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679 HARBOR ISLAND : T.�--• /. .� � r. . t-"�+� ' _ _.-,..-_;f_-� �1 ��u��v��ur��.nvuvV t irvy�u�vtar�L�r�i�vuti..i i ��.__r.._ ... � , NATfONA1rFLQODINSURANCEPROGRAM V•M.L-1. No. 3Uli/-UU// ' f ' 4 � ' , , ,�. Cxpires Doccmbcr 31 2005 � ; ��,� C � 2�04 __;. �ELEVATION�.��RTIFICATE � � � � � � __ _.___.� •Im ortant;�Road . :� � , .. •. • , d i �t., ;u..;,,- .:r;� ;,t. ,,- , :;, fho lnabucNons on � ca 1-7. . � , . , P �-� . . _ ' SECTIONA-PROPERTYiOUVN�RiNFORMA?lON � Falrevaraef 'g t� m . . PORTER HAIL Pa�yNw,�t n . . . N � � DUILDIIVG STREET ADORE$S(Including Apt.,UnQ,Sulte,urxf/or Oldp,No.)OR P.O,ROUT[AND DOX N0. Compeny t� � � 679 HARBOR ISLAND ' . ' � . c�CLEARwATER � � srnTC � zir�co�[ —� � : . FLORIDA � � P LOT���SCRIPTION�Id Md Olock Numbcro,Tux Parcei Number Lo�n�i Doacrlp�lo� o1c, � � M ,r,.•�I.TI�� .'7•C I S.LANI� ESTATES O�' CI�EARWA�TE� � OU0.01NO U8E(ap.;I�ealdonuel,,Nor►{o�1deMIol,AddlUon,Aaooesory,e�o.�:4so,n Commanla area,If noco9asuy,) O r RES�ZUEN•T,•z�AL. ,. . . , , .. . . , . . � o � ' LATffUOFJl.O Qf1'UDE.(OPTIONAL) • ' �HQRIZOM'ALqATUM.`- � • . ' • SOURCC: GPS(fypo): m � ( 1/Ar'-pJ!'-pM.pAr''or 1�N.MHNJIl1� �NAD 1�J27"(]N/1D 1�1t13•� ❑USOS Quad Ma . . . _ r p � 0 � - - SECTION B-FLOOD INSURANCE FtA'f�MAP(FIRIV�INFORMA11pN • . • : . = N � w O — • D. • TY •6 TY ta.M(lCR COl.N1Y NAMC.� � D�.STATC Q'� �' a : • CLEARWATER-125096 ' � • � PINELLAS FLOR � U �� 01.MMMD PMIEI • "D1�,f UiM PANEL 0.�1.W�S�FLO � m N 12�5 a�10 2'.• �•��'K . �:fIRM II�AGX OA7C [fF[Cl'NURMSEO DATC D0,fL00p ZpNC(S� �(ZpaAO, ,. �..:•: : 8-19-91 ,,,.9-03-03 • "AE'" . �I:O-------,., D10.ItxkaVe tl�oeotroo d.lha Ba�o Flood Eicvation(BFE�data ab�so Ilood if�lh oMcrod In 89. ' p Fis P�o6b '� � . '�j F�RM' • •.p•carinuMy�olamin«� : p p���. � � � � U 11.IrxScalo tlw clovalion datim.u9od!a Uw OF�l�pg��j NGVD 102�J. : :, ��.(]N11VD,1900,�[]pU�(D�o); D 12.b Uw bukinq locnbd lii a CoosEol Donior Rosairoos3yslorn(CBRS)orn4 a.0lhavdso Pro0acledAroa(OPA)? ��I�Yas �IQJ No Doskn+►6on Onlo ' SECTIONC BUILDINOEI.�VA110NINFORMATION.(SURVEYREQUIRED)' �''""' � . • C 1.[kdkinp daVe6ans tro basod aC Q Constrt�cUon DrutiMrx,�s", .,:'p gulking����' .�.Flnishod Ca�s6lxUon ��'A newElc�ra6ori Car6bcab v�il bo roquirod wf�ai oanshuc!'an ot Iho buldng Is crn��lelo;, . ���J��J�?N!