1350 GULF BLVD '��3�" 6 9��� FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
��/J o� NATIONAL FLOOQ INSURANCE PROGRAM Expires December 31, 2005
�o�c v�_�3 p,� ELEVATION CERTIFlCATE
SECTION A-PROPERTY OWNEit INfORMAT{ON For Inwrance Compairy Use:
/� BUfLDING OWNERS NAME Policy Number
R.J.BUNBURY COMPANY,INC. SITE Uto ia Condominiums
BUILDING STREET AQDRESS(Includin9 Apt,Unit,Surie,and/or 81Cy.No.)OR P.O.ROUTE AND BOX NO. Company NA1C Number
1350 GULF BLVD.
cirr sY�Te �L ziP coa33767
CI,EARWATER
PROPERTY DESCRIP710N(LOt and Block Numben,Tsx Parcel Number,LeQal Deuxip8on,etc.)
TAX PARCEI.ID.NO. 19 29 15 00000 i40 0300
� � , ss re , n ry.
RESIDENi7AL �
LATITUDE/I.ONGITl1U (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(rype):
(##-##-�#.##or�II#.#�AF#.) ❑NAD 1927 ❑NAD 1983 USGS Qusd Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM}fNFORMATION
81.NFIP COMMUHI7Y NAME 3 COMNUNITY NUMtBfR B2.COUNTY WuAE 89.STATE
CTTY OF CLEARWATER 125096 PINELLAS FLORIDA
B�.MAP ANO PANEL 87.FIRMt PANEL B9.BASE FLOOD ELEVATION(S)
B 8 .S F • EFFECTIVEIREVISEO DATE �• � 0 ( oneAD,we ep otlloodn9}
12103C0104G 0104 G 9/3/03 9/3/03 VE EL 13
810,Indicate tMa�auroo of Ihe Baae Fbod EleveUon IBFE}data or�sse�fbod deP�entxad in 86.
❑Fls r� �Fir� Q c«��cr���i�a p au,��e�.��—:��
Bt 1.lndicate Ihe alettatbn datum uted fa'tlie BFE in Bo:Q NGVD 1929 �NAVID l968 �c�mx(Descnbe).
Bi2.Is th�bull�np loeated in a CoaatAl B�rtier Re�ouress Systan(CBRS)aroa or Olherwifs Piokded+4sa{OPA)7 ❑Y�i �No De�l naUon Date�
- SECTION C-BUILOING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Buiid'ng de�radona ere based on:[]C����^��• ❑�I�np Under Cons�on' Finiahad Candrw�lon
'A new Elevatlql Cer�e w11 be roquted whan cantbuGion d fhe build'np ia oomplete.
�C2.Build�p Diaqram Number 6 (SeleCt ths buAdrcg d'�apra�n most aimilar to She bu�dinp for w�hidti th�a cerl�ca�e ia bainQ tanpleted�pepes 6 and T.lf no Qiep�am
acarataly�epreaenls the bu�d�ng�p�vide a akelch or ptatoyraph.)
C3.Elevatfona-Zanes AFA30,AE,AH,A(With BFE},VE,V1430,V{With BFE),AR,ARA,ARAE,ARlAN�30,+4R►+W,ARAO
Complete Items C3.-a-I bebw ao�irg to 1he building dkapran ape�ied�in Item C2.State the dalum uaed.IF the dahm ia dilte�ent trom tha datum used for the BFE in
Sedon 8�convaS the dahxn to ihal uaed fa the BF£.51aw field measurenerda and daWm aonvaaion nlalaHon�Use the spece p�ovided or tl�e Comments area of
Section D or Sadion G,as appnpriate,to doa,ment the dahun oomrerabn.
