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2723 LAKEBREEZE LNU.S. DEPARTMENT OF HOMELAND SECURITY Federal s'nergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-8. OMB No. 1660-0008 Expires February 28. 2009 - SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Rottlund Homes of Florida, Inc _P* j'.lumber. 65. Suffix A B6. FIRM Index Date MAY 17 2005 B7. FIRM Panel Effective/Revised Date September 3, 2003 B8. Flood Zone(s) X B9. Base Flood Elevation(s) (Zone AO, use base flood depth) LOMR DATED 8/07/07 N/A A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. f !J !J LE�� 2723 LAKEBREEZE LANE City CLEARWATER State FL ZIP Code 33759 FEB 2 5 2010 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 18 CHAUTAUQUA LAKE ESTATES PLAT BOOK 128, PAGES 39-43 L - ,,.." A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL jQ LEP E �j NEA 1 A 1121440 8 A5. Latitude/Longitude: Lat. 28d 00' 20.8" Long. 82d 43' 29.1" A6. Attach at least 2 photographs of the building if the Certificate is A7. Building Diagram Number 1 A8. For a building with a crawl space or enclosure(s), provide a) Square footage of crawl space or enclosure(s) N/A sq ft b) No. of permanent flood openings in the crawl space or enclosure(s) walls within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in being used to obtain flood insurance Horizontal Datum: NAD 1927 Qd NAD 1983 A9. For a building with an attached garage, provide: a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the attached garage walls within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER - 125096 B2. County Name PINELLAS B3. State FLORIDA B4. Map/Panel Number LOMR-F-0704-4491 65. Suffix A B6. FIRM Index Date MAY 17 2005 B7. FIRM Panel Effective/Revised Date September 3, 2003 B8. Flood Zone(s) X B9. Base Flood Elevation(s) (Zone AO, use base flood depth) LOMR DATED 8/07/07 N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. 0 FIS Profile ❑ FIRM 0 Community Determined ® Other (Describe) Creek Watershed. Vol.1 (1997) B1 1. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 ® NAVD 1988 0 Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes No Designation Date N/A ❑ CBRS 0 OPA SECTION C - BUILDING ELEVATION INF• -MATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings". ,+,, i„•frtg Undet_GoolstiUdtion" 0 Finished Constru' 'A new Elevation Certificate will be required when cor V coon of-thebw • la t C2. Elevations - Zones Al -A30, AE, AH, A (with BFE) VE,, \)3I V (w4h.FBFE) AR; AR/,� Aii(A t4R/A1rA30, AR/AH, AR/AO. Complete Ito below according to the building diagram specified in-�te 'p."1i ''' ` ' • " '.` r '' _ Benchmark Utilized CAMPUS J Vertical Datum NAVO(�'F Conversion/Comments NGVD LESS 0.85 EQUALS NAVD a) b) c) d) e) 0 g) Top of bottom floor (including basement, crawl's'pace,'or enclosure floor)_ Top of the next higher floor Bottom of the lowest horizontal structural memb6'r tv-aStrety , Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment in Comments) Lowest adjacent (finished) grade (LAG) Highest adjacent (finished) grade (HAG) Check the measurement used. N/A ® feet is Cj reefeetl N/A ® feet N/A ® feet N/A ® feet N/A ® feet ❑ meters (Puerto Rico only) 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ 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 law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ® Check here if comments are provided on back of form. Certifiers Name KATHLEEN C. LANZNER License Number 5120 Title LAND SURVEYOR Company Name CUMBEY & FAIR, INC Address 2463 E RPRISE ROAD Signatu City CLEARWATER State FLORIDA ZIP Code 33763 Date 02/1 FEMA Form 81-31, February 2006 Telephone 727-797-8982 See reverse side for continuation. co co M 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. 2723 LAKEBREEZE LANE For Insurance Company Use: Policy Number City CLEARWATER State FL ZIP Code 33759 Company NAIC Number • SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy toth sides of this Elevation Certificate,for (1) community official, (2) insurance agent/company, and (3) building owner. Date ❑ 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. El. 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 0 feet 0 meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is ❑ feet 0 meters 0 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 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters 0 above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet 0 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 owners authorized representative who completes Sections A, 8, 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.INFQRMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community'sfloodplain management ordinance can complete Sections A, 8, 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. 0 The information in Section C was taken from other docurn.entatrori that has laeen 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. 0 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. 0 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 0 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 Siynature Telephone Date Comments 0 Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions U.S. DEPARTMENT OF HOMELAND SECURITY Federaltmergency Management Agency ELEVATION CERTIFICATE Important: Read the instructions on pages 1-8. OMB No. 1660-0008 Expires February 28, 2009 • SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Rottlund Homes of Florida, Inc Policy Number 85. Suffix A B6. FIRM Index Date MAY 17 2005 B7. FIRM Panel Effective/Revised Date September 3, 2003 1 A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.�ij�a 2723 LAKEBREEZE LANE ><r iJ� tttJJJ IUUYww 1 City CLEARWATER State FL ZIP Code 33759 i FEB 2 5 2010 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 18 CHAUTAUQUA LAKE ESTATES PLAT BOOK 128, PAGES 39-43 J A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIALNErO�E jf9 E$ 43' 29 1" Hnriz. 