�1�.fScloci p►o bu&in9 d'KJarri most siir�iL'ar to tlio bdid�fa w19di U�f s cacfilfcalo�bclrx�corrnlcicd-�co pa G and 7. If no d . nocura!dyreptcset�t�tl�obukirig�txvv(do n�Cekh apl��h,) : . `� � . c�.nova�a►s—zmoB nt,�o,nr-.nH.n(�a,,o�,v�,vt v�o,v�,�u,or-�,n►t,�u v�itrvnc,nrvn�-n�o,nrvnH,nrvno Cart��lob Itflms q.-a-1 bolow a000rc6xj b Iho buicirx�dacf�m�ocifiod tn I(cm;C2:S4�loltlto dahrtt txc�d I(tlw cfahrn is d(facnl Iran Uto dal�m uwd(or tlw Df�in � Soc6on Q,oanrat tl�o dalum a tlxd�od kr Iho DFE Stiaw f�id measuranenls and d�ilum caivasion cakukilion. Uso Iho��co�widod a tlw Cam�m�arca of ' Sa6on D or Soctlo�0.t�s oppro�xlato,to doamcnt Iho datixn oonvcr�bn. . � DaE�m CornrersloMCbrmien� � ' • . �lov°�or!Nefaonoa trl�t used '� bocs Iho devatian rolaonco ma►k usod�c�r on Oio�IRM? ❑Ycs (8(No > � ,. u u)TcpotbolbmAoor.(ndudrx�ba°�ncn!a cnclae�rc) 7:�6 n�m� �"_,' 0�11mQ .� „�e��a�r �5� '' o b)TaP h���. � � . . �S.0'S'R�m� � � N(�i� ��, ��'�a�� �� o c}Ootbm of lo�est f�or�onfal sUvclual rr�ar�cr(V y) R m - , '� � � � ' . mnes on NLA � �. � ,� ,��•� �:,� � � � °.�1�►�d9�tbPo(slab) � ^�(m). . �g ���,�? ,� ,�, �. 0 0)L o w�e s t o l a i v a l i�o n o l m o c h h c x y m c Y o r o q u p m en t w�„`�M •�,s";¢;., . �''�;�t�� n '.s • '^"•""'^J'��!M q►��0�t1 A CClTY11Cf1�S NCC1� � � } H� r��� ,� � o Q Lan�est t�ooa�l(6nWx�d1�dO M�) t 5� 1 Il�m� Cm, z�� i� ;."`�i � ° '���'���Q�(�1 f�C��) 6.7 n�m� �, . ! ,t :. ,� ' o t►)No.o(Pam?r?oM ope�ng;(I{ood vents)wiVi�t Il abwo:xiacent prado ^ ' �i � . ' � )To�lm�c►dnl � . .. . , R�G�:� �kl` 2n Of�Ofl POft11�l1Cf1 0�0 t 1�(1�$�I�p({y C(1���Fl r i 3.�1 S(�..�t l:�9C,.Q11�, * ,..: P�,..; SCC�ION D-SUftVEYOR,ENGINE�R,OR AftCHI1L-CT,CERTIFlCATION — � Thls ccrtlficntlon!s to bo slpnod and senled tr�,n land survoya,,onginca.a archlloct authorhod by'�aw lo,catity olovuUon Infama0on. 1 certllylhM 1he InlbrmaUon,ln,5ocllons l�Q,nnd C on.fhls corUlkato roproaenfs iny tiosf oA'afs(o Mforprot Iho dafa avnliablo, . � I undasfandlha�e�y lahe stalamonl mny bo ptrnlshablo by�no or/mp�lsonmont�imdar 10 U.S,Codo Secflori�001. ' ', CERTIF�R'S NtAM6 . UCENSE NUMBER• W�LLxAM C. K�ATING ' � • � N0. 152Q TITLE ' COMPMIY NAME • . R�CIST �RT;n �URVrYOR ALLT�D SURVEYING . : • /�DDRESS �CI1Y � STATC � .21P COOC SIGNATURE .. / � C.I�r�,�In�nTr•.R rr.nnrnn •qq�r,� . UA7E, .. TELEAHOt� ' NOV. �5 :• 200•3 72�-446.7.2G3 , ... .. . . UUADPv175lIiLLiI�CC(1l:,S:,�(IrrJtxJ�x��{ �� � ' A.,Ur .,ulqaixYullklj.Nc�.)Ofi!'OI �`-------- • lGU1L•.l�WIk�XNO.• ---- -- - -------•--. ..... .__. .. • • `. • 679 HARBOR ISLA . . I'd�.yNumlxx CrrY Np.,,.,.,:�;. ' t CLEARWATER • • •• • ••;tsTnTci.