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1365 LAKEVIEW RDU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name CCRDGLOBALLLC Policy Number. A2. Building Street Address (induding Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Company NAIC Number. City State ZIP Code CLEARWATER Florida 33756 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 1 & 2, LAKEVIEW ROAD SUBDIVISION A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat. 27.94961 Long. -82.77990 Accessory, etc.) RESIDENTIAL Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade M NAD 1983 0 2 photographs of the building if the Number 1A Certificate is being used to 0 sq ft with a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached permanent flood of flood openings flood openings? or endosure(s): or endosure(s) openings in the crawlspace in A8.b 0 sq or endosure(s) within in sq ft within 1.0 foot sq in 0 ❑ Yes X No garage: garage 0 openings in the attached garage in A9.b 0 ❑ Yes 1 No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CLEARWATER 125096 B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0109 B5. Suffix H B6. FIRM Index Date 08/18/2009 B7. FIRM Panel Effective/ Revised Date 05/17/2005 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 33' B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data ❑ NGVD System or base flood depth entered in Item 89: ❑ Other/Source: a FIRM datum used located in a 1988 ❑ Other/Source: or Otherwise Protected 1929 i2 NAVD (CBRS) area ❑ OPA Area (OPA)? [] Yes 1 No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number: City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ 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, Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: SEE COMMENTS Vertical Datum: NAVD 1988 Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation datum ❑ NGVD 1929 used ei for the elevations in items a) through h) below. NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (induding basement, crawlspace, or enclosure floor) 33.4 F2' the measurement used. feet ❑ meters b) Top of the next higher floor 34 0 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet [] meters d) Attached garage (top of slab) N/A x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 33 6 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 33.0 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 33. 8 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, induding N/A. x feet ❑ meters structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect I certify that the information on this Certificate represents my best efforts to interpret statement may be punishable by fine or imprisonment under 18 U.S. Code, Section Were latitude and longitude in Section A provided by a licensed land surveyor? Ea authorized by law the data available. 1001. Yes ❑ No to I understand ■ certify elevation information. that any false Check here if attachments. Certifier's Name License Number DAVID C. HARNER 2650 .. `Seal,; , 2 Herd � r`> .. ~ r ' if ©! Z"• Title PROFESSIONAL LAND SURVEYOR AND MAPPER Company NamePWce DAVID C. HARNER Address 9925 GULF BOULEVARD City State ZIP Code TREASURE ISLAND Florida 33706 Date Telephone360 Signaturep--e.i / 05/07/2019 (727) 360-0636 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) BENCHMARK ELEVATION=25.81' ON CITY OF CLEARWATER BENCHMARK "D-08". C2e: A/C COMPRESSOR AT EAST SIDE OF HOUSE. SPECIAL PURPOSE SURVEY. PAGES 3, 4 AND 6 ARE NOT APPLICABLE. A5: PER GOOGLE MAPS NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR & MAPPER. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number. City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number 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 complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑ above or ❑ below the HAG. crawlspace, or enclosure) is ■ feet ❑ meters b) Top of bottom floor (including basement, crawispace, or endosure) is ❑ feet ❑ meters • above or ■ below the LAG. 9 (see pages 1-2 of Instructions), ❑ above or ❑ below the HAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters E3. Attached garage (top of slab) is ❑ feet • meters ❑ above or ■ below the HAG. ❑ above or ❑ below the HAG. with the community's certify this information in Section G. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No • Unknown. The local official must SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments • ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number. City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for. ❑ G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone AO) depth of flooding at the G10. Community's design flood elevation: New Construction ❑ Substantial Improvement basement) ❑feet ❑ feet ❑ feet ❑meters Datum building site: ❑ meters Datum ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number: City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. nin j Photo One Photo One Caption FRONT VIEW 05/07/2019 I' - - Photo Two Photo Two Caption REAR VIEW 05/07/2019 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Pape OMB No. 1660-0008 iration Date: November 30, 201 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number: City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo One Photo One Photo One Caption N/A Photo Two Photo Two Photo Two Caption N/A FEMA Form 086-0-33 (7/15) Replaces all previous editions. U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name CCRD GLOBAL LLC Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Company NAIC Number. City State ZIP Code CLEARWATER Florida 33756 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 1 & 2, LAKEVIEW ROAD SUBDIVISION A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat. 27.94961 Long. -82.77990 Accessory, etc.) RESIDENTIAL Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade ® NAD 1983 0 2 photographs of the building if the Number 1A Certificate is being used to 0 sq ft with a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or endosure(s): or endosure(s) openings in the crawlspace in A8.b 0 sq or endosure(s) within in sq ft within 1.0 foot sq in 0 ❑ Yes 0 No garage: garage 0 openings in the attached garage in A9.b 0 0 Yes No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CLEARWATER 125096 B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0109 B5. Suffix H B6. FIRM Index Date 08/18/2009 B7. FIRM Panel Effective/ Revised Date 05/172005 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use Base Flood Depth) 33' B10. Indicate the source ❑ FIS Profile 611. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources ❑ CBRS data ❑ NGVD System or base flood depth entered in Item B9: ❑ Other/Source: 12 FIRM datum used located in a 1988 ❑ Other/Source: or Otherwise Protected 1929 Ci NAVD (CBRS) area ❑ OPA Area (OPA)? ❑ Yes No FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 iration Date: Nov IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number. City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations —Zones A1—A30,I AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: SEE COMMENTS Vertical Datum: NAVD 1988 Ki Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation datum ❑ NGVD 1929 used for the elevations in items a) through h) below. NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 33.4 ill the measurement used. feet ❑ meters b) Top of the next higher floor 34 0 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet ❑ meters d) Attached garage (top of slab) N/A x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 33 6 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 33.0 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 33. 8 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. x feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect I certify that the information on this Certificate represents my best efforts to interpret statement may be punishable by fine or imprisonment under 18 U.S. Code, Section Were latitude and longitude in Section A provided by a licensed land surveyor? gl authorized by law to certify elevation information. the data available. I understand that any false 1001. Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number DAVID C. HARNER 2650 Place Seal "; Here , w , / �'� g Title PROFESSIONAL LAND SURVEYOR AND MAPPER Company Name DAVID C. HARNER Address 9925 GULF BOULEVARD City State ZIP Code TREASURE ISLAND Florida 33706! Signature Date Telephone P" --g' Cj 05/07/2019 (727) 360-0636 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (induding type of equipment and location, per C2(e), if applicable) BENCHMARK ELEVATION=25.81' ON CITY OF CLEARWATER BENCHMARK "D-08". C2e: NC COMPRESSOR AT EAST SIDE OF HOUSE. SPECIAL PURPOSE SURVEY. PAGES 3, 4 AND 6 ARE NOT APPLICABLE. A5: PER GOOGLE MAPS NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR & MAPPER. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number. City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number 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 complete Sections A, B,and C. For, Items E1—E4, use natural grade, if available. Check the measurement enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ■ above or ■ below the HAG. ❑ above or ❑ below the LAG. 9 (see pages 1-2 of Instructions), ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's certify this information in Section G. b) Top of bottom floor (including basement, crawlspace, or endosure) is ❑ feet ❑ meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters E3. Attached garage (top of slab) is ❑ feet ❑ meters E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, 6, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments • ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEW ROAD Policy Number. City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone AO) depth of flooding at the G10. Community's design flood elevation: New Construction ❑ Substantial Improvement basement) 1:1 feet feet ❑ feet ❑ feet meters Datum building site: ❑ meters Datum ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1367 LAKEVIEW ROAD Policy Number: City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. :T1LE iii 1361 y i Photo One Photo One Caption FRONT VIEW 05/07/2019 4 Sof it 1 Photo Two Phot.) Two Caption REAR VIL V V 05/07/2019 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 / • ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page OMB No. 1660-0008 iration Date: November IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1365 LAKEVIEVV ROAD Policy Number. City State ZIP Code CLEARWATER Florida 33756 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo One Photo One Photo One Caption N/A Photo Two Photo Two Photo Two Caption N/A - - - - - FEMA Form 086-0-33 (7/15) Replaces all previous editions. orm Nage b o ti. s •. U.S. DEPARTMENT OF 1loasaAND 86aJRrrr ELEVATION CERTIFICATE Federal Etrwrpusq Wnegrmrt Aaa,ay *dorsal Road kr,aanos Program Important Read the instructions on popes 1-9. OMB No. 1080-0000 Expires Weis 31, 2012 SECTION A - PROPERTY INFORMATION Foo bassranr Coopsry Uric At AMLAKEVIEW LAND TRUST; DAMIANI J9RGE.A TRUSTEE A2. Bidding 9keat Adders (kmatrsna Art.. %. d. Sala. MON tete re.) fir PA ham* mid Dau Me.' 1365 LAKEVIEW ROAD Polipitusllr City Sw CLEARWATER FLORIDAw Co pear Neth'. Noir - ZIP Cods 33756 • A3. Property Deeaiplion (Lal dal Block ttunbas, Tax Parch Number, Lega Daaipson, Mt) LOT 1 & .. :ear :t • A4. Btr/drg Use (e.g.. Re0dentlel. Nott Raeddenlei, Allton. Aoarmory, du:) RES IIlENTTAT. Florlmrdal Oatam: ❑ NAD 192T Q NAD 1913 A5. Lagmlotonslialac Lat. 27.9496 tares. -82.7799 AO. M oab at Mae 2 phonlepraphs of We building demi 01110:1 1111 k Waal A7. Bulling Olagr$rn W+nber 1 A A6. For bolding _. a aemrpeo, or andoskw(s): a) Some tooling, o1 uartepece or aheoehae(s) na eq R b) No. of penmen! load opening, tote aawlspeos or andostas(s) *Min 1.0 foal above adj amt grade c) Taal net ere, of food *mew in NA Ile b d) Engkheewd bad openings? 0 Yes 0 No A9. For ■ Imbibe; web an dledrd genus: a) Liqume Nobatof a>esrMr garage 499 a It b) No. of pNma and flood openings to dr ar,arlp grape within 1.0 foot above &Bac lid mode u c) TOW not area of moor amines In Alb 0 aq in d) Enai rider load oparilsgs? 0 Yah No SECTION E -131.000 NSNRAMCt RATE Wit (Pres, INFORMATION 81. NF1P Community Nems • Carrwsksily Nuuabsr 1 82. County Name CLEARWATER 125096 PlaLLAS BO. Malo FLORIDA 04. blotaPanot Number ` Sal. $tit et rifts Mar - 97. F P.lsi M. Rear Zone) ice. Sar Floud amelonp) (goes Otte Edo kedhai ls,d Oslo AO, ua bete Isar doped 12103L 0109 H 8-18-09 •9 .3-01 "'- AE & X .- 31.5 810. kdb*Is h. MOM of the Brae Flood ElaWbn (BFE) dale Ot tortes 10011 depth erdaer In Idem BC 0 Fes Phone © FIRM Comm* Dwneiriod ❑ os,a (oaalbe) 811. adagio elemlon datum um! for BFE In Mem 8r: 0 NOW 19129 ® NAW 11116 ❑Otho► n ) ® No 812. M1 the bk 91 ed Brr bye CoCo„anter Reeows *Wm (s�RB)) hi MRS Protected Asa OPA)? 