83 A5. Latitude/Longitude: Lai. 28d 00 20.8 Long. 82d A6. Attach at least 2 photographs of the building if the Certificate A7. Building Diagram Number 1 A8. For a building with a crawl space or enclosure(s), provide a) Square footage of crawl space or enclosure(s) b) No. of permanent flood openings in the crawl space or enclosure(s) walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b is being used to obtain flood insurance. N/A sq ft N/A N/A sq in A9. For a building with an attached garage, provide: a) Square footage of attached garage N/A sq ft b) No. of permanent flood openings in the attached garage walls within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER - 125096 B2. County Name PINELLAS B3. State FLORIDA B4. Map/Panel Number LOMR-F-0704-4491 85. Suffix A B6. FIRM Index Date MAY 17 2005 B7. FIRM Panel Effective/Revised Date September 3, 2003 B8. Flood Zone(s) X B9. Base Flood Elevation(s) (Zone AO, use base flood depth) LOMR DATED 8/07/07 N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. D FIS Profile 0 FIRM 0 Community Determined ® Other (Describe) Creek Watershed, Vol.1 (1997) 811. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 0 Other (Describe) 912. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date N/A ❑ CBRS 0 OPA ❑Yes ®No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings' ® Building Under Construction* 0 Finished Constru '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 It below according to the building diagram specified in Item A7. Benchmark Utilized CAMPUS J Vertical Datum NAVD Conversion/Comments NGVD LESS 0.85 EQUALS NAVD a) b) c) d) e) 0 9) Top of bottom floor (including basement, crawl space, or enclosure floor)_ Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment in Comments) Lowest adjacent (finished) grade (LAG) Highest adjacent (finished) grade (HAG) N/A N/A N/A N/A N/A Check the measurement used. ® feet ® feet 0 feet feet ® feet ❑ meters (Puerto Rico only) 0 meters (Puerto Rico only) 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) N/A ® feet 0 meters (Puerto Rico only) N/A ® feet 0 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 law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ® Check here if comments are provided on back of form. Certifier's Name KATHLEEN C. LANZNER License Number 5120 Title LAND SURVEYOR Company Name CUMBEY&FAIR, INC Address 246IJ ENTERPRISE ROAD City CLEARWATER State FLORIDA ZIP Code 33763 Signatur Date 9/10 Telephone 727-797-8982 w 1- U LL tY w U 0 1-- Q > w J w atlas# 233A 0 J 0 fV FEMA Form 81-31, February 2006 See 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. 2723 LAKEBREEZE LANE For Insurance Company Use: Policy Number City CLEARWATER State FL ZIP Code 33759 Company NAIC Number • SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copyboth sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Signature Date 0 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. El. 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 0 feet ❑ meters 0 above or 0 below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is . 0 feet 0 meters 0 above or 0 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 0 feet 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of slab) is . 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . ❑ feet ❑ meters 0 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? 0 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, 8, 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 Comments Date Telephone 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, 8, 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. 0 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. 0 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. 0 The following information (Items G4. -G9.) is provided for community floodplain management purposes. 0 Check here if attachments G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: . 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet 0 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 U.S. DEPARTMENT OF HOMELAND SECURITY Federal,Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name TODD A. and DIANA M. SHETTLE Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 2723 Lakebreeze Lane Company NAIC Number City CLEARWATER State FL ZIP Code 33759 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 18 CHAUTAUQUA LAKE ESTATES, BPB 128 PG 39-43, PUBLIC RECORDS PINELLAS COUNTY A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 28°00'17" Long. 82°43'29" Horizontal Datum: A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? ❑ Yes ® No N/A sq ft N/A N/A sq in ❑ NAD 1927 ® NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage N/A sq ft b) No. 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 N/A sq in d) Engineered flood openings? 0 Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number CITY OF CLEARWATER-125096 B2. County Name PINELLAS B3. State FLORIDA B4. Map/Panel Number LOMR-F-0704-4491 95. Suffix A B6. FIRM Index Date AUGUST 18, 2009 B7. FIRM Panel Effective/Revised Date SEPTEMBER 3, 2003 B8. Flood Zone(s) X 89. Base Flood Elevation(s) (Zone AO, use base flood depth) LOMR DATED 8/07/07 N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile❑ FIRM 0 Community Determined ®Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 0 Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Designation Date N/A 0 CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* ® Finished Co *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/A0. Comple below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized CAMPUS J Vertical Datum NAVD Conversion/Comments N/A Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) N/A. 0 feet b) Top of the next higher floor N/A. 0 feet c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet d) Attached garage (top of slab) N/A. ❑ feet e) Lowest elevation of machinery or equipment servicing the building N/A. 0 feet (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) N/A. 0 feet g) Highest adjacent (finished) grade next to building (HAG) N/A. 0 feet h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑ feet structural support 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) 0 meters (Puerto Rico only) 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) J c\ N F-) W cL W m cr) W � Y � Q 0) J O M N U N 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. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 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 0 No Certifier's Name Kathleen C. Lanzner, P.L.S. License Number 5120 Title Vice President Company Name Cumbey & Fair, Inc Address 2463 Enterprise Road City Clearwater State FL ZIP Code 33763 Signature 7/19/10 Telephone 727-797-8982 FEMA Form 81-31, Mar 09 See reverse side for continuation. , /TA &, • --• •Replace's•ap,prpgto,a editions 0 0) 0 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. 2723 LAKEBREEZE LANE For Insurance Company Use: Policy Number • City CLEARWATERState FL ZIP Code 33759 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Signature Date ❑ 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. El. 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 0 above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters 0 above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet 0 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 management ordinance? 0 Yes ❑ No 0 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 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. 0 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. 0 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. 0 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: 0 New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet ❑ meters (PR) Datum G10. Community's design flood elevation 0 feet 0 meters (PR) Datum Local Official's Name Title Community Name Signature Telephone Date Comments 0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name TODD A. and DIANA M. SHETTLE Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 2723 Lakebreeze Lane Company NAIC Number City CLEARWATER State FL ZIP Code 33759 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 18 CHAUTAUQUA LAKE ESTATES, BPB 128 PG 39-43, PUBLIC RECORDS PINELLAS COUNTY A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) A5. Latitude/Longitude: Lat. 28°00'17" Long. 82°43'29" A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 1 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) No. 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 A8.b N/A sq in d) Engineered flood openings? ❑ Yes ® No RESIDENTIAL Horizontal Datum: ❑ NAD 1927 (0 NAD 1983 to obtain flood insurance. A9. For a building with an attached garage: a) Square footage of attached gar N/A sq ft b) No. of permanent flood openingtrl, the attached garage within 1.0 foot above adjacentrgie N/A c) Total net area of flood openingt A9.b N/A sq in d) Engineered flood openings? CQ ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER-125096 B2. County Name PINELLAS B3. State FLORIDA B4. Map/Panel Number LOMR-F-0704-4491 B5. Suffix A B6. FIRM Index Date AUGUST 18, 2009 B7. FIRM Panel Effective/Revised Date SEPTEMBER 3, 2003 B8. Flood Zone(s) X B9. Base Flood tlevation(s) (Zone AO, use base flood depth) LOMR DATI=D 8/07/07 N/A 910. 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 99: ❑ NGVD 1929 ® NAVD 1988 0 Other (Describe) 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date N/A ❑ CBRS ❑ OPA 0 Yes SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 0 Construction Drawings* 0 Building Under 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. below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized CAMPUS J Vertical Datum NAVD Conversion/Comments N/A • Finished Const Complete 1 Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) N/A. 0 feet 0 meters (Puerto Rico only) b) Top of the next higher floor N/A. 0 feet 0 meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet 0 meters (Puerto Rico only) d) Attached garage (top of slab) N/A. 0 feet 0 meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building N/A. ❑ feet 0 meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) N/A. 0 feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) N/A. 0 feet 0 meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. 0 feet 0 meters (Puerto Rico only) structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION N 0 0 r- 0 VEZZ :# selIV co N -o IV IN co o > X o m 01rri• Pj m N 7:711 z This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. /certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 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 0 No Certifier's Name Kathleen C. Lanzner, P.L.S. License Number 5120 Title Vice President Company Name Cumbey & Fair, Inc Address 2463 Enterprise Road City Clearwater State FL ZIP Code 33763 Signature 7/19/10 Telephone 727-797-8982 FEMA Form 81-31, Mar 09 See 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. 2723 LAKEBREEZE LANE For Insurance Company Use: Policy Number City CLEARWATERState FL ZIP Code 33759 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments Signature Date ❑ 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. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is . ❑ feet ❑ meters ❑ above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is . 0 feet 0 meters 0 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 management ordinance? 0 Yes 0 No 0 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 Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 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 -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: 0 New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet ❑ meters (PR) Datum G10. Community's design flood elevation 0 feet 0 meters (PR) Datum Local Official's Name Title Community Name Signature Telephone Date Comments 0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions 0 3 oJ 4. co 0 FPKN&D LB 6113 cr 4.1 c.) FC L c.) ift IN ELEC PED 4— 0 05 St/ Lu / TELE ncc PED o 2 6 13 20 BRICK PAVERS 0' 811110 3.2' 3.2' 10 0 CURVE DATA • , 1.1 C79 C80 C118 1625'10 0'09.20, 124'29 214.00 214.00 2533.77 S 8534'49"E NR 478.25' 7.25 F 80.0' 2—STORY RESIDENCE GARAGE ELEV= 91.18 L.F.F.E.