+FLORzDA zIrCCOC�•'':" Can(x�!yl`WCNunbcr e ' . �� :., : � '"•' :':;' '•, ' �SECTION D-SURVEYp �N61N6C 'OR A1tCHITZiC7 C�RTIFICA710N(GON71NU�i�) � Capybofhikfoo ot Q�b Clavalbn�Cal�Cnto ta(t)crnY»uniy olf�la�,(1)�u;x�oo'iiperiVoanix►►ry,md(�)tx,ik��,�ow,x�r. ' •.COMMENfs •, . � . . , • ---------.. ._..— _ � . ... . . . .. . ... . . . � . . . � . � ' . .. . d+ � � � . . . . � � �`I'� . , � . .,� ,i � - . . � . . _. ;F�; . ' ' ' ... : �. - � � . ' . �{.,..yi.:�.�' ::.�.'•:.��1�i4.'.,� '... � 5ECT10N E-BUIL.DING ELEVA710N INFORMA'iION URyEY I�pT R�qUiRED)FOR zONE Ao AND ZoNE a(IMTHOUT B�1� �or ZonoAO orxJZono/1(wiUbul DF�,oat�,lOb��at�C1'Uxvt�jl�C4. If Uw[lwnUon CciUficnlo M�InOencfcc!(a u:A a�sy��atiixj In(amalion(a o LOM/1 or LOMR•F, Soctlai C m�t bo oar{�ic{od•>� ••' : .. � ... �,�� , . . . E1.OuWngD(ogmtNtmbor_SclaiUptx,fkt '�''` ' ��. � � . . � �. . rxJ ciaq�atn moct sinikir b Uw txikfax�(a tMycl�Uus caGficalo�lxinc�carplciccl-sco��ages G anc17. If no cSac,Tam aocuoldy �p'osonb tlw bukir�.p�c�a atcoich ocpt�ota,�pti.) • � , . ,% , , :�71M otlhobol , . ., ' ., ,' ' . . ' . • . •' . �A Ion1 AooP(ncluctr�basac»ail c�onc{ocuro)d Uio txik5i�a _,(�(n�)�'I•jn.(an)[]olxrvo or ❑lx�ow(cliak ono)U�o 1�71tost:ul�acml p adb. �ral Dradu.d avala�ble)• , . (lkll��o ;�.Fiif'@tulc$g p'qg�rjg�a.(!YNUI oj�Onit�(soo P°Dp 7),.p�nacl lw,�xxx Iloar a cicvabod�oa(clwalion b)o(uic bu�c�rx��; �t(m)�in.(a�,}:Jx�,rc llw ligl�,t acf�wenl �•Carpteto loaru p.h.arx!C31 cn nonc a ram.' �` ;4.Tho kp o(tho �pla�ain o(machlnay orxYa eq�iExncnt cavicinc�U�o lwad��D� `(l(rn)'�in.(an)Q abwo or ❑bdmv(chock aio)Ux�1ip►�osl oc�jacml p:xfo. r�krd grado.N avdk�t�lo). . N� ., . �5.�r Zato AO oc�: Ilno 11ooc1 cfcplli nui�a'G availablo,�Iho tOp d Illo bd�ctil Ibq'cltNalal In aocouJinco vN01 Uio carxiwnily's Ilooc�laki mana�ana�l arli�anco? _ I�Y� ❑No ❑Unlu�awtt '1'ho bcd o(fiicl�almustoottihr ff�ls Ir�amuGon ki Socibn G � . ' •. �.SECTION�=PROPER7Y:OWNER(OROWNER'SREPRES�NTA71yE�CEEt71FICATION �� • T�ProPaN�na'a a+ma's.auu�ort�od rqxocontoWo wt�o cu�ot�;s��,�;�:���.CJ.h or�d C3.1 oNy);�orx!C ta La�o A(v�U�oul n f-�GMl1�'rsuod c�r cutrnu�iy- 'I.