0 Yee Codwislion SECTION C • Ut*.aaO ELEVATION NOPOOO A710N (SURVEY REMOVED) C1. SUMO dsvalon* are Mead on: 0 Construction O! 11s, ® Buldhg Under Cambodian* (] FirIalrd Can coon •A now ElewYon Cretfloele ell ba required when omweuction at rhe budding * oompbb. C2. Eons — Zones Al.A10, AE, AN. A (war 8FE). V. VI -V30, V (errs BFE). AR, ARIA, ARAE, ARIA1-1110, ARAM, ARIAO. Comhpeb Manns C2.4a-A below a000rdk+p to 8M building disarm apeoMrd h Nen A7. Use do sem dermas the BFE. gencrmrt mow SEE COMMENTS " Antim0 ra ' NAVD-• 1988 ConvanioVOmments N.A. a) b) d) e) f) 9) h) Top of boMora leer (M,drinm $Sema t. ormA p«oa, or *dexo tear) 34 Top of Be nod Now Boor Bottom of th iwraat haworkW eleadrst aleskbsr (V Zaps ares 3 3 M»ahsd game (top of alai) Lowed ebvaron of m ,chin ry or pu4maih serAoeg 8r b AM% (Neat* type of agiap nos t and bouton to Commits) Lowest Klemm (e+rhed) (rade nerd t0 boldly (LAG) Hlghrnt agw era (linielyd) grade nod b bNldkp (HAG) Lowest atiaoat grade at lomat etevston of da* ce atoks, including riniCearol mood Curet the mss maimant used. MI mem por10 Roo any) Mot maw (Peel► Roo orMy) 33 0 33`4 X Ieel test lost tot feat bat mens pawls ata ore') mews (Rab Rico dray) reeler* (Puerto Rico only) motors (Puerto Rloo only) resins Marla woo Dray) meters (Pomo Rico orgy) VECTION 0 - SURVEYOR. EN—ER, CR ARCWITICT CER7IPIGAT1001 This aramOB h Is 19 99 i jrrd and air by a rues srvea,r, arybrr. ar eeddleot orderer by be fo oerNy elrvsior, khlrtnmeon. f caMy Met Po isbor s,lor, on Ids Ceram* wprtaanas ay Met elbola b Margret Ida dile wmaibl . t undsrobond IMO any foe aMwkerr rimy 0e prawMlb er tiro aIr briprleolrwatt r rt rr 141 as doll . awl** 10ng1. ® Medi hew I aornaerkb me podded en bar* of fow VIM telladednd WOW, le Soul A tasl0ed by a tcansed Ilyd etavayeR ®Yee U No Codifies Name DAVID C . liAUER PROFESSIONAL LAND SURVEYOCR Lisa„e Nranber DAVID C. H.A.RNER y5 GULF BOULEVARD TREASURE ISLAND FLOAT nA ZP Cads 11 7 (16 olaphona 11-1114-10 T t4.1!7:111. -C. HAR .0 ` 1t..,d1'26g400 :_STATE or F€MA Form 81-31. Mar 00 Set rewrse aide for oontrnulion• IMPOItTANT: 4*see opecos, copy the correepoodbeg WessonSoso boss Sodom A. Eluting it,eat Address irciuding Apt, Unk Wei, smear Bldg. No.) or P.O. Raids and Ifon No. 1365 LAKEVIEW ROAD For inmeimoo Comps. Wet Polley Weber city somo CL EARWAT ER FLORIDA 33756 SECTION 0. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CCiNTINUED) ZIP Code Cempany imemer Copy bah sides of this Bevelion Codices for (1) oanniunity (2) Insurance egenecornpriny, and (3) bulang owner. Commmis THE RESIDENCE ON THIS PROPERTY IS LOCATED IN FLOOD ZONE "X". BENCHMARK FIFVATTON 32.26' ON NAIL & DISK IN SW CORNER QF DROP INLET, 55' E— iL.20' N. OF NORTHWFRT Por)PRRTY CORNER. Simeon Deo 1 1— 1 4— 10 Ohm* here11alentenena SECTION E BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (IMTHOUT SFE) For Zones AO and A Mahout 13Fp, comasis ewe E1 -E5. If Me Owilicale Intended io support a LOW or 1.0.F ream* compere Sealers A. 8. and C. For hems E1 -E4, as Mural grade, if mmilehis. Check Me messumment used. In Puerto Rico only, war mama. El . Provide elevelion Information tor Ps blowing and check Me septuplet' boxes to show whetter V elmetion he above or Wow re West etijacent grade (MG) and Ike bawd adpoont goods (LAG s) Top of balloon Soar (Idiuding hillnosa croviftPook endolistmi) 111 . Obit Clemeleis or he NAG. b) Top al bantam floor enduing kesement. creetnpace. er endows) . Deel Damn or ihe LAG. E2. For Bulking Oligranis 84) vilti immanent good openings proiridedja8saignA Is $ minx 9 (see mei $4 at Indiuclions), to nest higher Icor (mmation C2.4 In ihe megrims) 04 8* building le U lieSS U mien Stmnli ar Woo its NAG. • — E3. AllaChod garage (top al ebb) Is 0 feel 0 ateliers 0 above or 0 below Ms HAO. E4. Top of pisionn of rroMineri anillor equipment esivioing building is . 