Dalum NAVD 88 �anrersioalComme�ovsa
Elevatioo reterenoe martc used ov�Dces the elave6an refera�meric used appe�r an the FIWrt? ❑Yea �No .
ay Top at bo�om tba(eduding bas�ent a endoaure) 6.3 n.(m) �
b)Top d next hiyher tl�oor 15.8 R.(m} �
c)Barttan d lowest horironial atructurai merriber N zones onh� 1 S.1 R.{m) �
�/yfad�ed 9arege{�OP Of slab) NA ft.(m) .
e}Lowest ebratbn d macninery atxYor eQuip�r�ent �
servic6,p Iha bwlding(Desaibe�a co�miants�res} 15.8 R.(m) . �� °
�l.owe.st�dl'acent(fini�9rada(LAGI 5.9 ft.(m) � .�I
8)High�t adlat�l{fe�ist�ed}yrade(HAG) 6.6 R.(m) $
h)No.ot partnanent openings(ibod+rentt)wilhin I R above adjaoent grade NA. it.{m) 88-06/0 2/OS
)Tofal era Of al1 pertnenent openinps{llood vaib�n q.h Over'q.h�(sQ•p�)
SEC'�'tON D-SURVEYOR,ENGINEER,OR ARCHRECT CERTIF1CATfON
This certification is Do be signed and aeafed by a land swveyor�enyineer,or a�chifeet authorized by Iaw tn oati(y elavation ir�fortriatias.
!certify fhat the iniortnatior►in Secbons A.8,and C on this cerlHicate�my best efEats tc interpret fhe data avalable.
J understand tl�at a false statament be nishabla fine or im t under 18 U S Code,Section 1001
CERT S E lICENSE NUMBER
JOSEPH R GORE,P.L.S. L5 5188 .
TInE COMPANY NAM£
PR03ECT MANAGER HAMII.TON ENGiNEERING 8t SURVEYING
� ��7y STATE
311 N.Ne e, ' 0 Tam a FL 33606
S�GNA.NRE pA7E TELEPN NE
06/01/OS 813-250-3535
FEMA Fo 81-31,January 2003 See reverse side for oontinuaUon_ Replacas all prevlous editbns
�P �b 3�'Q Q :��' FEDERAL EMERGENCY A�ANAGEMENT AGENCY O.M.B. No. 3067-0077
� ��� NATIONAl FLOOD INSURANCE PROGRAM Expires December 31, 2Q05
�� �° f`'�`�` ELEVATION CERTIFICATE
1�� SECTION A-PROPERTY OWNER INFORMATION For Inwrana Canpany uae:
BUILDING OWNERS NAME Policy Number
RJ.BUNBURY COMPANY,INC. SITE Uto ia Candominiums
BUILDiNG STRE�T A�DRESS(1nduQing Apt.,Unit,Suite,and/or Bldp.No.)OR P.O.ROUTE AND BOX N0. Company NAIC Number
3350 GULF BLVD. �
CITY STATE ZIP COQE
CLEARWATER FL 33767
PROPERTY DESCRIPTION(Lot and Block Number�,Tax Parcei Number,Lepal Desuiption,etc.}
TAX PARCEL ID.NO. 19 29 15 00000 140 0300
. , o - , i , s , a mme a, n
RESIDENTIAL
LATITUD LONGITUDE(OA i NAL) HORIZONTAL DATUM: SOURCE: GPS(Type):
(##-##-##.##or�.�1#�.} �NAD 1927 �NAD 1983 USOS Quad Map [�Other.
SECTION B-FLOOD INSURANCE RATE MAP{FIRM)INFORMATION
B1.NFIP COMMUNITY NAME i COMYUNITY NUTABER $2.COUN7Y NAME 69.STATE
CITY OF CLEARWATER 125096 PINELLAS FLORIDA
B4.MHP AND PANEL 87.FIRM PANEI B9.SASE FLOOD ELEVATION(S)
� • � • EFFECTIVElREYISED DATE g.FLOOD NE( A ,use np)
12103C0104G 0104 G 9/3/03 9/3/03 VE EL 13
610,Indicate ihe course of fhe Base flood Elevatfon(BFE)dele a bese flood deplh entered in 69.
❑FIS Prof4a �FIRhI Communiqr petermined ❑OIMr(Desaibe):
Bt 1.Indipfe tlro devetlon daUsn uaed for tlie 8FE n B0: NGVD 1929 �NAVIb 19@8 �Uther(Deiaibe):-
Bt2.Is!he buildinp bcated h a Coastal 8arrisr Resources System(CBRS)area or Othervrise Protetled Arsa(OPA)7 ❑Ye• �No Designation Oa69_ __
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRFQ)
C1.Build'qip elev�tionE ere besad on:Q Construcdon Drawinps• Buil6ny Under ConsWction• �Flnith�d Contbuction
'A aew Elevafion Cal�de wll be roQuired when Gansinx�ion d U�e buildiny is canplele.