=91.82 #2723 LOT 18 50.0' 35. CO POOL PUMP z 8.0' 13.2 61.33 37.93 62.27 19 0 ' 16.7' 61.12 37.88 62.26 PAVERS SCREENED POOL BRICK PAVERS DECK PAVERS S 8534'49"E (NR) 472.20' (P) 20 SCALE IN FEET SCALE: 1"= 20' 17 6.5 30.8: 19.0'- 31.1 FCIR LB 6 N: \JN 769B\DWC\769B18.DWG HORD BEARING S 1734'14`W S 00'43'02 E N 18'05'23"E 1/2- 113 1 Q Z ti FCIR 1/2" LB 6113 DRAINAGE & CONSERVATION AREA S 47'36'49"W 13.02' 341.00' DRAINAGE & CONSERVATION AREA 336.87' DRAINAGE & CONSERVATION AREA 769B 1s V 2723 LAKEBREEZE LN BCP2009-10356 Zoning: LDR 7 Atlas #: 233A Section 32, Township 28 South, Range 18 East, Pinellas County, Florida LEGEND. FCM = Found Concrete Monument 4x4' LB /2168 F1R = Found Iron Rod FCIR = Found Capped Iron Rod 1/2" LB /2168 SCIR = Set Copped Iron Rod 1/2" LB /2168 A/C = Air Conditioner and Concrete Pod PCP = Permanent Control Point FPKD = Found PK Nail & Disk SPKD = Set PK Nail It Disk LB /2168 LF.F.E. = Lowest Finished Floor Elevation = Covered Concrete (P) = Plotted (M) = Measured (F) = Feld (C) = Calculated O/A = Overall OR = Official Records PG = Page CONC = Concrete DESCRPTIONS LOT 18 OF 'CHAUTAUQUA LAKE ESTATES' , AS RECORDED IN PLAT BOOK 128, PAGES 39-43, OF THE PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA. CERTIFICATION. CERTIFIED TO: TODD A. AND DIANA M. SHETTLE HOMEBANC, N.A. MACFARLANE, FERGUSON AND MCMULLEN ATTORNEY'S TITLE INSURANCE FUND, INC. ROTTLUND HOMES OF FLORIDA, INC. THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF r1NOFESSIONAL SURVEYORS AND MAPPERS IN CHAPT ,R''6,1 ',1; + ' FL'ORIDA. ADMINISTRATIVE CODE, PURSUANT TQ=•S O'JO�N'#072.1��7'©F FLORIDA STATUTES. F9R .i �� <' }k -L: #21 .8 NOT VW) WITHOUT THE SIGNATURE AND ORIGN1Cfc VEAL0F C'OPDA LICENSED SURVEYOR AND MAPPER Notes 1. Bearings are based on the North line of the described lot as shown on the record plat, Said line bears 035'34'49"E. 2. Elevations are based on N.G.V.D. Datum of 1923V Mean Sea Level = 0.00. rV 3. This survey was prepared without an abstract of Title. There may be additional restrictions that are na shown on this survey. 4. Boundary calls reflect deed and field measurements unless otherwise noted. HUD/FIA FJ.RM COMMUMTY PANEL NO. LOMR—F 07-04-4991A DATED. 08/07/07 ZONE. X AND A TYPE OF SURVEY DATE TYPE OF SURVEY DATE PROP. HOUSE LOC. 10/15/09 FINAL 7/19/10 HOUSE STAKEOUT 12/07/09 UPDATE VACANT 12/07/09 FOUNDATION 1/20/10 CUMBEY & FAIR, INC. ENGINEERING LAND SURVEYING 2483 ENTERPRISE ROAD CLEARWATER, FLORIDA 33783 CLWR (727) 797-8982 TPA. (813) 223-4333 14.00' co0 V o a O INLET FPKN&D EIEC PED (V LB 6113 I— Q z cr •• J w 0 LuU 14J 0 2 14.i O U LI W /QZ / �L O ujz CO .� g wz J /i tY a F L Lu z 0) Z I o w BRICK w ' PAVERS 0 S� J 1" Lu v0I 0 J E7) co c 4 / co TELE iE PED a o j 2 20 .0' 0 N N 3.2' 3.2' tri 0 co 10 0 CURVE DATA CURVE DELTA. ARC CHORD TANGENT C79 16'25'10' 214.00 61.33 61.12 30.8 C80 10'09'20. 214.00 37.93 37.88 19.0 C118 1'24'29' 2533.77 62.27 62.26 31.1 19 S 85'34'49"E NR 478.25' 137.25 F 80.0' 2—STORY RESIDENCE GARAGE ELEV.= 91.18 L.F.F.E.=91.82 #2723 LOT 18 50.0' CONC z 0 8.0' 13.2 N O wi 16.7' PAVERS SCREENED POOL BRICK PAVERS DECK 135.33' F POOL PUMP PAVERS S 85'34'49"E (NR) 472.20' (P) 20 SCALE IN FEET SCALE: 1"= 20' 17 16.5 N: \JN\7695'\DWG\7695'18.DWG FCL' LB c` N CHORD BEAEINQ S 12'34'14"W S 00'43'02`E N 18 05'23"E 1 /2 13 Q• DRAINAGE & CONSERVATION AREA FCIR 1/2" 1.8 6113 S 47'36'49"W 13.02' 7698 341.00' DRAINAGE & CONSERVATION AREA 336.87' DRAINAGE & CONSERVATION AREA co C.) 2723 LAKEBREEZE LN BCP2009-10356 )(2kJ Zoning: LDR Section 32, Township 28 South, Range 18 East, Pinellas County, Florida LEGEND' FCM = Found Concrete Monument 4"x4" LB /2168 FIR = Found Iron Rod FCIR = Found Capped Iron Rod 1/2" LB /2168 SCIR = Set Copped Iron Rod 1/2" L8 /2168 A/C = Air Conditioner and Concrete Pad PCPs Permanent Control Point FPKD = Found PK Nail dr Disk SPKD = Set PK Nail de Disk L8 /2168 L.F.F.E. = Lowest Finished Floor Elevation = Covered Concrete (P) = Plotted (M) = Measured (F) = Field (C) = Calculated 0/A = Overall 01? = Official Records PG=Page CONC = Concrete DESCRIPTION. LOT 18 OF 'CHAUTAUQUA LAKE ESTATES' , AS RECORDED IN PLAT BOOK 128, PAGES 39-43, OF THE PUBLIC RECORDS OF PINELLAS COUNTY, FLORIDA. CERTIFICATION. CERTIFIED TO: TODD A. AND DIANA M. SHEIILE HOMEBANC, N.A. MACFARLANE, FERGUSON AND MCMULLEN ATTORNEY'S TITLE INSURANCE FUND, INC. ROTTLUND HOMES OF FLORIDA, INC. THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61 Ct;14rrteii,,D_ORIDA ADMINISTRATIVE CODE, PURSUANT TO SE1/406N 1442 J .,QF FLORIDA STATUTES. F R C ={ t• 21 >8 FLORID. 6PERg)— Utz te: NOT VALD WITHOUT TIE SIGNATURE AND ORIGINAL,� 6P A `itA uteSED SURVEYOR AND MAPPER ; ',r ., .....-. ,,.cC:7 ti4 115 Notes •Ir tr* II1,. 1 _ Bearings are based on the North line of ��he1�1�11 escribed lot as shown on the record plat, Said line bears S.85'34649"E. 2. Elevations are based on N.G.V.D. Datum of 1929, o Mean Sea Level = 0.00. t� 3. This survey was prepared without an abstract of Tith5,4 There may be additional restrictions that are not sh rn on this survey. 4. Boundary calls reflect deed and field measurements unless otherwise noted. HUD/FU FIRM. COMMUNITY PANEL NO. LOMR—F 07-04-4991A DATED 08/07/07 ZONE, X AND A TYPE OF SURVEY DATE TYPE OF SURVEY DATE PROP. HOUSE LOC. 10/15/09 7/19/10 HOUSE STAKEOUT 12/07/09 UPDATE VACANT 12/07/09 FOUNDATION 1/20/10 Atlas #: 233A CUMBEY & FAIR, INC. ENGINEERING LAND SURVEYING 2483 ENTERPRISE ROAD CLEARWATER, FLORIDA 33763 CLWR. (727) 797-8982 TPA. 18131 223-4333 , . , .. r U.S.DEPA�RTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 . Exqires Februarv 28. 