0 ism 0 thee 0 above or 0 beim he HAG. E6. Zone AO only: no food duple number le irrsillsile. Is fie lop ol brawn floor Meowed In isconiffinas wiii 11* commurels loodpiein minegernere ordinate*? 0 Yee 0 No 0 Unknown. The loci cadet must ay* informellen In Section G. SECTION F - PROPERTY OINNMI (OR MIER'S REPRESENTARVE) CERTIFICATION The property owner or owner's euthortned representeere who completes Secions A. 8. and E tor Zane A (Si.(.FEk4A-Issued or coninimity-lesued or Zone AO must aim tare. Tho ohOontonto in Sections A. a and E all corny g o are bog 04my Property Owner's a Owners Autiorted Representative's Nem* Address City Stale ZIP Cade Sonatina Date Telephone Comments SECTION 0- COMMUNTTY INFORMATION (OPTIONAL) 0 clock hem It aiertmmta Ths local Acid eitiO 1 Niord by Cr Oldininal ocineramIty's lxmMmensosetwit oninardos can complele Solaro A. S, C (or E), and t3 of Bevegon Ceniemie. Campine Ole apl-es Ilern(s) and sign Wow. Clack he niessuremeni used in lima Ott obi GO. 01. The iniannelion In Section C was taken ilmin alter documeniation mei hes been Waned and melee by • lamed arveyar. engineer, or architect who suihorized by two to ossify elevellon uAwmmon.(kidkais he source and dabs 041* ekradon diets et Ins Cameras arise below.) G2. 0 A coMMUNILY OMOISI oorngOoloa Seaton E be located In Zane A (without a FESAA4eaued or ccisinutiltrissued BFE) or Zane AO. G3. 0 The 'Mowry "doon (Num G4 -G9) Is provided tar community loodpien menspernent purposes. G4. Permit Number G6. O. Penni Issued 06. Date Carllicsee Of ComplancelOccupency Issued 07. This penal hie been Issued *x 0 New Corson 0 Substatelsi Improvement Ga. Bevedon of as-buit lomat Soar (kriuding bssernen) 04 8* Sulam 0 feet 0 melee; (PR) Datum 09. BFE or (in Zone AO) depth of toning al the building ells 0 terst 0 meters (PR) Daum 010. Community's deep food simmer:ft 0 feet 0 molars (PR) in Local Ofeciare Name Ties Community Name Taistennil Signature Doti Comments 0 Clock hare If attachments FEMA Fortn 81-31, Mar 09 Repteces previous 'Mons 1365 LAKEVIEW ROAD CLEARWATER BOO letix Cede FLORIDA 33756 amitime 111614r Oimporkiefoloirr ElmsD 1 CoolltaulD b ___ NFIP In/ atInindib� ► bli�l0 , ans lar am At own* r plindaysids vac awl liver We" _ --.—;- --„ Ili VW and Lt ads Mew.' arianaling maw phalograpils art wi' * « 1* paw it wr Cahn raw an 11-14-10 REAR VIEW FRONT VIEW ,� - - u.s.r���e�rr oF F«oMearosecx�remr ELE1l'A"TKlN CERlt1FlCATE t�a No�.teea�mis F�+���►����Y�► E�iM wilre�ts 34.2Q1 Z nNo�w Fa�d kw�r.nos�raq►aR+ hnp� Rs�d�1 inafix�ions on psQ�s 1-9. �, l�EC'TIOM A-PIlO�ERTY N°OIIMATK�N Fa IMwua�r G�r u� ^4' Ai�KEVIEW LAND TRUST� DAMIANI JORG � A►2. 8uldnv����(�+��0�P�.�9u11w rw�or�.Ne-}a► .O. ,rwd 1�e�c No.. , � _ _ . 6 L � CLEARWATER FLORIDA 33756 A3. Fh'oPMy Desatpllon tLa ifd�Dut lJwnDus.Tax ParoM Misr�W►,lmpd D�a�ia�.�Ic.) LOTS 1 & 2 M. 9t�p UN(�-p..RMidMlirl.�.lld�lon.Aooworp.MC.} ,�. �,,�,p���,�, 27.9496 �or,o. -82.77 t�orrnoi,al D.wn: w�D��2t x ww t9e3 A0. At1�A�t iw�t 2 pUolepapha d ifw buf�nY if Yr GM1�Ms.ii kiMilp t�Ct b oi�Nr wooa 1n�uranor• . _ . . �7. a�+�dY�Q OMpram M+rnb�r lA _. _ _, .._.. Ad. For a b��q wN!