �, �= � .. . � .:. � F,�:.: � P W'� . . � r, .. �t.�, � ` ,`r /. �, .,.., � s . . 4 n�' . .,:�., „ , , . , p _ � . . � _ �' f t �' ,.a ' � ` �p _ ' ��.� yR- _ � � ,� „�� , ., ._ a T. _ ,4 " � g,� ,.� .: � . + . . . ... �+, . r�' "� 2� _.. ,.. ..., .., �. +& gt � . � . �< ". � .. i' _... '�- ' ,� �.�'. ,�. � `� ' '� .. �� . �-'n ��. �� 6��n.+°r � � � � � �"� � �<" �. � .c � - �� .„ wr , - ,.�� . � �a ;�°. � a:: S �� . � �" �� r � , � � �� "�* �� _ � a ' s � ,, � . �„�+��, ,�� " "` w`,�'`� n a �. .. " b v. � � _ � �° -- — ---------- Photo One Caption LEFT SIDE VIEW - 05/04/2016 a ; - �. +�' �''S'{ � ��r � f �. �`' �' �,;:„=+�. , � � �„-�;,.�, � �, � � . ,� ��, i•- 'e . ��.� �": }�� . �� . TP . � ` 4 _ q �� .-�. . � �.. � E 6� � � : � �."� . . . '9, w '�� $'�s.. � . . . . .. „*^°.a"",n . . . ��. . �He . . �. . mm»..A—.+-ee v ., 4 nv+ � 't .., e. ..,.. � _..._ ..... . � .Xo;�` � �3„ � . �. t ;, � - � , w " �' : � �.z� � �� i ��f � � "�°,�mo �� .� � � � �,� � �'' �� a �1 _ ��` �i" ''�' � 'r �s.i�' . • n'�' � -_ � � �"'" ;. � & et � a , " � :� .�" � , �f'.a Y�� : { � � �, ,�� `�� r„r ., ..:!`+�. y� �,'�,�.a-�,rr,+sf44.,'�� '-a ��'Y'��'� .�a rv : . , . �„ ' .� �p �. � . �., ° � . - c � a, _ . c . . . ,. =:�:�w+r» 's.1*�`s'�.. .. .�a's.im �'.. -�^�i.�.,�.. . ..��a.,.w.3a�.. Photo Two Photo Two Caption RIGHT SIDE VIEW - 05/04/2016 FtMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 ,f�/� -- -.; ELEVATION CERTIFICATE OMB No. 1660-0008 �`---� �U�� 7' Expires March 31,2012 ��a�w��a��.,,.,,,,�,..,.,.,.. ._,._ I Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Pinellas County Solid Waste Department PolicyNumber A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIG Number 1060 Gulf Blvd City Clearvvater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) 17-29-00000-320-0000 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residentall-Portable Stora4e Shed-Shed No. 1 A5. Latitude/Longitude:Lat.27.960501 N Long.82.825786 W Horizontal Datum: � NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name&Community Number B2.County Name B3.State 125096 Pinellas FL B4.Map/Panel Number B5.Suffix B6. FIRM Index 67.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone 0104 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 09/03/03 05/17I05 AE 12' 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) B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑ Yes � No Designation Date ❑ 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 PCDSM GPS 78 1999 Vertical Datum NAVD 1988 Conversion/Comments N!A Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)6.73 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N/A. ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑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 N/A. ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 5.84 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 7.60 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. ❑feet ❑meters(Puerto Rico only) structural support 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 on this Certificate represents my best efforts to interpret the data available.l ,p '-. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.� ` ;:. a -��-•;:,, -' Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ''y "" ``°•. '� `, licensed land surveyor? � Yes ❑ No ~'•'!��- � ��': � .� . :��,�` Certifier's Name Penny Standridge License Number 5240 , >+�_ � . • ,:;.._.,,�" Titl dSurvey Specialist Company Name Pinellas County Public Works ;' + �'� ' .' '�V \, ,., Address 222 US H N City Clearwater State FL ZIP Code 33765 •., � _;" - nature � Dat � Telephone 727-464-8904 �, �" 0 F or 1-31, Mar 09 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(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number '1060 Gulf Blvd City ClearwaterState FL ZIP Code 33767 Company NAtC Number SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED) Cop�o ' es of this Elevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. ��omments This b ilding serves as a temporary storage shed for the Solid Waste Department at Sand Key Park / �/ % _� � - 2) IJ Sig�iature Dat � Check here if