�C2.BuAdinp Diagram Nwnber 6 (Seled tl�e buid'ng diagram moat si�rular to fhe buAding for which this ce�tlficata is beirg canpleted-eeepaqea B and T.IF no d�grarn
acaratery�epresents the buildinp,pmride a aketch a photopraph•)
C3.Elevatpna-Zooea AI,A30,AE,AH,A(Wilh BFE},VE,V1430,V(Wiih BFE),AR,ARA,ARAE,ARlAF�130,AttlAH,ARAO
Canplete Itarns C3.�1 below�opor�inG to 1he building dieprpm spec�ied In Itsm C2.State the dalum used.N the datwn ia d'AFerent from tlae daUun uscd tor the BFE in
Sedon B,canvert the datum�1�at uaed fa the BFE.Show fleid m�auremerrts and datum wrneraion cala�lation,ilse ihe space providod a the CommeMs area af
Section D or Sedion G,aa aPDroPriate,to doCUment ihe dofum oonversion.
Datum NAVD 88 �nversionlCommeMS o� � W .
ovex Does the elevation reference mark uaed appear on the FIRM7 �o V �.. . 'f,.
Elevatbn reference mark used • � • �;;..
a}7 o p d b o t D o m N o a('n d u d i r�b a s e rt�e n t o r e n c b a�r e) 6.3 t f.(m} (L,� � .�`�•".:'� � ,:%'�;
b)Top d next hiphe�fba 15.8 ft.(m)�r T�� #,,., �: `� .;,� '��
c)Bottam of lowest hor'rcontai struc3urel manbar(V zones oc�y) 15.1 $.(m}� � Z . '.� .+:. �. ,:-� `�I�
d�AUad�ad D�(toP Of sIaD) NA ft.(m) C="' �"� W �,",'� ;i. -: �G:.' ':
e)Lowast elevatbn ot machinery endlor equipmeM � a :�Y; '' � ;�: i:`7 , • �
se�vianp tha buNdiny(Des�ribe in a Camierda area) 15.8 R.(m)� = O .
nloweatadjaceM{finWed)grada{LAG) 5.9 it,(m)�! .••� ,,.X `�„*�`. '`; .'`..
g}Highest adjaceM{finiafmd�grada{HAG) 6.6 R.(m) " W �.��'. . -. . • • � .
h)No.of pattianerd operdr�p(flood ventt}withn I tl above�djaoeni 9� NA R.(m)� W s°�� 88.i0�1 '.�'_;
n Tdal area Of aU perrnanxd openngs(11ood rats)h C3h Over ey,n,{�q.an) 4=-�� � �-' ,::i i:i'
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATIO
This oe+tific�ion Is to be siyrfed and aeeled by s laad awveyor,ergir�eer,or arohifed au�oria,ed by law to oertity eleve�on i�ortnatian.
I certify tl�at tt�a ir�ormation in Sedlona l�B,pnd C on thia certific�te represerds my best eRats to Interpret the data availabla
I understsnd thad anY falae e�atement maY ba qunishabte bY 6ne or lmpriaooment under i8 U,S.Coc1B,SecHan 100f,
RTfFI R ' LICENSE NUMBER
JOSEPH R GORE,P.L.5. LS 5188
7iTLE COMPANY NAME
�r► PROJECT MANAGER HAMILTQN ENGINEERINd&SURVEYIl�G
CITY STATE
311 N.Ne e, Tam a FL 33606
SIGNATURE DATE TfLEPHONE
06/O1/OS 813-250-3535
FEMA Fo 81-31,January 2003 Soe reverse slde fo�corttinuation. Replaoes all pravious editivns
�$�ar� � CITY OF CLEARWATER
� V J /, �
� � p DEVELOPMENT &NEIGHBORHOOD SERVICES DEPARTMENT
9� ^ �O POST OFFICE BOX�74$� CLEARWAT'&H� Fw�DA 33758-4748
"��� MUIJICIPAL SERVICES BUILDING, 100 Sou't7�MYa'r�AveNVe,CLEARWATER,PLOrunn 33756
TELEPHONE�72�SGZ-4567 Fnx(72�SG2-457G
MEMO OF REVIEW F�R CORRECTNESS&COMPLETION
In accordance with participation in the NFIP/CRS program,aA elavation certiFcates are required to be reviewed for correctness and completion prior to
acceptance by the wmmunity. This complete form shall be attached to all elevation certificates maintained on file and provide with requested cop(es ot
elevation ce�tificates.