�vodtJF�aZawAOmustsign'I�cra 71�osla(an'rr�s7ri�Socqonsl�D,C;'atdEavclxivdfo'O�oGos(oliiry�kriotitifedcp: ' PR�TYOWt�R'S OR OWNEf7S AUTFIORIZCO�L-PRESENTATNE'S NAME �, .. . � Y� ,.,. , , ' • :. . . .. . ' � ,CITI( . . �� ;.,, . STATG ZIP CODC sicr�nmc� .. , ,. � . . �� onn: . � �, � . . . � ���c�rion�c � . co��M's , . . --_- - . � � � . _ - . • _...._. ❑Chock txxg K al��cfmonts . - _ • ' SECTION G-COMMUNIIY INFORMATION(OpT10NAL). � • . ' ' �o local otficjal wlto Is aW�ai�odby lawa a�c�nanoo Io actnin�la Iho crmnu ' 's r�ic,�a oar�plolo Soctiau/�U,C(a L�,and G o(U�s Clavntion' . xGficalo. Can�to Iho opPk�O ilan(sj nncl�r�Udow. � �0°���i mn nonl crcSiu�nco can 1.[]Tho ii(anrwtion kt Soc6o�C yws takc�brom dl�c.do��n�aGon 0�a1 tx�s bocn si�ecl and at�a!ly a I�,cr�ccf stxvcrya,enginccx,a archi6bci wtio�nu0iqtzvd try stnl� . a kxai taNt Eo crttiy ofn�r,�6ot�It�arrt�tia�. (Itxbcato ux�sar�o ancJ c.Uto of G�o olovUlia�clala i�IhoLq!Yncn�aroa bclow.) . �. 2•p Aoorrmu�ty olridal,Qar��btACj 9o��cn G br a buk�bcatoc!In 7aw A(v�ltliout u FC1,M•Is�uccl a oannuNyI�ucc!DrL-7 or Zono A0. � �.p Tho�clnwi�g kdaTria6on ptems G4-c�)apcwic1octta carmuniy�oocplain n�anu�aiiciilpupoc�. . , ,,. �.rc�nr t�uv�x;tt � . c�, OATC f •(UvIIT I°.�;u�o . , � cu, UATI•C(:IZiU�ICA'f L•'q�COMI'IIM�('100CU1�/WCY IaiULO 7.TI�permil Ms boqt issuocl br:[J Ncw Cotutructiat ❑Subsbn6al urprwanatt:'� : . • �.Ekvabon a as.2x;n iow�o�t aoa(indudfng basan«,q of up buildr�G: _�.o�a��zo�AO��u�a�o�a�o�u�a,�w���: � ';� . � .._._n.t�►,� � �. n�a��,: _�(n�) Oalun,: OCN:OFFICUV.'S NAMC 1'ITLC � � � .>,,�.- . . -- — . �' . =OMMUNIIY WIM� . • . TGLCPI�IONL-' �� • . . �IGIVNTUR� . � � � � : ,.,,.onn , 'D���S ' � r . . ,�^ -— - �;. . ' • • i( . . • r^ _. ' . ' • . . '` �i �� �'- �. .N - �� ��l i~ I �I I 3t ��uuuu.unuwt.iV�.l.Iruy!U�U6.�vll.����wL�r�,i . .i l ; i> . . . ` �I.I i �1 NA7TONAL�FLQOD tP1SURANCE PROGRNN U.M.I-t. No. 3U�/-uu// _ � � , ; ��.,, � � ���� ;i ;� Cxpires Docember 31, 2005 ��I '➢ �a� � :' � � �ELE1/ATION�.�ERTI�ICATE . � � } _ -- _._.. .._ �_� .�rn orlanl�Road fho Inslru'ctlons on es 1-7. � '�` ,� +': ' :�,�� �"�����•� `"= . � ' SECTIONA-PROPERi•YiOUVNERtNFORMA't10N ER"Nir�rtE --- . Fa irouaroe f m PORTER HAIL � " Pak.yNwnt � . . . . . . N ' � DUILDING STREET AODRESS pnchxllnp Apt.,UnA,SuKe,andlor�idp,No.)OR P.O.ROUT[AND DOX NO. �mp�,y H� � 679 HARBOR ISLAND ' . cCLEARWATER ' � FLORTDA STAT[ ' ZIPCODE —� � PROP.C•Rl'Y D�SCRIPTION(Ld ond[ilock Numbcre,Tnu Pnrccl Number Le�ai�oxtt lon,olc. • � M LOT 1�8 ,,...I71�IT,•7.0 ISLANI� ESTATES O� CLEA�WATE� � � DUIlA1NO,USE(e.D.;f,ReeJdanitel,,NonaoslderiUel,AddNlon,A000aaory;cto.,;l�so,n Commenta area,If nacoseary,) . O r RES�ZDEN•'t;�Z`�1L. ,. . � ..� .. .. . . , . ' O LAT(TUOEJLONQfI'UDE.