►a rewiNp�o�o��w�w(i). AS. For��/i!p+�an tldrlMd pra0r� � . . s) Sq�w�t�orp�oA asr�p�a�wr�ndoiu�(s1 na p R �f 8qu�r�loodp�d a1f�cAN�r� 4 9 9 p et D} No.of p�ennMwk Aood cp�ept N�aiswl�o�a by No.dpr�M food e/M+iqt In 1he all�d�¢pir'+p� «x1o�x�(sy wMt�N+t.o�oat�bow.q.o�k aad� ww+i►�t.o�oot�boa a4.od asd� � c) TaW n�t MN d�ood�nM�ps b M.b �4 in � ToMi tMt ��? 1n M � �p in 0 a) �„prw�.e+ood op«+ro� ❑r� ❑"� `•af � � �s•f�.oroo����r t��►�ar+ a,. w+,.s � . CLEARWATER 125096 p . PMnb�r . - ' �/W.w i�w�#oM i�p�+} p�t ��Aw1Yi�d 0� I�N� .. �.._ . '•. .,... _. 31.5 221 0109 8-�8- - - s�o: k�ao�i�ih.�auror at u+f e...�ood�.�ion�?a.r.a a+w woon a�pw«ww.et n wn+eo. _ . ❑��. o F� �.�,►� o«��.� e,,. ka�ca..rw�on a.�,�,+�,..o�e�r,�eQ:Q Nc3w,az� (�w►w��ee ❑aio«to..�r»� 812. Is�M OYMMnp IOCawd in AC�oNW M1f�RMOwOM 9rMr�t��o�„ONMwIM P1oMO1rd Ms(OF'ly'r [j YM � No E�ipra�fors[IaM N L� SEC'TNkI C-M�.DMG EL�E.'1/ATIt�N MM�ORMIl�1Q1!(�tJRVEY 1l�Qt1Nl�?� ...,�...�.�...�. ���. c�. e�+arro«.�.�.anse or�: ❑con.kua�on aa�+�.• �e�+aw+o+�c«�aro�r �1�w»a ca»«Lmo� •A nrw EMNYon GrMo�1�w�b�n�+lAd w�M^cawrn�on d ri�Oui�np w oonhiM�• C2. EMwtlORM—ZQrMS A1-A30.AE.AN.A(w��E�.NE.1M-V30.V h�►BFE).AR./1WV�.AR1AE.11R/A1�1136.ARtNl.ARfAU. Co�pl�M�ns C2.a-R a.iaw.aoadima b!i��+Miw dM0►an��v.•�ti�wn�u. ur.�n.s.�.mAri+as h.eFE. g�a�+�ktJ�m�d SEE COMMENTS _ �fiiWi�lC�iiu�a ��p 1988 . . N'A ... ,. Cfi�dc riR m�wwu�Mn�nl uad. �) Top d OoNoin�ser�drMra NrM�k�P�.ar�Iowir�!or}3 4 �l �Mris IF1iMb Wo4�anM p) Tap d ri�n�Q Ml�rr iot Mt n1�lP�d��I � q Br�o�u of tr twr��t Ao�'rnoMlM aNreMa!��t�1t Lrra adlr! Mt a�1�R lP'+�b i�oO a�h? d1 ���l�V of WD) �� 1Nt nNIMS(Pu�b Rfo�a�c�rt e? 1.aMrNt Mwlion d�d+in�rl►or pi�rr�'M s�rvia�p tt�bulldino ._�iMt m�M►s tPiw�lo it�oo ontY) (p�aa�s typ�d rqt�pnM�t afd bo�oe�in Conm�+4) 3 3 0 x ir�t n+rMrs(Pwrb R1oo anly) � �owwt�x t�r�t�d1 ar+e�rr�te�mrw Ma) ---�".4 �rre n�rws tPu�b Rioo a+hr3 Q) �fM+��k t�Mdf 4�d�nm w bui�finp t�) — � mNws(!"t�w Rioo d�fY? n} 4ownc sar.o.rK R.e.at a�t eMa.lio�r a e.a�ar.aMb..,:iauarp � lIEC710M O•atM!lIE1�OIM.QION1EWt.C!t AIIdNflG'i'CER71WCJ1710N i�b o..rn.a,r�e...MS eq.Mni*.r.�ar..eab..r.ar r..w a�.t� 's�tpm�In. �oNl�r rlM M�NMan��ar+ar Mis OMMo�wprwnls�1►+bMt�Rri b iMrp�f Mrl�Y w�i11R r uncw�+r+e ftnr anr a��I�wr n�ry b�p�iM+14 br�ar i�prt�orir�t�war rt v.S QodR srdt�r toof. �ClMCI�hw i(co�w�rMit w porid�d eei Mdc d lo�. YMIiM 11�,�11o�d�h Sw�J1 b�►a loawd MnQ ar�M? �Y�s No Gr�s� l.1�t fiiwiOM �!`� �, , ; Z650 � �y�t�i�; li� � •, , ��R. PROFESSIONAL LAND SURVEYOCR� DAVID C HARNFR -- " � �� � �„� ��,�I;I�b C. xAR�;�, yy15 GULF BOULEVARD TR�F�ISURE I�LA�t1� FL�RID�__— �'�7[�fi --- P�.��`2�6�(���3 � � 11�-�1M4-10 T� _ � a �Y n i'r� _. �AA Fwm 81-34,1rAsr 09 Sss te�a+se afde/or oorMYxia�on• . !�� �• IM+ORTANT: In tl�sp�w,copr�r tA�t in�o�ffow fno�w 3i�son A. tar�aruar�ot l:o�t!� " Bu�dNp Sbeet A�ddtsa(�nd�drp Apt.,11r�i.Suis.��Qiat Bkp.Na)a P.O.Ftouls aM Baoc No. PiaYc�r i�luriNr 1365 LAKEVIEW ROAD , �Y Sf�1e Z1P fiAds M+�eOer CLEARWATER FLORIDA • 8ECTi0N D-�t�tYE'1'CR.EIi�MiEERf OR ARCENTECT CERtiFICATION{CONT�D) . Copy bdh sides of Mris ENvalfon Csr�IlaAe tor tt 1 con�nw'iNp ct�i.{�irx�u�anoe�,and(33 euidM�q owr�. ��s THE RESIDENCE ON THIS PROPERTY IS LOCATEn IN FLOOD Zp �.�"X„ gE����zu FT FUATT(lrj 32.26' ON NAIL & DISK IN SW CORN R 0 R ' ' CORNER. � :r�/�,/� 11�-14-10 ��twre IF a� ���' �.�.�i�.����ri��r�i��w���q�r�.