The attached elevation certificate requires corrections by the surveyor of sedion(s) prior to acceptance by the community
7he attached eleva6on certificats is complete and correct
X Minor corrections have been made in the below marked sections by Community O�cial
SECTION A-PROPERTY INFORMA710N For Insurance Company Use:
A1.BUII.DING OWNER�S NAME Policy Number
A2.BUILDING SFREET ADDRESS(including Apt.,UnR,Suite,and/or eldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Numtrer
CITY S7ATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Black Numbers,7ax Parcel Number,Legal Description,etc.)
A4. BUILDlNG U5E(e.g.,Residential,Non-Rasidential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:Q GPS(Type):
���.�_�.�^ ar �;{t.#;�##°) ❑NAD 1927 ❑ NAD 1883 ❑USGS Quad Map❑Other
SECTION B•FLOOD INSURANCE RATE MAP�FIRM)INFORMATION
I .�.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.CQUNTY NAME 63.S7ATE
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM INOEX DATE EFFECTIVFJREVISED DATE B8•FLOOD ZONE(S) {Zone AO,use depth of flooding)
12103C0104
B10. Indicate the source of the Base Ftood Elevation(BFE)data or base 800d depth entered in Rem B9.
❑ FIS Profile ❑FIRM ❑Community Determined �Other(Describe)
B11. Indicate elevation datum used for BFE in B9:Q NGVD 1929 ❑NAVD 1988 ❑�ther{Describe)
B12. Is ihe buiidin located in a Coastal Barrier Resources S stem CBRS area or Otherwise Protected Area OPA? ❑Yes ❑No Desi nation Date
SECTION C-BUILDtNG ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construdlon Drawings' ❑8uilding Under Construction' ❑Finished Construction
•A new Elevalion Ce�tificate will be required when construclfon of the building is complate.
C2. Building Diagram Number (Select the building dfagram most similar to the buikiing for which this certificate is being compteted-see pages 6 and 7. It no
diagram accurately represents the buitding,provide a sketch or photograph.)
C3. Elevations—Zones A1-A30,AE,AH,A(with BFE},VE,V1-V30,V{with BFE),AR,ARlA,ARlAE,AR/A1-A30,AR/AH,AWAO.
Complete Items C3.-a-i below according to the building diagram specified in ttem C2.State the detum used.lf the datum is different from the datum used for the
BFE in Section B,conveA the datum to that used for the BFE.Show fleld measurements and dat�n conversion calculation. Use the space provided or the CDmments
area of Section D or Sedion G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Doss fhe elevatlon reference mark used appear on the FIRM? ❑Yes ONo
e) Lowest elevation of machinery or equipment servicing the buflding(Describe In Comments area) ft.{m)
h) No.of permanent openings(flood vents)1ft.above adJencent grade
i) 7otal area of all permanent openings(flood vents)tn C3.h sq.in.(sq.cm)
Comments: _
Qate of Review: Community Official:
�varion cadihcates shap De meintaine by the corrmunity and copies wrth fhe aftachedmemo mede ava;lable by raquest
FRAI4K H[ARARD,MAYOR
GEORGE N.CREiEKOS,COUNCiLMFMRER JOI W DORAN,COUNC[I1�7EMBEA
PAUL E.GIf350N,COUNCILMEMBER � CARIEN A.PE'TERSEN,COUNCIIMHMBER
��EQUAL EMPU.)YMEN7'AND AFFIRMA'I'IVE ACTIUN EMPLOYER��
.