(OPTIONAL) • ' �H�RIZOM'AL4ATUM.`- � . � • SOURCC-: GPS(lypo): m � (pN'-ql!'-qM.p�' or 1�q.Nqq!l!1°) (�'W1D 1�J27"(]N/1D 1�3•� ❑USOS�uaxl Map �� � � - SEC"RON B-FLOOD INSURANCE RA'f�MAP(FlfilN�INFORMA'f1pN• . � � . a N � w = O — • n. u' T Y •b TY P1�tdUCR COI.NTY W�trl�� . D�.STni[ � a' �" .. • CLEARWATER-125096 ' ' • � PINELLAS FLOR � U J•� 01.MMAW PMIEI • • • Q7�FIPM PANEL tC Ln 2 N I35.SUFF�X . tl6:�IRM It�D[X OATC CFFEC �.4�EFLC 12 5�10 2'.. 1'M�RLIIIS[D DATC D0.f100D Z O N E(S� •(Z p n o A 0. : G:�: : 8-19-91 .,,.9-03-03 • ��AE„ . �I:O��---v, D 1 0.k i d�a t a tl t oeot�o o(.Iho Baso Fbaf�Ievation(BFE)dnta abaso ibod dq�lh o�al ln 99. � . D Fls�v610 ��. . .�(F7rrd°� � �.[��c«m,utr�,Dot«n,inea : � ❑ouxr cD�c�: � U1 i.Irxkato dw dwalion dahm usod(a Uw DF���p�:p Ncvo�flz�. . � : ;O r�w,1900;•(]pUior(posa��o); . U 12.I�uw tx►kfnr�locnlad in Q Cauhol Omkx Rasaroae3ystan(CBRS)aroo ar•O�haHlso Pio6eclad Aroa(OPA)? N[)Yos 6a No Doskl►n6on Onlo SEC710NC 8111LOINOEIFVAT1pNINFORMATION.(SU VEYR .REQUIRED)' . • Ct.W�Ikinp doVe6ons ero basod on:p Catshvction DrutMrx,�! •;�'[]Bufld!?9 Ur�o�����• .�.FlnlshodCa�s6ucitan • �'A newEl�vatiori Ca6bcab xit bo toquirod vNxxt oau6vc.i'�on o(Iho buidig ls car�leto:. � . � ''C2,Du'Idng�bcJtr►�N►rr�xr 1 ..(Sdoct Iho buDdn9 dagarn►r�slit�l(ar lo dio tididn�fariid�(ch Ws caGlicalo fs bd . . •....,.�. rx�carplcicci-sco aauatc�r rcp�senls C�o bukfng.fxovldo n�cekh a pl�to�rnnh.) • •�: , f��G and 7.if no dagam . cs.owa�a►s—zaws nt,a3o,nc.nft n(�in�o�,v�.v�vao,v(xiu�or-�.nR nrvl�ivvAC,nrvn�-�o,nrvnH,nrvno �0�°b�p.'���Q00°�'�a�0�l��J����d In IIam,C2:S4�lo�o daE�m used,If tlw cfalum[s dRacnl fran Uio clahrn tsod fa tlw Df[In Soe6on D,oonvM Ux+dalum to Uuil t�od for tho DFE.Sliaw fieki rr�suraner►ls nrxi datun oorivaslai cakulaGon. Ur,o Iho�ace�noviclod a tlw Cam�en�area of � � Soclfon 0 a Soetlon 0�as appnopcfalo,to doament Iho datim oorivacbn. � Dahm Cctn�etsiaYCatrnen� � � - ' G1avnUal refe�onoe mor�c used �� Docs Iho dcvaGon rotaanco mark usod�xar ai Uio�IRM1 ❑Ycs �'No o u)'fap of bof6om Iloa jr�dudrx�b�cmcnl a cnclacve) 7:2 6�,�m� • k � n b)7apoft�axthighor'Aoor � '. . 9.Q7 R(m) � � NaV��0^5, .�20d3 o e)t�onanotJowestho�zont�sauctua�mar�aNaonesony} �A��m� � �� � a � " � , � F �� °.d)/U�CfialiT��(bPofs4�b) n�m� 8 �`-" . W a 't.,,a .,� x �. .d�_ O O�LWI�,'StOIdVBI�Of10I111E1Ct1�'1C�/tYl(YOfOClU�:(i1Cltl � � `� �' �" ,vr ' � n �, ,o � 9l7VIC�f19'a10 bll��09p�Q�t1 A CCfTYY1CI1tS 1fCC1� . ��fll� �,�'� � ,,. y �j � ��'r f ' 'x � $ a . ��N'�►►°Sl�noeM�(6ntst►��piAG) 6.