The URL can be used to link to this page

703 HARBOR ISLAND _ . __ . � �� U.S.DEPA�2TMENT OF HOMELAND SECURITY. ELEVATION CERTIFICATE OMB NO. 1660-0008 Fed`eral Err�ergency Management Agency Expires FebruaN 28.2009 �National Flood Insurance Prograr►� Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION iuikns"�i,; a °' �`- Building Owner's Name Steve S.Anderson � . Building Street Address(including Apt.,Unit,Sufte,andlor Bldg.No.)or P.O.Route and Box No. or�a�a; � � ��, ` 703 Harbor Island ��,.v � �; -�°��: City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lot 21,Units 6D,7A,7C,ISLAND ESTATES OF CLEARWATER A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential A5. LatitudelLongitude:Lat.N 27 59 25.02007 Long.W 082 49 00.02128 Horizontal Datum: ❑NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building'rf the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 6 A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) T sq ft � a) Square footage of attached garage • N/A sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade Y5 walls within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in AS.b 3� . sq in c) Total net area of flood openings in A9.b 0 sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State Clearwater 125096 Pinellas Florida B4.Map/Panel Number 65.Suffix 66.FIRM Index B7.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102 G 09/03/03 09/03/03 AE 11' 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 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-V3Q V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized "D" Vertical Datum NAVD 88 �0 Conversion/Comments See Sect."D" � Check the measurement us ..� w�r.. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 6.35 �feet ❑meters(Puerto Ric �. � b) Top of the next higher floor 6.92 �feet ❑meters(Puerto Ri � � c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(PueRo R' �.j ,�s d) Attached garage(top of slab) N/A. ❑feet ❑meters(Puerto Ri 7►,� d�,,, e) Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑meters(Puerto Ri � (Describe type of equipment in Comments) � }�� Lowest adjacent(finished)grade(LAG) 6.0 �feet ❑meters(Puerto R g) Highest adjacent(finished)grade(HAG) 6.2 �feet ❑meters(Puerto � SECTION D-SURVEYOR, ENGINEER,OR ARCHITfCT CERTIFICATION � This ce�#iflcation is to be signed and sealed by a land surveyor,engineer,or archftect authorized by law to certify elevation �„ ;�; 'r--,,; f �� information: 1 ce►tify that the infom►ation on this Certificate represents my best ef/oRs to interpret the data available. 0�. ��-"� �4-�9g ;,, I underst8nd tMat any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ..��a,��,� •,� ;,:. �-�o ✓ � , � `Check here if comments are provided on back of form. ' �; p r="��PLA �n �w`� �; ��`� _� �� +�. �� , ��SE�A�,� . . Certifier's N'airte .Nicholas Circello License Number 4898 �'� ' , , . � �„r. �i�'� d�� -��..: � ✓f ��-�� .'Rrofe,ssional ur4eyor&Mapper'. Company Name George F.Young, Inc. �`��,� +' '$ � �� Address 299 r,MLK Jr.Street North City St.Petersburg State FL ZIP Code 33701 t"�. � , �, .� ` -; �',,, °�,�°�rt X�.�g% Signature �`. • e 08/20/07 Telephone 727-822-4317 rt,�,. _ 07-13-0305-01 _ ,:-. ,�`,: FEMA Form 81-31,February 2006 See reverse side for continuation. Replaces a�l pr�vious editions IMPORTANT: In these spaces,copy the.corresponding information from Section A. ��r�r��e�s��r`= Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. �` � 703 Harborlsland ,,�;' • �� ' City Clearwater State fL ZIP Code 33767 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) � Copy both sides of this£ievation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. Comments BENCHMARK USED:"F 3"(The NGS Data Sheet,PID AG0504),located near the intersection of Kipling Plaza.8 Narcissus Avenue,having a published adjus d elevation of 2.72 feet(NAVD 88) C2.a)Garage; C2.b)Entryway (Next higher floor(living area)=17.39') ..