�p �e�S"'� a ��` FEDERAL�EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
� �$.. NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
'�`'`� �� ���`� � 9 ELEVATION CERTIFICAT�
� SECTION A-?ROPERTY OWNER INfORMATION For Insurana Company uu:
BUILDING OWNERS NAM£ Policy Number
R7.BUNBURY COMPANY,INC. SITE)Uto ia Candominiums
BUILDING STREET ADDRESS(InGuding Apt.,Unit,Suite,andlor Bldg.No.)OR P.O.ROUTE ANd BOX NO. Company NAIC Number
t350 GULF BLVD.
C�7Y STATE ZIP CODE
CLEARWATER FI, 33767
PRdPERTY DESCRIPTION(Lot and Blvck Numbers,Tax Parcel Number,LegalOesc.�Iption,etc.)
TAX PARCEL ID.NO. 19 29 15 00000 I40 0300
e.y., en is, e e , � , ss , , men area, e ssary.
RESIDENTIAL
LATITUDElIONGITUDE(OPTIONAL) FiORIZONTAt DATi1M: SOURCE: GPS(Type):
(##-##-##.##or#fF.####.) �]NAD 1927 �NAD 1983 USGS Quad Map [�pther. ,
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
87.NFIP COIAMUNITY NAME d COMMUNITY NUMBER 82.COUNTY NAME 63.STATE
CTTY OP CLEARWATER 125096 PINELLAS FLORIDA
8�.MAA AND PANEL 67,FIRM PANEL 69.BASE FL40D ELEVATTON{S)
BER B5.SUF . I IN A EFFECTNf1REVISED DATE Be.fl 0 NE ) oneAD,use 6epth oodinp)
12103C0104G 0104 G 9/3/03 9/3lU3 VE EL 13
8t0,Ind'x�le U�e soarce of Ihe Base Flood Elevafion(BFE)data a base flood depth entered ln 69.
❑FtS Proftle �FI W�f ❑Community Determinad ❑Otl�er Neaa�e):—
61 1.Indcate�he elevalion dalum used ta 1he 8FE in B9:❑NGVp 1628 �NAVI01988 ❑Other(Desc�ey:
B12.Is the buildng located in a Coastal Bartier Resourcea System(C9RS)area or Othenrise Prokcled Mea(OPA)? ❑Yes �No designaUon Date
SECTION C-BUILDING ELEVATION IfJFORMATION(SURVEY REdUIRED) �
Ci.Buildiny elevations are based on:Q Construdion Drawinys' �Bu�ldmg Under Canstrudion" �Finished ConsUuction
� 'A new Elevation CettiFx�te will be required whd�cons6udion o(the builduig is�t�te.
C2.Huilding Diagram Number 6 (Seied 1he butlding diagram most sanilar to the bui�'uy ior which thi�catificate is being mmpk#ed-seepeges 6 and 7.If no diagram
aauralelr represents tfic bu�inp,provide a sketd�or pholopraph.)
C3.Elevations-Zones AI-A30,AE,Ali,A(With BFE),11E,V4430,V(4Ydh BFE),AR,ARA,AFiAE,AWAI,A30,ARlAH,ARAO
Camplebe ttems C3.�a-i bebw accading�O tl�e buikiing diagram speciC�ed in kem C2.State the datum used.l[the datum is dHfe�ent from the daGm used for the BFE in
Secton B,oonvert!he datum to th�used far the BFE Show field meauaemerds and datum carversion cakufatian,Use the space provided ar the Comments area of
Section D a Section G,as appropriate,to documerd the datum convasion.
