1007 LEE ST ,�� /���✓�) '"' �� � � � ttUtKAL tMtK(�tNI:Y MANA(�tMtN I A(itNt;Y
� O.M.B. No. 3067-0077
= 6 ,�,1 NATIONAL FLOOD INSURANCE PROGRAM �xpires December 31, 200E
. .
`a��` ��� � ELEVATION CERTIFICATE .w
' Im rtant: Read the instructions on a es 1-7.
� SECTION A-PROPERTY OWNER INFORMATION - ^ �a Insur�rxe Cwnpany Use:
• BUILDING OWNER'S NAME - pp�i�y;�um�
MODEST SYLA "
BUILDING STREET ADDRESS(Induding Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOXNO. ,�;ampanp f�AIC Number'
1007 LEE STREET ' _. _. . _.._.: . :._ �_..,.:... :._.
C�N ` STATE ZIP CODE
C�e�~�'�'T'e� FL 33755
PROPERTY DESCRIPTION(l.ot and Blodc Numbers,Tax Parcel Number,Legal Desaiption,etc.)
NORTH 45 FEET OF LOT 4,BLOCK H,PLAZA PARK
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,'rf necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-#t�'-##.#t�" or ##.�) �NAD 1927 ❑NAD 1983 ❑USGS Quad MaP ❑Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
CLEARWATER 125096 PINELLAS FL
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S)
NUMBER 65.SUFFIX 66.FIRM INDEX DATE EFFECTIVEIREVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depth offloodirg)
12509fr106 G 9-3-03 93-03 AE 24
610.Indicate the source of the Base Flood Elevation(BFE)data a base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe);_
B11.Indicate ihe elevation datum used fa the BFE in B9:�NGVD 1929 �NAVD 1988 ❑Oth�(Desaibe):_
B12.Is the building located in a Coastal Bamer Resources System(CBRS)area a Otherwise Protected Area(OPA)? ❑Yes �No Desi nation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Buiiding elevations are based on:�Construction Drawings` ❑Building Under Construction' �Finished Construction
`A new Elevation Cerhificate will be required when construction of the building is complete.
�C2.Building Diagram Number 1(Select the building diagram most similar to the building fawhich this cerfificate is being completed-see pages 6 and 7. If no diagram
accurately represents the building,provide a sketch a photograph.)
C3.Elevations—Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARIAE,ARIA1 A30,ARIAH,ARIAO
Canplete Items C3.-ai below according to the building diagram speafied in Item C2.State the datum used.If the datum is different from the datum used fa the BFE in
Sec�on B,oonvert the datum to i�at used for the BFE.Show field measurerr�ents and datum conversion calculation. Use the spaoe providetl a the Comments area of
Section D or Section G,as appropriate,to document the daham conversion.
Datum 1988 ConversionlComments_
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes �No `
o a)Top af bottom floa(induding basement or endosure) 25. 7 ft.(m) � ,���"�' �����-f -
o b)Top of next higher floor N.A ft.(m) a ,'�� ,� ''&a F ,� .:..,
o c)Bottom of lowest horizontal structural member(V zones only) N.A ft.(m) N � ,;. �� a{
o d)Attached garage(top of slab) N. A ft.(m) �� '-.��' « :� J� .x
o e)Louvest elevation of machinery ancUor equipment W ' �� ' '�,
serviang the building(Desaibe in a Comments area) N.A ft.(m) �'� :� �� ,� � ��,�'�
Z � , i � x., • � �;'�
o fl Lowest adjacent(finished)grade(LAG) 24.2 ft.(m) , a-
o g)Highest adjacent(finished)grade(HAG) 24. 2 ft.(m) �� - �° � r
o h)No,of permanent openings(flood vents)within 1 ft.above adjacent gratle 0 � _
o i)Total area of all permanent openings(flood vents)in C3.h 0 sq.in.(sq.cm) " "
SECTION D•SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION `
This certification is to be signed antl sealed by a land surveyor,engineer,or architect authorizetl by law to certify elevation information.
I certify that the information in Sections A,8,and C on this certificate represents my best efforts to interpret the data available.