�n�m? 'z' °'„-''f � `n'r ' R(m) �f� ;,• °"s' ,� � o h)No.of portr��u�ont opmlr�s(Aood vents)wiUin 1 IL abwo oc�acenl c�rado � ' ' o )Toiat oroa of al parriarx.n!oponirx�s'{Aoo'c! �.. . , . � R�C"��'�`�;I�`�, k 1` 2 f3 ven�s)I�C�.h sq.Jn:(sq an}. . . _ �f,V..y.�;x;.:,. SCCTION D-SURVEI(OR�CNGINECft,ORARCHIT�CT,CERTIF1CATlON — Thls cetllficn0on Is lo bo sipnod and senle4lry.A Innd survoya,,on�lnea,a archlloct authalzod by'law to.ce�lily olovo0on InfamaUon. I cortlfy Ihal lho IrUbrmeUon.In 3acUons l�Q,and C on.lhis corUlknfo ropmscn(s iny bos�ollods fo/nlo�prof fho dala avollabJo. • � __i undersland fhe�enylahe slalomont moy bo pimkhnbia by 11no orlmprtsanmonf�bndor f 0 U.S.Codo Secqori i001. ' � �, CERTIFIER'S NAME . . LICENSE NUMBER. W�LLxAM C. K�ATING ' � • � ` N0. 1528 � YiY►.� � co�a�nrninMe � . R�GZST �Rrn �URVrYOR ALLI�Ij SURV�YING . � /►DDRFSS ,CI1Y ' STATL- � .21P CODC / ' �CT.i�ARW11Ti`R T`TnnTnn SIGNA7l1RE . . UATE. .. ���r� TELFPHONE • . . NOV. �5 :� 2003 727—Q46.12G3 JIlDPr1��IliL(:1ACC(11:5:, rcluJix � � . ... Q J�•.�1�ul.,ulo,mxYuUlilj.No.)Uft!'O.! �—'------- • : '•• ' ` ..••. : 679 HARBOR ISLA ' {�I�..n,w,t�xt�o.• --�..-- -�,�� ------._ _....... ..... .. , � N.p, . . y r��,�„t�x ::�:'; � CLEARWATER • � •• • . ' ;`ST/17E1:iFL�'ORZDA z1f'C�=•�"�" C«npon/NNCNuntxr ' i .�•: ••`�;• •.� ' �SEC110N D-Si1RV�YOf�ENGW[C 'OR'AttGHl1EG7� r ���a�� . , . FRT1FIClMYION(GON71h1U�ip) . Ifon�Cal�icnto tora(1}anYnuniy officlal,(2)b�u��oo' `Vcc, ' � . / . � 'Mh1ENTS . • � �ni+�orxl(d)buik6��owtxr. - --. -- — ( ,: .. ' • . � �:�. . . . . . ,,; ••;. . . . . . . ;:� . ' • .. ', • . � . ��...:..:... ::..:r:�.,i:��;��,; •... 5EC?lON E-BUILDING ELEVA710N INFORMA710N URVEY NOT F{EqUIREU)FoR ZONE�AO AND ZONE a(IMT}i0U1'B�� '�°n0°txJZqw{1(vui'U�ou(DF�,art�'kb Itar�[t�Uxviipl�C4.I(U�o[Iwnliai CciUfiailo b In6enc1ecl ta tr�.,o r�st,��ortiixj In(arnation fa�LOMA or LOMft•f�, n C m�!bo oorrpk�{od•�' •�': .. • ... . ,. . � . ikfrg Diogmt Ntmbcc . . �'�� '. .�,. _(Scloct Uw tit,ikirx�cfa�am rno�t:,irilor W Uw Utikfrxj fa wiiicli Ihis caGfrato�lxirx�carplciccl-sco��a�G anc17. I(no c5acfam aauatdy pr'osonb Iho bukS�D.P�!�#?n skolch apf�otoc,�tt.)�. • _ � . •�:� �, . . ', . o bp of Ua bolbm'�Aoor rtclucS � 'r ' ' • '' . . ' . �hrai(TadD,OuVailable ` �6 bosanoril c�oncloeuo)d Uw Rxikir�G _fl(m)I•L ht.