�.��1.�._ �/�......C� Signature Date 08/20/07 ❑ Check here'rf attachments 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�1-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 measuremeM used. In Puerto Rico only,eMer 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 lowesf adjacentgrade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑abovs or�below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑metets ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with petmanent flood openings provided in Section A Items 8 and/or 9{see page 8 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 and/or equipment servicing the building is ❑feet ❑meters ❑above or 0 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 m�nagement ordinance? ❑Yes ❑ No ❑ Unknown. The local o�cial must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFICATION The property owner or owners authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or cflmmunity-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's or Owner's Authorized Representative's Name • Address City State ZIP Code Signature Date Telephone Comments ..,, �__. • . _.. , ❑Check here"rf attachments �;;i ' " ' SECTION G-COMMUNITY INFORMATION(OPTIONAL) {� ��:� The lo�lq�'�ial who is aqtMorued by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this�levation CA�rti{�c�te. Complete the applicable item(s)and sign below. Chedc the measurement used in Items G8.and G9. G1 ❑ � �TR�inform�tion�n:�er�tion C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who •is;;t�uthorizqd by�a4v xo.cert'rfy elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ �:A`COmm�wily o�ci�l�crompleted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ �Tiie followi��infwmation(Items G4:G9.)is provided for community floodplain management purposes. G4.Pemtit Nurnbe � G5. Date Permit Issued G6. Date Certficate Of Compliance/Occupancy Issued G7.This permit has,peen isSued-�or: ❑New Construction ❑Substantial Improvement G8.Elevation of as-buiR 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 Local OfficiaPs Name Title . Community Name Telephone Signature Date � f�,� Comments P Q� ��O�P here ff attachments FEMA Form 81-31,February 2006 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. Policy Number 703 Harbor Island Company NAIC Number Clty Clearwater Stat@ FL ZIP COde 33767 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. . .. P�� . - '��+. '" �y,�. �, . .. - l. ��f � 9� � �['� �C��' ��1� P!"k" � ��' �� ,. x. �u Q1.,',�i� :'� -,.v'�� Y ��;, � §�4. � + .w y-T.^ � 4�.. &ry fs�*.� ,y� ,.. - ..� `r . d � 5� � +:�.�{r, w'��,�_y. ,. '�] iI � �� "� y� �� - � � � ��f + - . 5�f� �l':' .8K -U ;.. {'�^� 6.k`.4j.�-. . �s ' ��. � �. . � . 4 � .., ' w,. . . . (•• ,.. , ..�.... . .;#' { .. � . . .. ' .. "s.� p�� .. .. �_ � � {%�8�c. � �`c �� y" -nn: .�' �� , ;�� "ss+*^�5:� . . �� ' �:y�3�:, ' � �� FRONT VIEW .. z, � A;�.. � �� ..��o� . . !4 /�� x . �� .�� t�h� s;,� ,�. ,. '��",��' � aD , 4 , , � �� . , , , . , . ��.�..�� _ „r � . „ � C� _ , �� _ ' � ,s�i. _ ' �� '' � � � irr��"' - . � /� ` � � . �.w,�' nI {y , � M �w , � Qo . �y -- _ �U Tr �: � ,�� } � � � ., � ;�� •F . - .�� 'j Q ,,,,� � � � � `� � �; _ ___ b � — _ �' �� ,� . - , � i �?�� ` REAR VIEW �, { n {"� '`�`Jt l�, I�l �i�� .��}C'1 ,: �Y �� ... ,� �� . . �. ,.,t � � , � �, , , . „ , .;� .� .,.