Datum NAVD 88 �mersioNComme�s ovex V� W
Ele+ralfon reference madc used o� Does the elevation reference mark used appear an the FIRM? �o � �--
a)Top of bottan fbor('nduding basertieni or endosue) 6.3 fi.(m) � �
b�Top of next hgher floor I5.8 ft.(m) � �. ���• �
c)Bottan af lowesi tarizartal strudural memUer(V za�es only� 15.1 R.(m}� � Z . ::.: -
d)Attad�ed g�rage(top of sfab) NA tt.{m) � m W 1��' � .` - :
e)Lowest eleration d madinery andlor equiprt�ent ° � �..• ' r:
servidr�p the buiidxg{Desctibe in a Catm�ts area) 15.8 ft.(m) Z �' ��� � •,'�
� � �
�i.owest adjacerd{tmiddtad)grade(1.AG) 5.9 fl.(m) "� J
iad �
9)�9hest adjacent(Fmished)grsde(HAG) 6.6 ft.(m)� W '�'�' •'
h)tro.of pem��erd oPenir�gs(fload venls}wiC�ln I R.aboire adjacent grade NA. ft.{m� W �`' �` 88-0G�Di�Q'S``�
)Tdai area of a�t Pem�nt op�in9s�lood vents)in C3.h over eq.n�{aq.an) t�=�-'� 0 F' .: �3�a s .
SECTION D-SURVEY�R,ENGINEER,OR ARCHlTECT CERTIFICATIO
This cerdfication'ts tn be signed arid sealed by a land surveyor,engineer,ar architect authaized by 1aw to ce�dfy elevaUon inforrnadon.
!oertify that the irdonna6on in Sec�ions A,B,and C on this certificebe�epresents my best efforts to inte�pr�et the dafa available.
/understand tl�at any false staferrieM may be punishable by firx or imp�isaanent under 18 U,S.Cade Secl�1001,
�ERTIFIERS NAME ' UCENSE NUMBER
JOSEPH R GORE,P.L.S. LS 5188
r` TITLE COMPANY NAME •
PROJECT MANAGER HAMII.,TON ENGINEERING&SURVEYING
CITY SSATE
311 N.Ne e, Tam FL 33606
SIGNATURE DATE TELEPHONE
o6ioiros gi3-2sa3s3s
FEMA F 81-31,January 2003 See reverse side far contltwation. Replaces afi previous editions
r
��► a.4d S'"d � 2�` FEDERAL EMEitGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No.3067-0077
� �o �..�,��� �.,r��,,��"' Expires Oecember 31, 2005
ELEVATlON CERTIFICATE
T
SECTfOM A-PROPERTY OWNER INFORMATiON Fa hamna Comp�rry U�e:
BUtLDING OWNERS NAME Policy Number
R.J.BUNBURY COMPANY,INC. SITE U ia Comdominiums
BUiLDtN(i STREET ADORESS{indudinp Apt,Unit,3uMe,arW/or$Idg.No.)OR P.O.ROUTE AN D BOX NO. Compeny NAIC Number
135Q GIJLF BLVD.
c�TM STATE zir caae
CLEARWATER FL 33767
PROPERIY�ESCRIPTION(F,ot and Block Numben.Taz Psr�e{NumDx,Lepal Dsscripbon,etc.)
TAX PARCEL ID.NO. i9 29 15 00000 140 0300
RESIDEN'I'TAL , , . . . �
TI D i7U (OP ) HpRIZONTAL OATUM: SOURCE: GPS(Type):
(�#-�1a1�-#414�41t or�+k.###�.) �NAp 1927 �]#IAD 1983 uSGS Quad Map �]Other.
SECTION 9-fL00D INSURANCE RATE MAP(FIRMj INFORMA710N
81.NFIP COMMUN(fY NAME i COMAIUNITI'NtlMBER 82.CUUIfJY NAME g�,STAiE
crrY oF c�axwArEx izso� Pn�,r.as r�.,o�nA
84.MAP AND PANEL B7.fIRM PANEI 8Y.BASE FL000 ELEVA710N(S)
• EFFECTIVFIREVISED DJ11'E . N ,we
12103C0104 G �f5�03 9/3/03 VE EL 13
B10.Y�d'iciEe fha�ouroe d tlis 8eM Flood Ebvalbn jBFE)dM�ar b�N lbod drplh en0er�d In 89_
❑FlS Prd�s �F4RM ❑COfmmunlQr 0�lsfmined ❑Olfler(De�c11e):
Bt 1.fndinfe 1M develkn dshm tped fOr fie BFE h 8Q:Q NGYD 192� �wano taea ❑an��n�«��:
B 12.1s tl�e buldhp loated in a Coattal Ba�i�r Resa+oa 9ys1Nn(CBR3I ara ar 0lhawl�Pmbc�ed Are�(OfN1�9 ❑Ye� �No DasiOnation�ebR_
SEC710N C-8UILDING ELEVATION INFORMATION(SURVEY REQUIREDy
�t.euidnp elevafiaa�re msea on:0 conaudio�oi.wfp.' euldno uaK con.+Na�an� Fln�hea cm,a,rction
`A new Ekvsfion C�1ic�k w�be��ied when aonqnrdion o(the buklinp k aonpkfe.