attachments CTI -BUILDING ELEVATION 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 ly,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show er the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawispace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclos i ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings pro ��i 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 ❑ ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment s icing the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number i� ilable,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 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 statements in Sections A,8, and E are correct to the best o y 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 G8 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 law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-i sGed or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4-G9)is provided for community floodplain manage nt purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑Su antial Improvement G8. Elevation of as-built lowest floor(including basement)of the buildin � ❑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 See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy rvumber 1060 Gulf Blvd Clty Clearwater State FL ZIP COde 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page, following. . " „ � , , - , . . � h • � „� � ._ ,•�; .� . .�. � < ,_.... � ..� ,�.,_ �- ., �,- � t��, .,�� x, . , � s �._u. .�. �;''" � � � � i r �°��: ,A°,•f'�; > �,� '�� '1c� �'�i� .� �� tiY r :.. ,�,� � � -'�?.1" r J . . , � .,._� •,, ^• � , ! � �+��• � ` - �.. .- - � . ,�, _ y , � .. „� �, /' /. . '1a�fB- . "' � . t,�# ,, . c . � :. , , .. - � �„�; • �, � .�`, �„ �.'a,+, . r J '~ .,.�'� !�, �,.. � � , f , � � f �.� � '�R" ��;� . ., �; � � - � . I . ,4�' 1 � ��r: . I�' � #.''t ��,`�'�, p&w°�"yA,•�� ,�� .r.. .r rR• r..* ; I r . �'��¢Y;��y• � . �.,,.,�r� ,F, � �f` ?�»��,��s,".��*,.s��.� a .;�.;^ f .'` � �,' � �'."`N`� �yR✓ �'. ,.� �..�...�"^��:x:;:�� . f � . �& ` �;?;�"�, . . »� _i '�'�.+,4a ��, *k Ms. � `+.. ✓ � M� ' ; , a �* �' ` � ,°. �:µ •w 4 �1 . � . M.� � f � ' �:# . .. '�'"`�.��&' , rs>� r, � � �I��+�, n r, � p r t„' ,.".,. �"�^ t�"f;��p F 1 .1�' r�•. ��= � +. � `G,^�"s�f' ��; t .:,„ i .� r� x 1 , , .. , � � ��,j!_ �n�5 �.. "� . ��"` +J . ♦ . �� t ,; �3 .r � •y C ./� �� . ��' �, .. �t ' �� { '�, 1N!'.i'� � . �� ' .��e�M ' R Yp k! " � *�• e:-��' �, '� ? ..., r t�r � . , t'"`"d" �M' .J� ' J � General Location showing Shed #1 and Shed #2 , : �, - � Building Photographs Continuation Page For Insurance Company Use: Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 1060 Gulf Blvd Clty Clearwater State FL ZIP COde 33767 CompanyNAlCNumber 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." � i Photo Date 09/14/2010 �I . r � - _ _ �I + , "�¢y.. W P �.y � � � � ��,. � � ��' � � i p, - +��p.. ` v' �x � , �~_�� . , � "�r _ � ' � y, ... ��' Shed #2— Front View Shed #2— Rear View i �� 'w��'�,�'�ul�illll�� ""`�I�� ,. ��.. � �� - -��... �... ., � Shed # 2 (on the left) . � , U.S,DEP.ARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008 �Federal Emergency ManagementAgency 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 Pinellas County Solid Waste Department Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NA1C'Number 1060 Gulf Blvd City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 17-29-00000-320-0000 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non-Residentall-Portable Storaqe Shed-Shed No.2 A5. Latitude/Longitude:Lat.27.960501 N Long.82.825786 W Horizontal Datum: � NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61. NFIP Community Name&Community Number B2.County Name B3.State 125096 Pinellas FL B4. Map/Panel Number 65.Suffix 66. FIRM Index B7.FIRM Panel 68.Flood 69. Base Flood Elevation(s)(Zone 0104 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 09/03/03 05/17/05 AE 12' 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 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 ❑ 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 PCDSM GPS 78 1999 Vertical Datum NAVD 1988 Conversion/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawispace,or enclosure floor)6.20 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N/A. ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑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 N/A. ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 5.23 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 5.69 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. ❑feet ❑meters(Puerto Rico only) structural support 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 on this Certificate represents my best efforts to interpret the data available.l , understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.� ? `��, Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a � -' �� ";,� �'°, , licensed land surveyor? � Yes ❑ No _,. �•r r�,�'-.,��? ;;. ,:5 .,.' .: (r�, �.; -�. Certifier's Name Penny Standridge License Number 5240 ;,»i '" " �' � ,�n ��:� i le Land Surve Specialist Company Name Pinellas County Public Works �; �,.�: { f�-= {� / Address 222 Hwy�1,9 N City Clearwater State FL ZIP Code 33765 '� ;=� �';.•, ' ' ir . • ure Date , Telephone 727-464-8904 � ''%: �° � FEtvl m 81-3�, Mar 09 ee 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(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. PoliCy Number 1060 Gulf Bivd City ClearwaterState FL ZIP Code 33767 Gompany 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. Co ents This uilding serves as a temporary storage shed for the Solid Waste Department at Sand Key Park /� � � �\ 1l'� !/c7 Sig ture J Date � Check here if attachments SECTION -BUILDING ELEVATION INFORMATIO 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 onl ,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show wh 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 enclos re)is . ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or en hos� ' . ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings pro 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 eet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipme rvicing the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number 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 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 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 y 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 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' ems G8 and G9. G1.❑ The information in Section C was taken from other documentation that has been signed and sealed a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevati data in the Comments area below.) G2.❑ A community official completed Section E for a building located in Zone A(without a FEM ' sued or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4-G9)is provided for community floodplain manage ent purposes. G4.Permit Number G5. Date Permit Issued 6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction S sta al Improvement G8. Elevation of as-built lowest floor(including basement)of the build�n�; ❑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 I Continuation Page For Insurance Company Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy rvumber 1060 Gulf Bivd City Clearwater State FL ZIP COde 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." Photo Date 09/14/2010 � .�� . �� ,.. � . ✓� � � <�� +rr.�.rMr . � ;� � + �� . w �. � �"' ii Shed # 1 Front Shed #1 Rear *� � P yi q ++, �► M ' '�ta k , i��.:,. ,�,, V X �.w,;,.;, ��'� _ ,�aw,ti.. m.,.,._ , Shed # 1 (on the right) Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poi�cy rvumber 1060 Gulf Blvd City Clearwater State FL ZIP COd@ 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page, following. ', I . � , . - •� � . . , � A � , .��/ . _ .. . E � �t ,� r^/ , . ,�,.� �. � { � f- "�,,,:�... .Ys„� ��e. � �. . � ,: �:. � ,� � �...� �•� � � � �. . �..� a� _ti w��, � C .n yf� ,'S :�!!�! .,. � ;. `Ji t'• ��; �� °,�`��°�' r ,"i �`'�r,�` ,� � � �� '� � {` . .r, a, `+IA' + `j �.,� � � � , • k} . �'� � .� � .. . . � . � � � � � (��i ��9� , y "� � � . ^ ` p 'Sw 4�:A�:'.� - � "y A , ,��,,W_ x. '•. � :r, , , 1t, � �f .�4e �. �" .*r, � ��' :`�� w..e!' 1 i' h1�.