�� i��r�r�� i�EC710N E-9t11L.D111G EI.EYATK�N MIFORMIkTqN(8tJRVEY Nd'1'RE�JIRL��FOR Zt1�ME A4 MIL>ZOME A�IAA'tt10UT BFE) For Za�ss AO uW A(w�lAout 8FE}.aoaapMl�M�ns E1�E5. K Mis Grtl�c�b is iNernlsi!1u N,ppoR a l�tA or Cq�i-F mqwe�t,oon�s6�Ssetl�xx A.B, and C. Ftx IMtna E1�4.uM n�sak¢adl,#awY�bis. l��dt ttu nrawenieM u�eQ. b Puee6D Rfoo orU�r.a�N�r mskts. E1. ProrkJs eisvatlon inbrm�lfon dor�b torowinp and ChecJt�w apQteptiM�baxes�o ahow Mdrs�er fM ek+a�lioe!is abows or below�+a hi�et s�oent 9rad�(liAti)aM M�IowMt a�aMK PaRM NK�. .�ropa eo�om�oo��a,ar�s...�.a.«a�.o..««raa.w.��. - Da•� C7,+w� o� +r�.r�. b)Top d bc�►bor(induAn�bra�M,aswir(�.a►Mwlawry ia ____ [�rM [�Mws �ar �w M UG. EZ. Fat 8utdin0 Diprau�s B�wNh pernnnent f0od Op�e1111pt praAdsd�81ic1TqQ,r1 MN1N 8�}p/Or�{see ap�s 3-0 of knrtlidions),1As nad hipHer 11oor (NerM�tlae C2.D h tl�aqpraeas)af tne a,ilQi�,p+s tsst t_.,1 nf�M�s L..J�a l,_!r�Mow 1ho MAG. �. Ag.a,.a�.teop or.ney�s p n«[j� p.�.« p ewoM►in.w+c. E4. TOp dp.�o��aa�a�ep�«�a«Man�aswrbrq r ..,._..p�c Q�s p aeo�.a ❑a�e+ow rr.wu�. E5. Zone AQ Onl�r M n0 tood dapYt tMrnb�r is aw�bw.is Ihs!op d tl�boll0rn Aoot dealed in�000rAMloe wi�ws conrnu�is Ao�dpi�in� o�Nranada p ra. ❑No ❑�. n,s�oa+o�w+�wr aAy*r.rMo�a�ion a ssaMoA c;. _. aECr'°ro F-,_,r�eo�� ��n�c�c�►noN .r...._, _�. _ The�xop�erty owr�sr or owrMr's auN�ortr:ed rpras�rN�ivs who ooenpMles S�e�ons A.B.and E ta Zons A(�r�o�R a fE�AA-isM�d a��ed BFEj a zone.no rr�e si�n►,Ke. rn.afa�e+�+«nr:rn sea�ans A,et.�a E.n.Qonsex iu ati.e�set a my a�owlecips. Property OMrr�er'a a O�s AuhoAzsd Reprose�rt�s'i tpune Addross CXfy Sta� I�Code � � �� Carrvnents ❑Chsck hen�a� sEC'T�o�t G-C0�l11Rr M�IFtiilYl►t�ON(OP'1'ION/IL� Ths ioc�d d�who i�autfo�ed�b�iir or o�i�dirwics~adn�iiil�r�s aoiaaun�s foa�++�wrp�nw ar�d1�e��aonipilt S�cfior�s�4 B,C(or Q. a�,c o a�de ElsYapon e,e��lkals. c«rpl.+.+ne appicve�e M�emts}a�+e slpe�aeloM►. ara�n.n+e.�n+�+��.ee tn iMms oa.r+a c�l. Gt. � TM 1Marra�tlon in.Si�cqor►C wa hken lrone alt�doa�mar�Mon 1l�t Ma bsen�ipn�d aM ss�isd by i ioerwd aurwYar.�qY+w,or ar+d�Mc,t who �s ai,AhorF�d by Mw to o�r9y akroatlon Yrform�tlon. (Indk�ie tl�s aaxoe and d�b d tlre eNvatlon d�dr in IAe f:arkr�NE anw Odow•) G2. ❑ A oommufKy aAc�W ean4'�MeMO SscYion E br i huidY�p WaMd In Zans A(�a FB�a�sd or od�nuAit�rNw�d BF'E)ar Zone AU. G3. ❑ Ttn1 fobrrY�p infotm�dlan(IMRN Ci�-C�6?k W�'+�d��+�h�'aP��P�1�• c+.�� r�. c�e s�ra� cs. o.�s c�cw a � c�. rn+�wr,+�n n.�a��a�or: ❑�c�a�aror� p��c ca. �ewnor,a�,�-a,��ow.sc�oor c�na�x��d m.a,�aro ❑,� ❑ms�.rs tr�n oawxr► cs. eFE a c�,z«��oa�n�r��a�a�a� CI ts.� Q�.t�} o�, a,o.c«►�eY:a�,+�ooa� Q t•« i��t� r� LOC��I t�t�al't Name '1'i1�R C,ptrn�urtily NNne '� Telepliais 5iyrwture Dal4 CorrNrrents . ❑Cff�it h�'e iF� FEMA Form 81-31>Mat 09 Rep�oes aN prerious ac�io� _ _ _ V ^ �� ��� � A ` �����• �� �� . . � � 1365 LAKEVIEW ROAD i, CLEARWATER FLORIDA 33756 ' � N uMiq M�Br�on C�+M�b ai1�+I�P A�od iiwwio�,a�c at i�t INS Oii�pUoloP�Ol�0�►�+0�D I �,�.�oraM�w�+�s. arrf►ai p�arv�p.wrr+�a■r►�w+c'+�wrr a�a�r w��r;�+s,M wq�+�4'� sm.v�wr ane vR sis.vrw.•r a�e�+r��.v�+��+•��e��•+�■��••a c.rr■+r.�Pa�.o��n. { �'�� � � � � 11-14-10 ! ; • � � I REAR VIEW FRONT VIEW �+ ( � � ! ` ' � ` '_ � �,� 1 I �. � i -_' ' '�_ �' f 1 � � x �' t ; - � j � � � � ; r,� ,-;� � - � � � � �-�� � ; �-* { �� _ � ; �._ � � � �� � �� _ � ; - -- � . . , __ , i � ; . _ - , } I ' - r�"�� t . r���-.,�� - ,�. l�. ��."' , , ' Yi N�` b::. . 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