*q . .. Building Photographs � '� Continuation Page r' � � � Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy NumberCompany use: 703 Harbor Island • City Clearwater StBte 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." V � �� o � �� ,� ��' � JU Qow � O � ��,`� . ; �� ,'.x�. .4� 1^ . � ii> , `�, ( � DRAWN t F�c 7�3 .sr►. � �ovN� �X* CUT � SEC. 5 TWPF- 29��R.� RNG. �5 E. CHECKED N� /ND �� CM 4„ p1A• �pT 2� 22 �' LEGEND F `O.r \ 0.2N• �'W O 6� m A ARC FRdcD FOUND RNET AND DISK RCP REINFORCEp Cp►JCREfE PIPE �p /�/C NR CONDfTIONER GEN. GENERATOR RCW RECWMm WATER • N� �AT pRM !� n» �"�c�+TOp,,.,p souj►�+ QCC.�7p9 "ECR&M� 4 q�1NN UNK�� z BLDG BACK�� PREVENiOR � GENERAL T4FPHON� IXCHNJGE R�, R�E��ATER VALNF J � M SOU-(f{�ST,i 24\ rn r SIR �� N �g 36 3� A,�(M OZ y G1LC. CAI.CUUTED ID IDENi1FlCAT10N R/W RN;HT �WAY L� ) w� 2 N .Zy � n .( CB CHORD BEARING INV INVEFtf ELEVATION SCM SEf CONCRETE MONUMEM ��RNER ;� l'FO�� N� � S�) 1 4 0��R� �40 � � � c�NK� L�P LuJG�P�OIEUSINE55 �R �s• i� � �e o2� �0.0' ..� ( S�vTM�JE > «x� c�wc�re ucKr � �s uco�sm suRVEroR sr�o ser rwi.n►ro asic :.. 0.8' s�ps f co c�iw our p1NG (M) MEASURm SRkD SET RNET AND DISIC i �JO� COMM. COMYUNICA710NS MAS. MASONRY THIA TEMPORARY BENCH MARK I p,p1D � A/�P� �B�Q � � CONC CANCREfE M.E.S. MffERED END SECTION TELE, TELEpHONE 1� . W�� C7 � COR CORNER M.H. MANHOLE TPm TELEPHONE PmESTAL 'I5 . RAI� � II 'I Q COSP CffY OF Sf. PETERSBURG NO NUMBER TRANS. TRANSFORMER t O g1.5 � . GONC•cNi� � � (p CON COVERED NGVD NATIONAL GEODEf1C VEF2TICAL DATUM TYP MIGL rioo�. _ ;� 11 O 11 c� coNC�rE � � occ occuPiEO iv raFV�sa� ,n O � (D) DESCRIP710N OHL OVER HEAD UNES TWP TpWNgHp �.O' 'LaJ.`L' V• v' � O � ELEC. ELECIRICIRON PIPE (P) Pu CIAL RECORD BOOK WPP M�OOD POWER POLE ?. CH�RD N > > p O.• N aFV �v�� Pc Poirrr oF cu� w/ wm� p �O p :- � � � � ESIdT EASEMENf PCC POINT OF COIAPOUND CURVE WM WATER MEfER � 0 18.a. T EWPB ELECTRIC WIRE PULL BOX RCP PERMIWENT CONTROL POINT WV WA7ER VALVE n W N� � ~ �+ FCM FOUND CONCREfE ►IONUMENT Pm PEDE5UL / NUMBER .� � �T ��/� FH FlRE HYDRANf W POINT OF INiERSECTION � �'1 O N � f�t FOUND IRON ROD PLS PROFESSIONAL LAND SURVEYOR 1 (J1 � �/ FlP FOUND IRON PIPE P.O.B. POINT OF BEGINNING �� $ o_.. �. 3A �. STEPS � a LO� �� F.L FLOOD UGHi PP POWER POLE /1.J � �DING` � �p; (�I FNdcD FOUND NAIL AND DISK PRC POINf OF REVERSE CURVE FOP FOUND OPEN IRON PIPE PRIA PERMANENf �ENCE MONUMENT � C � . RY �� H�,pIDRa � ST ENCE p �� O.. F'PP i0N'D PINCHm IRON�PE� PVC POPROFESSIONAL S�UDRVEYOR AND MAPPER 0 ; � �D r. � 0.6� MA/v� � RES 703 � � (RRA�D RRAWUS WNa- o OCC'# W � C� � �. STORY .. �a,o .� � � � 1� 1p p (uNO�c�a+ ) ( 2ND p,Np.2'FR�M �sT A BOUNDARY SURVEY OF � (n � Z � • � �ONS� EX�YDSH�`� HEREON ) R� �c.� � � J J � STOR LOT 21 N r � � .P„ W 3.0 � � 0 5� UNITS 6D, 7A, 7C, ISLAND ESTATES OF CLEARIPATER _ � N �� ` As recorded in Plat Book 64, Pages 1 and 2 � Z . �•� �e.o Public Records of Pinellas County, Florida. o � � � � �� 51.5 Np "X" CUT Clearwater, Florida � �. � � F�U NOTES: � Np 10) L � � 25•5' '� " (R$LM� C 1. Geor e F. Youn Inc. and the undersi ned make no re resentotions or uarantees � � � Tp CH�R� °'- $«18'32 W` O+ M, pertaining to e sements, rights of way, set back linespreservations, agreements ?' � 57o•rR� �4'0'3 � and/or other matters pertaining to survey. � � °'9 �4 � � 2. Basis of Bearings: N78'36'37"E, along the North line of Lot 21, per record plat. FOP �„ ��T 2 g� 3. This survey prepared without the benefit of a current title report or commitment for � 1 15•�� N� �� OCC•� title insurance. r � � �'- 4. This survey is a grophic depiction of the current boundary and visible improvements in � �" W E accordance with the legal description shown hereon and moy not reflect ownership. 