2009 Federal�fnergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. � SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Rottlund Homes of Florida, Inc �c Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. I 2723 LAKEBREEZE LANE City CLEARWATER State FL ZIP Code 33759 � A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 18 CHAUTAUQUA LAKE ESTATES PLAT BOOK 128,PAGES 39-43 A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL �E�1 � I.E� � �� A5. Latitude/Longitude: Lat. 28d 00'20.8" Long. 82d 43'29.1" Horizontal Datum: ❑ NAD 1927 D 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 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) N/A 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 N/A walis 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 SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number 62.County Name 63.State CITY OF CLEARWATER - 125096 PINELLAS FLORIDA 64. MaplPanel Number B5.Suffix 66.FIRM Index B7.FIRM Panel 68.Flood B9. Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) LOMR-F-07044491 A MAY 17 2005 September 3,2003 X LOMR DATED 8l07/07 N!A B10. 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)Creek Watershed.Vol.1(199� B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 � NAVD 1988 ❑Other(Describe) . B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑Yes �No Designation Date N/A ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INF MATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ConstrucUo[�Drawings ; �:$ � r��ncter�,srfi��ison• ❑Finished Constru� \\' 'Z *A new Elevation Certificate will be required when con��ruCtiOn o�th�pui,�i}� � �__,,,plet,e; , 5� .T �'",, Z � r�i N C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),�(E,��/3Q 1/(vuith.E�FE) AR;AF2/R,;l±y�(A�;�R/A1FA30,AR/AH,AR/AO. Complete It� � below according to the building diagram specified in-Ite '�� "` �� ' ' `"` c '�. ' J � \ , ca Benchmark Utifized CAMPUSJ Vertical Datum NAV9�`�rr �- � ` N � � � Conversion/Comments NGVD LESS 0.85 EQUALS NAVD W � � �/� Check the measurement used. W � � ;.. J �"jl _ . a) Top of bottom floor(including basement,crawl spa�e,°or enclosu�e floor)_ � N/A �feet ❑meters(Puerto Rico only) � � Q W b) Top of the next higher floor � � / �feet ❑meters(Puerto Rico only) m M U w T,,,r,r_ ��j-- ��_ _. _ . __ . _ � Y c) Bottom of the lowest horizontal structural memkfer'�Zb�'�on y "- /A ❑feet ❑meters(Puerto Rico only) W O � d) Attached garage(top of slab) N/A �feet ❑meters(Puerto Rico only) � r � � W e) Lowest elevation of machinery or equipment servicing the building N/A �feet ❑meters(Puerto Rico only) Q � U � (Describe type of equipment in Comments) J O Q d Q fl Lowest adjacent(finished)grade(LAG) N/A �feet ❑meters(Puerto Rico only) � g) Highest adjacent(finished)grade(HAG) N/A �feet ❑meters(Puerto Rico only) N a j � �, 1` V w � �= SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION N m w U rv 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 Certificate represents my best efforts to interpret the data availab/e. 1 understand that any false statement may be punishable by fine or impnsonment under 18 U.S. Code,Section 100L rt �4�{� , , . �V��/,''j s. � Check here if comments are provided on back of form. ar.;,;�,.-'@QtrouP,a�+ �� _: o;��, ��.�.,! . Certifier's Name KATHLEEN C.LANZNER License Number 5120 ^"a �l-. � '" S. �=- . �� ;"'?"''cas �✓ � � Title LANDSURVEYOR Company Name CUMBEY&FAIR,INC � .' �, <�;� --3 = .�.:. _..;r.:. �e;� � . .. Address 2463EN RPRISEROAD City CLEARWATER State FLORIDA ZIP Code 33763 `" �'% • `''°�""`:' , � . .,'�r Elr ��' ' Signatu Date 02/1 Telephone 727-797�982 �'�'�R°°'�°"��,�`�'°�� .',y � r�, ,r� �`.. `$,`ti °gt39a80110 FEMA Form 81-31, February 2006 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,andlor Bidg. No.)or P.O. Route and Box No. Policy Number � 2723 LAKEBREEZE LANE City CLEARWATER State FL ZIP Code 33759 Company NAIC Number - SECTtON D-S1IRVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy l�othi'sides'of this Elevation Certifrcate;for(1')community official, (2)insurance agenUcompany,and(3)building owner. Comm�nts � rj t�_ : i� � � . , � ._,.._ � , t , z: : Signat�r� . . , . Date .. '.` ,.., . .:_._... ... .... _:_ ._. ❑ 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,crawl 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 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, 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.INFARM�ATION(OPTIONAL) The local o�cial who is authorized by law or ordinance to administer the community's.flvodplain 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. � t .. �.. G1. ❑ The information in Section C was taken from other docum4entation th�t h2s heen 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 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 Com��unity Name Telephone Siynature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions U.SryDEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal�Emergency Management Agency Expires Februarv 28. 2009 National Flood insurance Program Important: Read the instructions on pages 1-8. ' SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Rottlund Homes of Fiorida, InC Policy Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. a r 2723LAKEBREEZELANE City CLEARWATER State FL ZIP Code 33759 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) � LOT 18 CHAUTAUQUA LAKE ESTATES PLAT BOOK 128,PAGES 39-43 ��{ �. A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL � �en��H 0 DE ' f9 r� 'E g A5. Latitude/Longitude: Lat. 28d 00'20.8" Long. 82d 43'29.1" Hor z 83 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1 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) N/A 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)walis within 1.0 foot above adjacent grade N/A walls 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 SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. NFIP Community Name&Community Number 62.County Name B3.State CITY OF CLEARWATER - 125096 PINELLAS FLORIDA B4.Map/Pane)Number 65.Su�x 66.FIRM Index B7.