�� .. { .M. . . � • ��, . J, ��.� . � � , . �+ . "�� * Ml�hr �f ^`'"�`i y`�i�� ".� j^.� }��^ s� � _� L •�.. � �� / ., � .� � �� . � �e''.d.' �'� �� . ` ;�� M =� � 4 +� �� f �� f ��, l , ,A M \ ! R n. , . . ., .�,. . .. �n_ ' � �� ` ' .. w,h , .. s �'1 � �r' � r. ., '� � ... *� „ '�'1..�'A. ' � , ,. � . � * � T � � . +k�.:� r 1� 4 �� , y,.�`� „�, ��'' . "'' ,� •v �+. �r�. i �, . ,� � . � . � , , _ .. ,a . � .- ,� a . r . �, y r ° s . . ' � �. „ . ` ,��6',�.,,,uj' ,.y� . . ... . . ,*�; : ' � �, L`��"�.r� .� "` �,,, � �'� r ��. ��' � ��, � �. �.�� ' �k Y(yg ,'�, s!'P .� � + ;e�� ;�. � � � _ ��•�, ; i, , ~ � r s ��. ,�,� ,� _ — � . y,� ,�r' ,�' '�. � .� 1 .,§s._tl �* I.,Y�. .' 4 . , ,w �. �es T� t �� ,� r � ,rI�� '� � �Y� S'` . . '"�i+,. .. 9" � � � � ��ai_j ,�_ , .�a. .r_ .... _ . . � � - _� . ' . . . (I . OMB No. 1660-0008 . U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Expires March 31,2012 Federal Emergency Management Agency - National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION A1. Building Owner's Name Pinellas County Solid Waste Department A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. 1060 Gulf Blvd City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 17-29-00000-320-0000 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Non Residentall PO Hor iontal Dat m: � NAD 1927 ❑ NAD 1983 A5. Latitude/Longitude:Lat.27.960501 N Long.82.825786 W A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. q7. Building Diagram Number � qg. For a building with an attached garage: A8. For a building with a crawlspace or enclosure(s): N/A sq ft a) Square footage of attached garage NIA sq ft a) Square footage of crawlspace or enciosure(s) b) No.of permanent flood openings in the attached garage b) No.of permanent flood openings in the crawlspace or within 1.0 foot above adjacent grade N�A enclosure(s)within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes � No d) Engine.ered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 62.Coun Name 63.State 61.NFIP Community Name 8 Community Number pinellas � FL 125096 68.Flood 69.Base Flood Elevation(s) one 64.Map/Panel Number 65.Suffix B6.FIRM Index B7.FIRM Panel AO,use base flood depth) 0104 G Date Effective/Revised Date Z AE S) 12' 09/03I03 05/17/05 610. 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) NAVD 1988 ❑ Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � Yes � No g12. Is the building located in a Coastal Barrier Resources System(C�BCBRSea or Oth�e OPAProtected Area(OPA)? ❑ Designation Date SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction" � Finished Constniction "A new ElevaUon Certificate will be required when construction of the buiiding 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 UGlized p��sM GPS 78 1999 Vertical Datum NAVD 1 Conversion/Comments N/A Check the measurement used. feet ❑meters(Puerto Rico only) a) Top of bottom floor(inGuding basement,crawtspace,or enGosure floor)N�Q 0 feet ❑meters(Puerto Rico only) b) Top of the next higher floor - N/A. ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) � �feet �meters(Puerto Rico only) d) Attached garage(top of slab) e) Lowest elevation of machinery or equipment servicing the building �IA. ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) feet ❑meters(Puerto Rico only) � Lowest adjacent(finished)grade next to building(LAG) �•� � 5.69 �feet ❑meters(Puerto Rico oniy) g) Highest adjacent(finished)grade next to building(HAG) feet meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. ❑ ❑ structural su ort 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 on this Certificafe represents my best efforts to interpret the data availab/e.l understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001.� Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �,�.�A4L licensed land surveyor? � Yes ❑ No ��_ License Number 5240 l�iERF Certifier's Name Penny Standridge • - e Land Surve Specialist Company Name Pinellas County Public Works , Address 222 Hwy 9 N City Clearwater State FL ZIP Code 33765 Date Telephone 727-464-8904 ure o FE 81-3 , Mar 09 e reverse side for continuation. Replaces all previous editions IMpORTANT: In these spaces,copy the corresponding information from Section A. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. 1060 Gulf Blvd City ClearvvaterState FL ZIP Code 33767 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. Co ents This uildi g serves as a temporary storage shed for the Solid Waste Department at Sand Key Park i /� Date � Check here if attachments Sig ture SECTION -BUILDING ELEVATION INFORMATIO NOT REQUIRED)FOR ZONE AO AND ZONE A(W�THOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a IOMA 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 onl ,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). ❑feet ❑meters ❑above or 0 below the HAG. a)Top of bottom floor(including basement,crawlspace,or encios re)is • []feet ❑meters ❑above or❑ below the LAG. b)Top of bottom floor(inctuding basement,crawlspace,or en s� � E2. For Building Diagrams 6-9 with permanent flood openings pro in S eition❑��e�e�$a abo e(or�below he HAG uctions),the next higher floor (elevation C2.b in the diagrams)of the building is eet �met�ers ❑above or ❑below the HAG. E3. Attached garage(top of slab)is • feet ❑meters ❑above or�below the HAG. E4. Top of platfortn of machinery and/or equipme rvicing the building is • � E5. Zone AO only: If no flood depth numbe o��The local offic al must ert fy thfls nformati n in Section G e�th the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unkn SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATI V E)C E R T I F I C A T I O N The property owner or owner's authorized reprn Sect�ions A,B,and E aee co�elct to he bestof rtiy knowledge. out a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements Property Owner's or Owner's Authorized Representative's Name City State ZIP Code Address Date Telephone Signature Comments ❑c'heck here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized Com lete the applicabae item(s)and s gn below. Chedc the measurement usedan ems GS and G9.�tions A,B,C(or E), and G of this Elevation Certificate P G1.❑ The informati ti law o certify eaevatkon'i fortnationtl(Indicate the source a dedate of theaele ati I dataan the Cmment�area ble ow.) r architect o is authorized y G2.�] A community official completed Section E for a building located in Zone A(without a FEM ' sued or community-issued BFE)or Zone A . G3.❑ The following inforrnation(Items G4-G9)is provided for community floodplain manage ent purposes. G4.Pertnit Number G5. Date Pertnit Issued 6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑New Construction S sta al Improvement ❑feet ❑meters(PR)Datum G8. Elevation of as-built lowest floor(including basement)of the build n � �feet ❑meters(PR)Datum Gg. BFE or(in Zone AO)depth of flooding at the building site: �feet ❑meters(PR)Datum G10.Communiry's design flood elevation Title Local Official's Name Telephone Community Name Date Signature Comments � ❑Check here if attachments Repiaces ali previous editions FEMA Form 81-31,Mar 09 � � Building Photographs � See Instructions for Item A6. For Insurance companyuse: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 1060 Gulf Blvd Cpmparry NAIC Nunber City Ciearvvater State FL ZIP Code 33767 hs below according to "Front View" and "Rear View"; and, if required, "Right If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building pho ograp the instructions for Item A6. Identify all photographs with: date taken; e, use the Continuation Page, Side Viev�' and "Left Side View." If submitting more photographs than will fit on this pag following. ` �; General Location showing Shed#1 and Shed#2 , , • , Building Photographs � COIItInUatiOn Page For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 1060 Gulf Blvd �pa�y NAIC Number City Ciearwaier State FL ZIP Code 33767 If submitting more photographs than will fit on the preceding pag e, affix the additional photographs below. Identify all photographs with: date taken; "Front View"and"Rear Viev�'; and, if required,"Right Side View" and"Left Side View." Photo Date 0911412010 8I I �! I � t `�'� CCXJ�Z �_,,'(��C�i Y`Q:` ��G� ; ''b�sx,, Shed#2—Front View Shed#2—Rear View ,� Shed#2(on the left)