5. The location of footers, foundations and structures beneath the ground surface has �EX�NDED S not been determined. � ' 6. As per the Federal Emergency Management Agency (FEMA) Flood Insurance Rate Map � � � 20� 0 10� 20� 40' (FIRM) Number 12103C0102G, Community Number 125096, Panel 0102, Suffix G, � effective date of September 3, 2003, the above—described property appears to be in �� Zone AE with a base flood elevation of 11 feet. RgOR1 7. This map is intended to be displayed at a scale of 1" = 20� or smaller. H A GE GR�PHIC SCALE A C „ , 8. Additions or deletions to survey maps or reports by other than the signing party or P SJ � = 2� parties are prohibited without written consent of the signing party or parties. � PREPARED FOR: ING Bank FSB GeOr�@ F. Young, Inc. Nicholas M. Circello • First American Title Insurance Company u� Bv� � THIS SURVEY NOT VALID WITHOUT Steve S. Anderson & Jennifer L. Anderson exc�cn�•�rcn�wc•�orn�rrei.• � e�c�cr� •pLANNING•s�r�vs�rn�c THE SIGNATURE AND THE ORIGINAL �� . sr. P�vxc • Bx�►nsKrox •cetr�svnJ� • oivarmo • Peia[ �cx • s�xn.sm�e • rnl�e RAISED SEAL OF A FLORIDA ORDER N0. 07-13-0305-03 RESPONSIBLE OFFICE: 299 Dr. Martin Luther King Jr. Street North LICENSED SURVEYOR AND MAPPER. DATE 9/20/2007 s�nce �s1e Tei.:P(i2�j s22 4317701Fa06(727) 822-2919 Florida surveyor's Reg'n. PSM#LS4898 , This survey is made for the exclusive use of the current owners of the property and also those who purchase, mortgage or guarantee the title thereto within one (1) yevr from date hereon: P�oTTED: 09/24/07 11:2s:o9 LOGIN: ECOOPER FlLE:I:\PRWECT�SUR\0713-0305-03\DWG\077303f1503FD.DW� _ ._ � /' aa �.. f<- . f�L-/" �-T!" _/�. � 1.�.�•.DEP�4RTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE oMB No. �sso-000s "'�,�"jederal Emergency Management Agency Ex�ires Februarv 28.2009 Natiorlal Flood Insuria,nce F�r��am Important: Read the instructions on pages 1-8. S'`,S^/ f� �"�K,►� SECTION A-PROPERTY INFORMATION Fo,r"Insurance�Company,ilse: A1. Building Owner's Name Steve S.Anderson Policy,l!Jumber fi >�. 2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Comparty NAIC,Nur.nber 703 Harbor Island City Clearwater State FL ZIP Code 33767 , A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) , Lot 21,Units 6D,7A,7C, ISLAND ESTATES OF CLEARWATER • A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential A5. Latitude/Longitude:Lat. N 27 59 25.02007 Long.W 082 49 00.02128 � 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 6 A8. For a building with a crawi space or enclosure(s),provide A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) 3734sq ft a) Square footage of attached garage N/A sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade 25 walls within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 3024 sq in c) Total net area of flood openings in A9b 0 sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name&Community Number B2.County Name B3.State Clearwater 125096 Pinelias Florida B4.Map/Panel Number 65.Su�x B6.FIRM Index 67.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12103C0102 G 09/03/03 09/03/03 AE 11' 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 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-g below according to the building diagram specified in Item A7. Benchmark Utilized "D" Vertical Datum NAVD 88 Conversion/Comments See Sect."D" Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 6.35 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 6.92 �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 5.96 �feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) � Lowest adjaceM(finished)grade(LAG) 6.0 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 6.2 �feet ❑meters(Puerto Rico only) SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by Jaw to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. O 9/O�' 0..