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood dep4h) LOMR-F-07044491 A MAY 17 2005 September 3,2003 X LOMR DATED 8l07/07 N/A 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)Creek Watershed,Vol.1(199� 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 N/A ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ,z C1. Building elevations are based on: ❑Construction Drawings' � Building Under Construction* ❑ Finished Constru Z M `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,ARlA,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete It� � below according to the building diagram specified in Item A7. W � `� Benchmark Utilized CAMPUS J Vertical Datum NAVD � \`� � C° Conversion/Comments NGVD LESS 0.85 EQUALS NAVD W � F-- Check the measurement used. W � �-�- tfl � a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ N/A �feet ❑meters(Puerto Rico only) m M U w b) Top of the next higher floor N/A �feet ❑meters(Puerto Rico only) � � Y c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑feet ❑meters(Puerto Rico only) � � � Q d) Attached garage(top of slab) N/A �feet ❑meters(Puerto Rico only) � � U q e) Lowest elevation of machinery or equipment servicing the building N/A �feet ❑meters(Puerto Rico only) O Z d � (Describe type of equipment in Comments) --� O p � C] � Lowest adjacent(finished)grade(LAG) N/A �feet ❑meters(Puerto Rico only) M N �- � -� g) Highest adjacent(finished)grade(HAG) N/A �feet ❑meters(Puerto Rico only) N a j Q �' SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION N m w U rv 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. ,a �+ � , I understand that any false statement may be punishab/e by fine orimpnsonment under 18 U.S. Code,Section 1001. �*R'a,0��11��✓',� `'r< •"�:- t�a�� r ��..� � Check here if comments are provided on back of form. '��`''_ � , ��; ' �n;��,,, a i°` _� j �d� �� - Certifier's Name KATHLEENC.LANZNER License Number 5120 �,j " :, � = : _. �-.:..a Title LANDSURVEYOR CompanyName CUMBEY&FAIR,INC P:=, '� � :;'�� ,� �:4; : Address 24 EN RPRISEROAD City CLEARWATER State FLORIDA ZIP Code 33763 so�'�m , -� c:.,�� ;� ' /��y .'+ ��"�l~..�` Signatur Date 9/10 Telephone 727-797-8982 '�r,=r#�i,�a1e��so��,`:1, FEM Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company U�se: Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number 2723LAKEBREEZELANE City CLEARWATER State FL ZIP Code 33759 Company NAIC Number - SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elev,ation Certifica'te for(1)community o�cial,(2)insurance agenUcompany,and(3)buiiding owner. Com�nents ' _ ; 4, . ;, : , � Signature '; ', , Date � ❑ 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,crawl 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 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, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items 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 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 Locai Official's Name Title �ommunity-Name Telephone Sign�ture Date G'omments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces ail previous editions U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal�Emergency Management Agency Expires March 31,2012 Nationel Flood Insurance Program Important: Read the instructions on pages 1-9. . SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name TODD A.and DIA A M.SHETTLE Policy Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number 2723 Lakebreeze Lane City CLEARWATER State FL ZIP Code 33759 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) LOT 18 CHAUTAUQUA LAKE ESTATES,BPB 128 PG 39-43,PUBLIC RECORDS PINELLAS COUNTY A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude: Lat.28°00'17" Long.82°43'29" 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 1 A8. For a building with a crawispace 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 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 B1. NFIP Community Name&Community Number 62.County Name 63.State CITY OF CLEARWATER-125096 PINELLAS FLORIDA B4.MaplPanel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zone LOMR-F-0704-4491 A Date Effective/Revised Date Zone(s) AO,use base flood depth) AUGUST 18,2009 SEPTEMBER 3,2003 X LOMR DATED 8/07/07 N/A B10. 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 Designation Date N/A ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) M Z � r� N C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction' � Finished Co � 'A new Elevation Certificate will be required when construction of the building is complete. ...� �1 � 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. Comple � below according to the building diagram specified in Item A7. Use the same datum as the BFE. N � � Benchmark Utilized CAMPUS J Vertical Datum NAVD � Conversion/Comments N/A W Check the measurement used. � a) Top of bottom floor(including basement,crawispace,or enclosure floor)N/A. ❑feet ❑meters(Puerto Rico only) M M b) Top of the next higher floor N/A. ❑feet ❑meters(Puerto Rico only) W c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico only) W � d) Attached garage(top of slab) N/A. ❑feet ❑ meters(Puerto Rico only) 3•• � e) Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑meters(Puerto Rico only) Q � (Describe type of equipment and location in Comments) J � p O J � Lowest adjacent(finished)grade next to building(LAG) N/A. ❑feet ❑ meters(Puerto Rico only) M N g) Highest adjacent(finished)grade next to building(HAG) N/A. ❑feet ❑ meters(Puerto Rico only) N a. °' h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A. ❑feet ❑meters(Puerto Rico only) r.. V o structural support (V m - N 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 availab/e. �� l understand that any false statement may be punishab/e 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 �,�eqv ±o s�?ecer ;, licensed land surveyor? � Yes ❑ No � � �,L-�� ej �� a'' ," �t � ✓ •. Certifier's Name Kathleen C.Lanzner, P.L.S. License Number 5120 � _` ° �- tl Title Vice President Company Name Cumbey&Fair,Inc ' ° ,�j;�///[�py'jf�'� ,✓-', - � �3t�t� 4� �� - Address 2463 Ent rprise Road City Clearwater State FL ZIP Code 33763 � , .: �i�V• � ' s � `�. Signature '7l19/10 Telephone 727-797-8982 %,,'';r°�;!.