( C2•Buildkip O�pram I�riber 6 (�Ihe b„idi�p�pan,moM�nitr to fhs bWdinp ta whid�u�s oert�c�oe it bei�campkled-ieepape�6�nd 7.II no�apra�m
aoaraky roD�s�enb fhe MYI�q,povide,�laeidi or pholopnph.)
q.Elavat(oru-Zor�et/U�A90�A�AH�A M�h BFE1�VE�Y1490,V(WGh BFEI�IIR ARI�MI►E,ARIAf,A30�IIR/AH.AMO
Campletie IOerta C3..N bebw scoardfnp io tl�e bu�drp df+D�rn specl�ed in pem C2.&t�le 1hs dalum u�ed.�1ha da4m b dl�erent irom ihe dwhm uaed f�a 1ho BFE in
Secton B,oonvert iha dedam b tl�at wed far ihe Bf�.SMw Reld�rema�is and dahan�ion c�laabbon,Uae C�e�a P�o+dded a 1he Cartn�en�area d
Section D or Settioit(i.u�pproprf�te,k►doa�rne��t!he dohm
p�NAVD 88 � (/� �
EkMafton►eference mark uaed�Ooes tie eb+raUon tefeeenoe an the FIRM? _� (� fW--
��ro�a�noor�m�«�a.�o«�.� � tc.cm� �
b)TcP d rieact hiphx Iba (��+ 1 A.(m)
c)Botbom d lowest horlxonfal�al meni�er(V xonee anbl V 1 .1 fl.( � Z
e)toweet ele+aation�nwddnay s�at sq�ipmaK � NA e ) b � � �
� t-�
aervk.hq 1be beidiig(De�cibe in a Cam�enh area) 15.8 fl.(m)� = O '''
0 t.oMrest aQpo�nt(���(�) S.9 �.�m�� —� J ' � r
Q?�yhea adl�oent(t�ed)praee(►�G) 6.6 fl.(m)� j
h)No.d psrerwr��t cDa�Qlood vents)wltlJn I it above adjaioeit Y�NA d.(m� W 88-U6/0I�05
�Tatai aroa Of d penrprfert opeNr�s fNood wnk)in Cah over�,�,(�4 p�) l.=-��
SEC?!ON D-SURVEYOR,QItiINEER,OR ARCH T!
7Trs aertificatlon k m be signed m�d seaied by a IoM suv+eyar�er�irieer�or ard�ilect aulhorixed by law b�aatify elevatiorti�formelton.
I oartify that fha Mnrrne�bm in Sec�fans A,9.and C on 1hi���R�le rspre�errts my beat effats b in0erqet Ih�dat�awdMi�le.
CERTI��tMt�r faloe atamen�ert m�Y be punisF�bb DY lins ar knpr'sorrnent under 16 U S Cods Sec�lbn 100t,
LICEt�ESE NUMBER
30SEPH R GORE,P.L.S. LS 5 i 88
�r�nF co�PMrr wu� �
PRO]ECT MANAGER HAMILTON ENGINEERINC3 8c SURVEYII�IG
ATE
3I l N.N e, ' - FL 33606
SiGNATURE , pATE TEtE NE
� --�'`��------ 06/Ol/OS 813-250-3535
FEMA F 8t-31,January 2003 See reveree side tor r1U-a�tio`n. Replaces aY pnevious ednions
_ ___. _ _.
�.