�. ��`�•$�8 I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �w� t ._. � Check here if comments are provided on back of form. r� 'p'� A�+ a . - .r�'�r- k,i�,.,r,..fia 4 E .. .. License Number 4898 . 1F��A� � M' Certifier's Name Nicholas Circello ` •, ,,,� ; ,. .._�.tiER� , . �+le Professionat Surveyor&Mapper Company Name George F.Young, Ina . ,�,,},.- � ;�r �� ,� dress 299 Dr. MLK Jr.Street North Cit St.Petersbur State FL ZIP f�T � Y 9 Code 33701 '.�„r..•.�;;,1 . Signature � • ate 09/05/07 Telephone 727-822-4317 `l �t �a �, {��(� y `' � d. �� # �a w, � •..J' ��t Y.l�iY�' (� � �'� �tAa S l!'�' .r..» 07-13-0305-02 ��-��;��,.� -��"� �, FEMA Form 81-31, February 2006 See reverse side for continuation. Replace ��'�all previous editi'ons _� . ,� IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: .B,uil�ig Street Ad,�re3s(��luding Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Polioy'umbe�r� • �0�3�Harb�r lsland • - City Clearwater State FL 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 BENCHMARK USED:"F 3"(The NGS Data Sheet,PID AG0504),located near the intersection of Kipling Plaza.&Narcissus Avenue,having a published adjus d elevation of 2.72 feet(NAVD 88) C1.�'Garage door(s)not instailed;Sidewalk(s)not built,eta C2.a)Garage; C2.b)Entryway (Next higher floor(livi g area)=17.39') C2.e)Bottom of elevator shaft;Top of raised wooden A/C platform=14.69'(North side of house) ..�.� �, C��.--.-� Signature Date 09/05/07 ❑ Check here if attachments 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,crawl space,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawi space,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 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 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 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 City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local officiai who is authorized by law or ordinance to administer the community's fioodplain 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 iicensed 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 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 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(PR)Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions . ,� , ,� Building Photographs ' See Instructions for Item A6. For Insurance Company Use: ding Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 703 Harbor Island Clty Clearwater State FL ZIP COd2 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. _� su� z�z . ._,.,.�. �: �' . . �� '� . � ��7� t'�� I1 !�l1� � . ' ,;: ,. _ � � + ��,;�y ',,:� t �� ,�.�". � ,r � "1* .�.��a.r "' �;_* �� a`..'"' .. . ; _»"` ",;k *^'� (��. . - �` _��.. � � ��§-.�# � -�tt�... � . -.. 1�� ,�r �r�"�s � �'.'� � �� . . i �� ,i y �� '� ,� � ,� �. �, _ '• . � ��. � � �n , � i� ..` _ � t� ` � �x,. °,�� S ��,. , . ��.. � �, _ . I . � ��b � � � �",� ��' ��ti: �� r-+�ea��-view � �( 4�4�/Fi1�p'��"s��'�� .; }�:,..s� �"n �,,r�l � �- 0°n�JY r ��1+# �� U P ^f��.��r�M1 ,�'� � � � ��i'.,� � � { v ,"�- . ..`1k .. �� .��ss:, ,, p ,. .,,: . �.,. n�� . a.,; ., _. .� A , � - �. ��w ..r� � � �'�!�" ��~y, ,,4 � � - '� �� _ ,;; � � - - ,� r,°' - �'� � �`�� - ,��1 '� � � �� _�� i:, �yI ' � 5 . t1 _— — . .—— � �.' � �� _ — �.., � . .. .. .. ... __ . ...... . �`'"... =--._ �ffi I REAR VIEW �� . ..:: . . .:.» . � a� •.�.::. •. .,< 4:i":'.. I y .. a :L