�'�`�`'�:�.'�r�:� `�. �<, �� . FEMA Form 81-31, Mar 09 See reverse side for continuation. Replac�s�a�4p�r�µia�t�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 Bidg.No.)or P.O. Route and Box No. Policy Numbe� ' - 2723LAKEBREEZELANE - City CLEARWATERState FL ZIP Code 33759 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 Signature Date ❑ 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(inciuding basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑ below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑ below the HAG. E4. Top of platform of machinery 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 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 sunreyor,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 G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name Title Community Name Telephone Signature � Date Cotnmen,s � __ _ ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 F�deral Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name TODD A.and DIA A M.SHETTLE Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number 2723 Lakebreeze Lane City CLEARWATER State FL ZIP Code 33759 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) LOT 18 CHAUTAUQUA LAKE ESTATES,BPB 128 PG 39-43,PUBLIC RECORDS PINELLAS COUNTY A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude:Lat.28°00'17" Long.82°43'29" 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 1 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 gar2� N/A sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood opening�fn the attached garage enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent gr�e N!A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings�?i 1 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 CITY OF CLEARWATER-125096 PINELLAS FLORIDA 64.Map/Panel Number 65.Suffix B6.FIRM Index 67.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone LOMR-F-0704-4491 A Date Effective/Revised Date Zone(s) AO,use base flood depth) AUGUST 18,2009 SEPTEMBER 3,2003 X LOMR DA7�D 8/07/07 N/A 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined � Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes o = � N Designation Date N/A ❑ CBRS ❑ OPA � � ..J � N � SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) r N W o O C1. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction` � Finished Const �] � r �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 I � � below according to the building diagram specified in Item A7. Use the same datum as the BFE. � om Benchmark Utilized CAMPUS J Vertical Datum NAVD (rJ rT7 ConversioNComments N/A W�1 Check the measurement used. � N a) Top of bottom floor(including basement,crawlspace,or enclosure floor)N/A. ❑feet ❑meters(Puerto Rico only) J rn b) Top of the next higher floor N/A. ❑feet ❑meters(Puerto Rico only) D �T c) Bottom of the lowest horizontal structural member(V Zones only) N/A. ❑feet ❑meters(Puerto Rico only) v �V ■� d) A t tac he d garage(top o f s la b) N/A. ❑f e e t ❑m e t e r s(P u e r t o R i c o o n l y) v, e) Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑ meters(Puerto Rico only) � � r (Describe type of equipment and location in Comments) N Z w fl Lowest adjacent(finished)grade next to building(LAG) N/A. ❑feet ❑meters(Puerto Rico only) y g) Highest adjacent(finished)grade next to building(HAG) N/A. ❑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. !certify that the information on this Certificate represents my best efforts to interpret the data availab/e. j,��Adsfi�� I understand that any fa/se statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ` � �. , 'a,,9 ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a .,,�� , n�"° ; o � , licensed land surveyor? � Yes ❑ No �b ° '' �`-- � '_j, Certifier's Name Kathleen C.Lanzner, P.L.S. License Number 5120 � �"y" ��- . M. � �j Title Vice President Company Name Cumbey&Fair,Inc '�� 1��- � r � !�,* a=,�,: Address 2463 Ent rprise Road City Clearwater State FL ZIP Code 33763 �r ��,q=4��'��li;.;,�y'�..~� �`'',,`�'t`•.J�°r�;n �� ;. Signature `7/19/10 Telephone 727-797-8982 �,� zt.�i� �,� ' �::s�:::�� FEMA Form 81-31, 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 � - 2723 LAKEBREEZE LANE _ City CLEARWATERState FL ZIP Code 33759 Company NAIC Number . SECTION D-SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community o�cial,(2)insurance agenUcompany,and(3)building owner. Comments Signature Date ❑ 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,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawispace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑ below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery 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 owners authorized representative who completes Sections A, B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items 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-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 G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local O�cial's Name Title Community Name Telephone Signatu;e Date t Comments ^ ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions , CURVE DATA . � �llBYE DEi TA Rarni�s azr �HORn T wrFUr C79 16'2510 214.00 61.33 61.12 � C80 10'09'20' 214.00 37.93 37_88 9.0 I / C118 1'24'29" 2533.77 62.27 62.26 31.1= 14.00' w I � � � o � � I � � U � � > I �9 � � � (n a �N� I �� FPKN&D ELEC (j,� LB 6113 PED - Z Z � S 85'34'49"E NR . � � �_ � � � � � 137.25 F 478.25' P � �, A/c W `� o � � � � c� �Z I g0 0. ^ � Z� N Q� BRICK a 2-STORY L�I Q Z Q� ' PAVERS N RESIDENCE m o� o� �ARAGE ELEY- 91.18 L�1 �,� r � 3 . 3.2' L.F.F.E.=91.82 13.2 "' PAVERS �' � � 3 �F= � o !�. � � "' 16.7' �.� �� c� 3� / Z � #2723 �g 5, o, ,_ / �� 32^ LOT �g � `` w� �Q / 2 - �r � �m Q. ^ ap U � J ,.� ui cv z SCREENED POOI ?Q TELE a^/ � BRICK Pq�ERS DECI( '''• c� PED j o � 50.0' �' ° 8.0' �rrn a FC 2 `� CONC IN L 6 13 / S 135.33�' F P�OL P�Mp � PqVERS Z:N �v 85'34 49"E (NR) 472.2 ' � 0 �o�� P� FCIR a / LB 6 / � . � 2� / ' / » � . _ � ti / 20 10 p � 20 SCALE IN FEET / SCALE: 1"= 20' N:\JN\769B\OWG\769B18.DWG . 