(an}(]nt>wo or ❑lx�ow(chock ono)Uio I�Itost:x�jxml t,�'at7b. (lkU��o � � ��9 n��'�s,(MBVUIh oponit�(sca(bil4�..Il�o nacl Ii�Ixx Iloa acicvabod Iloa�(clwation U)of Uic bu�c�rx�� �tl(m)`in.(a�,)�wc llw hic�l��t ac�pcc�il xlo.Can;�{eto jEoms C3,h otxt C3J cn b�onl of Iotttt.'� �kp of�o Plq�onp o(►nachfnay orxYor equ�xncn!cav�in�Iho lw�t�G `Il m.',in.an nbwo or . Arql g�do.lf eV011oblo). _ . �,)— � )❑ ❑lxlotv(chock onoj Up Irplwst oc�acal!p�:xfo. (Uso 'Zorw AO o�:II no AoocJ clepUi nu»ba'�ava��lal�lo,�Iho lop of Uw bdlan Iba.clavalaf In aocaclitxo wiU�Uio camx�niy's f{oocplain mari�7gpnait oNi�anco? 1 Y� [�No ❑Ur�u�a+nti Tho bcd o(Gdnlmi�stoatdy Ws Intamn6on 4i Soctbn G � . � : �.SECTION�-PROPER7Y:OWNER(�ROVYNER'S REPRESEM'A71VE�CER7IFlCATION �. • ropay atinoC a cn�nwi'aauU�orttod roptocontnWo yrf�o oatplotoo Soc6oc�/�;(3;C�(Ib�rq.C�.h ar�d C3.1 oNy);orx![fa Law A(ulU�oul n FtM/1-G.;uocl a currnu�ity- J IIFEj a Zaw A0 mu�t sign'Ix% ]7�o slalaner�fs 7n SocUa�s%�'f3,C;'axlE cr'o'cdriuct fo 010 Go�t ofirryRriotiifedcp: � 'ERTY O1M�R'S OR OVIMEaS AUTFIORIZCD aL-PRESENTATIVE'S NAMC . �, ;. •• .. �. .. , �ss .. . . . . � ;. . . .. . . � :� cinr . � ' � � � � • STATL- � ZIPCODC : � !1M?C� �. . , ,. • . � .L/t1'►: . 7Etii�'rit�NC � . , . . .. � dEMS. . • , � .,. �_ ' ,. �'� , . . . . �f . ❑Chock txat�Nat��dmonls . � � SECTION G-COMMUNITY INFOWNATION(OPTIONAL). • • � � �I otfichJ�nftois authaiaodbylawa a�cfiar�oo to nc�nirisla Iho cctnm s �iii ma • - ut�ity' Ifooc�'�I, r�anont orc(ru►nco can carplolo Soctiau q D,C(a L•�,nnd G o(U9s C1ovoGon� do.Can4�lo Iho q�pk�t�lo itan(s)anc1::��tx�a�x ;�. � . 7tw nfmtwbon kt:,�c6on C yws talcen hnm dt�erdocunenlalion Il�al t�as boen sic,p�,ecl arxl at�a�odl�r a I'►�,er�eci strvoya,erxanca,a mchi�octrrtio�uu0�a1 try stuto cC kx�i!aW�O ca�y�6ottlrti�attt�tiott Qnc�cato Uu sou�o u�xf dalo ot Gw oloitaGat data ii tho�qxncn�aroa beJow.) ' "� A��M�.�d 9o�Ocn�fa n buic5r�bcata!In Zaw A(�Itl�out o FCMA•Is�ecf a cannuNyI.;..ucd D�L-7 or Zono A0. � ' Tho hslw�+ng IrdaTra6on ptar�c GA�G9)s p�wicSod fa oatmu►�y Aoocp�ain n�ano�nntxrit pupoc�. . ,.. � Ji1�YTNl�N,II(;R R , . • GG.pATCI •(tJv�Tl°.>;UC'U . ' G(i.UATL•C[:(�ilf�A'(L'q�COMI'LIM�UOOCUPMICYI�ULU :pamit has boai issuod bc:�New Cautruction ❑S�bst�ntial lrr;xwanait.�� : . � �r�a�.�,��aoa�����o�o�n�,g au,o�,��s��: � . . n.«, � • :a(m 7aio A0j dcplh of Aood�al�o bukirx�sitc�: � —.— ( ? � . Dadm: l'OFFICW:SNAMC ' �.� _,R(m) papm..., F,-..•. .. . � 71TLC ,., . � rIUNl11f WVM� . • . TGLEPI�IONL-" . . • . . � � � � ' . � � � � : ,...,,D1�7C ' l��s ' � � .t_ ,, .