. . ,,
�$���� >,c CITY OF CLEARWATER
�� � ,� �, �
r�— -� � DEVELOPMENT &NEIGHBORHOOD SERVICES DEPARTMENT
9� � � POST OFFICE BOX`*74H� CLEARWATER� F�o,uDn 33758-4748
"�IQf E MUNICIPAL SERVICES BUILDING,lOO SOUTH MYRT7.'E AVENUE,CLFARWATER�FLO�unn 33756
TE�axoN�(72�562-45b7 F,�c(72�562-4576
MEMO OF REVIEW FOR CORRECTNESS&COMPLETlON
In accordance with participation in the NFlP/CRS program,ali elevation certificates are requlred to be reviewed for correctness and completion prior to
acceptance by the communiry. This complete form shall be attached to all elevat(on certificates maintained on fiie and provide with requested copies af
e(evation certificates.
The attached elevation certificate requires corrections by the surveyor of section{s) prior to acceptance by the community
The attached elevation certficate is complete and corred
X Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY iNFORMATION For lnsurance Company Use:
At.BUiCDING OWNER'S NAME Policy Number
A2.BUILDING S7REET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P,O.ROUTE AND BOX N0. Company NAIC Number
CITY STATE ZI?CODE
A3. PROPERTY DESCR1PTfON(Lot and Biock Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Additlon,Accessory,etc.y
A5. LATITUDElLONGITUDE(OP71aNAl.): HOR120NTAL DATUM: SOURCE:❑GPS(Type):
(##°-##'-#aR.�Y#" or ##.�°y ❑NAO 1927 ❑ NAD 1983 ❑USGS Quad Map�Other
8ECTION 8-FLOOD INSURANCE RA7E MAP(FIRM)INFORMATION
�1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNN NAME 83.STATE
I
Ba.MAP AND PANEL g5.SUFFIX es.FIRM INDEX DATE B�•FIRM PANEL B8.FLOOD ZONE(S) B9.BASE FLOOD ELEVATION(S)
NUMSER EFFECTIVE/REVISED DATE (Zone A0,use depth of flooding)
12103C0104
B10. Indicate the source ot the Base Flood Elevallon(BFE)data or base flood depth entered in Item 89.
❑F1S Profile ❑FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevatlon datum used(or BFE in 89:�NGVD 1929 ❑NAVD 1988 ❑Other(Describe)
B12. Is the buildin located in a Coastal Barrisr Resources 5 stsm CBRS area or Othenvise Protected Area OPA? ❑Yes ❑No Desi nation Date
SECTION C-BUILDING ELEVATION INFORMATION{SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construclion Drawings' ❑Bullding Under Constniction• ❑Finished Construction
•A new Elevation CeRificate will be required when construdion of the bufldfng is complete.
C2. Building Diagram Number {Seled the buiiding dlagram most similar to the building tor which this ceAifiCate is being completed-see pages 6 and 7, if no
diagram accurateiy represents the building,provide a sketch or photograph.)
C3. Elevations—Zones A1-A30,AE,AH,A(with 6FE},VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AFt,ARlAO.
Camplete Items C3.-a-I below according to the buildfng diagram specified in Item C2.State the datum used.If the datum is different from the dafwn used for the
BFE in Section B,convert the datum to that used for the BFE.Show fleld measurements and datum conversion calculation. Use the space provided or the Comments
area of SeCtion D or Sedian G,as appropriate,to document the datum conversion.
Datum ConversioNComments
Elevation reference mark used Does the elevatEon reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Commenls area) ft.{m)
h) No.of permanent openings(flaod vents)ift.above adJencent grade
i) Total area of ail permanent openings(11ood vents)In C3.h aq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�(�e/evation ceAihcetes shall6e malnfatned by the communrry and copies�Wth the attached memo made available 6y roqusst
r�
FReWK H18AARD,MAYOR
GEORGH N.CREIEKOS,COUNCflMEMAER JOI IN DORAN,COL�NCILMEMRER
PAUL F.GIRSON,COUNC[LMEMHER � CARIEN A.PE7'ERSEN,GOUNCIIMEMBER
��EQUAI.EMPI.OYMENT AND AFFIRMATIVE ACTION EMPLUYER��
�..:,< -_—.
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