7698 Section 32, Township 28 South, Range 16 East, Pinellas County, Florida . � LEGEND� HQRD BEAE3IH� FCM = Found Concrete Monument 4"x4° LB �2168 �P� = P�otted S 12'34'14"W RR = Found lron Rod (M) = Meosured S 00'43'02`E FCIR = Found Capped lron Rod 1/2" LB �2168 (F) = Field N 1 S'05�23'E SCIR = Set Copped lron Rod 1/2" LB �f`2168 (C) = Calculated A/C = Air Conditioner ond Concrete Pad O/A = Overoll PCP = Permonent Control Point OR = Of�cia! Records fPKD = Found PK Nail & Disk PG = Page SPKD = Set PK Nail & Disk LB �2168 CONC = Conc�ete LF.F.E. = Lowest Fnished Floor Elevotion � = Cove�ed Concrete DESCRIPTION� LOT 18 OF •CHAUTAUQUA LAKE ESTATES• , AS REGORDED IN PLAT BOOK 128, PAGES 39-43, OF THE PUBLIC RECORDS ,,� . OF PINELLAS COUNTY, FLORIDA. � /� Q- DRAINAGE ; c� & CONSERVATION CERTIFICATION� � . � AREA CERTIFIED T0: TODD A. AND DIANA M. SHETTLE • HOMEBANC, N.A. FCIR 1/2" MACFARLANE, FERGUSON AND MCMULLEN LB 6113 AITORNEY'S TITLE INSURANCE FUND, INC. ROTTLUND HOMES OF FLORIDA, INC. 341.00' THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS ' �S 47'36'49"W AS SET FORTH BY THE FLORIDA BOARD ,q�`��°iFfdFE�SIONAL 13A2' SURVEYORS AND MAPPERS IN CHAPT�R'�`f�,;�','��FC�RIJ�A ADMINISTRATIVE CODE, PURSUANT TQ`��t��J��f'�7�,Y5�],`fJF FLORIDA STATUTES. ° �.�° ,^�' * <° ` " F R ` c^c�t � . .a 1�1F...;rL� #21 8 <;i ;�: - �: ., LA �+ R � _ •`�'I 20 " ' DRAINAGE oRlt�a��.� � , � � & CONSERVATION '�`�' " NOT VALD YVRHOUT TFE SIt�NA'tURE MD OR�U1ti�'�F/d+�F°;�'0(�A AREA � ucasm suRV�roR�w�� , �� .�- ��3' ,,,> � V NOteS �<<�ir��ust'. , 1. Bearings are based on the North line of the de�cribed lot as shown on the record plat, Said line bears �$5'34'49"E. 2. Elevations are based on N.G.V.D. Datum of 192� Mean Sea Level = 0.00. � v� 336.87' 3. This survey was prepared without an abstract of Title. There may be additional restrictions that are nc�shown on this survey. -� 1/2" i 13 4. Boundary calls reflect deed and field measurements unless otherwise noted. HUD/FIA F.LR.M. COMMUNITY PAI�EI. N0. LOMR—F 07-04-4991A DATEa os/o7/o7 ZONE� X AND A D RAI NAG E TYPE OF SURVEY DATE TYPE OF SURVEY DATE & CONSERVATION PROP. HOUSE LOC. i o/�5/os �p� �/�s/10 AREA HOUSE STAKEOUT i 2/o�/os �pq� VACANT i2/o7/os FOUNDATION 1/2o/io CUMBEY & FAIR, INC. 27 2 3 LA K E B R E E Z E L N ENGINEERING LAND SURVEYING 2463 ENTERPRISE ROAD — B C P 2��9-10 3 56 � CLEARWATER, FLOR�A 33763 �.�� CLWR. (72n 797-8882 TPA (Bf3) 223-4333 � Zoning: LDR Atlas#� 233�1 �� CUR'VE DATA CURVE DELTA RADIUS ___ARC CHORD TANGENT . / C79 1525�10� 214.00 61.33 61.12 30.� / CSO 10'09�20' 214.00 37.93 37.88 19.0 C118 1'24'29" 2533.77 62.27 62.26 31.1 � / 14.00' � I w I � � � I 19 � � � I � � � 0 INLET I � FPKN&D ELEC Z � � 6113 g° ^ S 85'34'49"E NR 478.25' � � U � ^ 137.25' (F� P A/C � U � ^ L�.I � Z �r- I 80.0' Wi,, � w Z Q Q� BRICK o A-�STORY RESIDENCE w I ?� <v ?w � PAVERS � o� o Q ELEV- 91.18 �? PAVERS �� W '�' L.F.F.E.=91.82 �3.2 �- � �t� J v�l J 3 �, 3.2' � 16.7. ^,� Y W� � Q� Z � #2723 �s.s o � o � � W� o o J . LOT 18 � Z 3.2 / v� � � �m � � �J �a / � N Z SCREENED POOL �j '� �ri v BRICK PAVERS DECK w� �. z a TELE �"/ �n � PED � 50.0' 8 0' �o N 0 � � ao CONC o N a F 2 135.33' F POOL PUMP o PAVERS z• L 6 13 / S 85'34'49"E NR � � � ) 472.20' (p� �� / Fcl� _�, LB �o / � . / � . 2 / / � � 17 . � � / � 20 10 0 20 . � _ / SCALE IN FEEf SCALE: 1"= 20' N:\JN\769B\DWG\769B18.DWG _ _ - _ -__ _ - - - - - -- — , 769B Section 32, Township 28 South, Range 16 East, Pinellas County, Florida . � LEGEND� C?iORD BEAf21NG FCM = Found Concrete Monument 4"x4" LB #2168 Cf'� = P�ofted � S 12'34'14'1M F!R = Found l�on Rod (M = Measured > S �0'43'02`E FC1R = Found Capped /ron Rod 1/2" LB #2168 (F� = Field i N 1 S05'23�E SClR = Set Capped lron Rod 1/2" LB �2168 (C) = Calculofed A/C = Air Conditione� ond Conc�ete Pod O/A = Overol! PCP = Permanent Control Point OR = Official Records FPKD = Found PK Nail & Disk PG = Page SPKD = Set PK Nail & Disk L8 �2168 CONC = Conc�ete L.F.F.E. = Lowest Fnished f7oor Elevation � = Covered Concrete DESCRIPTION� LOT 18 OF •CHAUTAUQUA LAKE ESTATES• , AS RECORDED IN PLAT BOOK 128. PAGES 39-43, OF THE PUBLIC RECORDS � . OF PINELLAS COUNTY, FLORIDA. :.v � Q DRAINAGE o / �v & CONSERVATION CERTIFICATION� � . � AREA CERTIFIED T0: TODD A. AND DIANA M. SHETTLE � HOMEBANC, N.A. FCIR 1/2" MACFARLANE, FERGUSON AND MCMULLEN _- LB 6113 ATTORNEY'S TITLE INSURANCE FUND, INC. ROTTLUND HOMES OF FLORIDA, INC. 341.pp' THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS „' �S 47'36'49"W AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL ' 13.02' SURVEYORS AND MAPPERS IN CHAPTER 61 G�1,�m6r�„�,LORIDA ADMINISTRATIVE CODE, PURSUANT TO SE��pI sy4�2��s,QF FLORIDA STATUTES. F R C �� ,��8y` ,,, �i��f`#21 8 �► �p ��- � DRAINAGE ORID� ��ST RE�D�UL = & CONSERVATION "�� '� �a p�/� NOT VALD�WpIT�H�OyU�Tp TF�S�I�G�NpA�TU�iE At�D OF�GNAL'�� t'3�A`�L��1F�A,� A1\Ll1 � ��7�R7�G 1 Vf7��IqfYr�fl /� a+�� °d° '� ` V NOtBS '"'•,� �� (� +�:�_`; a'`�� r 1. Bearings are based on the North line of t�tie�t� escribed lot as shown on the record plat, Said line bears S.85'34�9"E. 2. Elevations are based on N.G.V.D. Datum of 1929, � Mean Sea Level = 0.00. � 336.87' 3. This survey was prepared without an abstract of Titk�,j There may be additional restrictions that are not sh�n on this survey. � 1/2" 13 4. Boundary calls reflect deed and field measurements unless otherwise noted. Hl�/FIA F.I.R.M. COA�9ulUNITY PANEL N0. LOMR—F 07-04-4991A DATEd� os/o�/o� ZONE� X AND A D RAI NAG E TYPE OF SURVEY DATE TYPE OF SURVEY DATE & CONSERVATION PROP. HOUSE LOC. �o/�5/os FlNp�. 7/�s/i o AR EA HOUSE STAKEOUT �2/o7/os t�DATE VACANT �2/o�/os FOUNDATION �/20/�0 CUMBEY & FAIR, INC. ENGINEERING LAND SURVEYING 272 3 LA K E B R E EZ E L N 2463 ENTERPRISE ROAD BC P 2009-�0356 �j� � a-EARWATffi, FLOF�DA 33763 CLWR (72n 797-8982 TPA 1813) 223-4333 , Zoning: LDR Atlas#: 233A �