� � � • • it . � y . �����r�c� C ITY OF C LEARWATER � � ,�I,, � � � p DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT 9��� �`O� POST OFFICE BOX 4748� CI.EARWATER� FLO�uDn 33758-4748 �ATER � MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDn 33756 ?I TELEPHONE�72� 562-4567 Fa�c(72� 562-4576 MEMO OF REVIEW FOR CORRECTNESS 8� COMPLETION In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of elevation certificates. The attached elevation certificate requires corrections by the surveyor of sedion(s) prior to acceptance by the community X The attached elevation certificate is complete and correct Minor corrections have been made in the below marked sections by Community Official SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1.BUILDING OWNER'S NAME Poliey Number A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Camp2ny NAIC Nurrtber CITY STATE ZIP CODE A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:�GPS(Type): (##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑USGS Quad Map❑Other SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME 63.STATE B4.MAP AND PANEL 67.FIRM PANEL B9.BASE FLOOD ELEVATION(S) NUMBER B5.SUFFIX 66.FIRM INDEX DATE EFFECTIVE/REVISED DATE B$•F�OOD ZONE(S) �Zone AO,use depth of flooding) 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 69:�NGVD 1929 ❑ NAVD 1988 ❑Other(Describe) B12. Is the buildin located in a Coastal Barrier Resources S stem CBRS area or Otherwise Protected Area OPA 7 ❑Yes ❑No Desi nation Date 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. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.) C3. 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 C3.-a-i below according to the building diagram specified in Item C2.State the datum used.If the datum is different from the datum used for the BFE in Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion. Datum Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m) h) No.of permanent openings(flood vents)1ft.above adjencent grade i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm) Comments: Date of Review: Community Official: �elevation certificates sha/l 6e mainfained by the communify and copies with the affached memo made available by request FRANK HIRBARD,MAYOR GEORGE N.CRE'1'EKOS,COUNCILMEMRER JOIIN DORAN,COUNCILMEMBER PAUL F.G[BSON,COUNCILMEMRGR � CARLEN A.PE1'ERSEN,COUNCILMEMAER ��EQUAL EMPLOYMENT AND AFFI1tMATIVE ACTION EMPLOYER��