1 understand thaf any false statement may be punishable by fine or imprisonmenf under 18 U.S. Code Section 1001
CERTIFIER'S NAME M.G.MAYER LICENSE NUMBER 4495
TITLECEO COMPANY NAME FLORIDA BENCHMARK
� ADDRESS CITY STATE ZIP CODE
1298 LAKEVIEW RD. CLEARWATER FL 33756
SIGNATURE DATE TELEPHONE
� , j�y�.%� 08-31-05 727-298-0286
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces ali previous editions
IMPORTANT: in these spaces,copy the corresponding ir�ormation from Section A Fa in�,rance company use:
BUILDING STREETADDRESS(Induding Apt,Unit,Suite,arxUa Bklg.No.)OR P.O.ROUTE AND BOX N0. p�,y���
1007,�EE ST1�EtT "
CITY� . STATE ZIP CODE Company NAIC Number
SAFETY HARBOR FL 33755 .:n�,A� . _- _. .. _ .. .., ,.:...,:,
- SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINU�)
�y boih sitles of this Elevatiion Cerlifificate fa(1)community offiaal,(2)insurance agenUcompany,and(3)building owner. � M� � � � :`
COMMENTS ; � �- �
� . . _ _ ,. . ...
�
r ,_
❑Chedc here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Ceitificate is intended fa use as supporting ir�ormation for a LOMA a LOMR-F,
Section C must be completed.
E1.Builtling Diagram Number_(Seled the buiiding diagram most similar to the building fa wt�ich this certificate is being completed—see pages 6 and 7. If no diagram aa;urately
represents ihe buildirig,provide a sketch or photograph.)
E2.The top of the bottom floor(induding basement or endosure)of the builtling is _ft,(m)_in.(cm)�above or ❑below(chedc onej the highest adjacent grade. (Use
natural grade,'rf available).
E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floa a elevated floa(elevation b)of the twilding is _ft.(m)_in.(an)above the highest atljacent
gratle. Canplete items C3.h and C3.i on front of fam.
E4.The top af the platf�am of machinery andla equipment serviang the building is _ft.(m)_in.(cm)�above or ❑below(check one)the highest adjacent grade. (Use
natural grade,'rf available).
E5.For Zaie AO only: If no flood depth number is available,is ihe top of the bottom floa elevatetl in aocordance with the community's floodplain management ordinance?
❑Yes ❑No ❑Unknown. The local offiaal must oerti(y this infamatlon in Secfion G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property o�vner or owners authorized representative who completes Sedions A,B,C(Items C3.h and C3.i only),and E fa Zone A(without a FEMA-issued or community-
issued BFE)or Zone AO must sign hexe. The statemerits in Secctions A,8,C,and E are conect to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
�
�DDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
[���he�k�ere if atta�hr�ents
�: � � � ,,
SECTION G-COMMUNITY INFORMATION(OPTIONAL) > ,° =d , ,.
The local o�iaal who is authonzed by law a ordinance to administer the community's flootl�ain management ordinance can complete Sechons A B;C��r��),an��o�this��ati6�
Certificate. Complete the applicable item(s)and sign below. _� <r,�
G1.�The infamation in Section C was taken from other documentation that has been signed and embossed by a licensed surveya,engineer,orarchited who7s au�horized bq state
a locai law to certify elevation ir�orrnation. (Indicate the source and date of the elevation data in the Comments area below.) ., ``',� ' �y�
G2.�A community offiaal canpletetl Section E fa a building located in Zone A(without a FEMA�ssued a community�ssued BFE)or Zone A0. j
G3.❑The following infamaation(Items G4-G9)is provided fa community floodplain management pu�. r �� �,,,,hf�,���9,,,'LL�,;��,�� �P�,N j-
G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6.DATE CERTIFICATE OF COMPLIANCEIO'C�1�#�Vl UED
G7.This permit has been issued fa: ❑New Construc�on ❑Substan�al Improvement
G8.Elevation of as-built lauvest floor(induding b2sement)of the building is: _._ft.(m) Datum:
G9.BFE a(in Zone AO)depth of flooding at the building site is; _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONF
- =�a� = == —_
� � ����� '
�� ��
S�P � � 2QQ5
D�V�L��'�VI�I�T �1,��5
CITY CJF ��E�RW�iTER
.
, i'
.
�
y
, ?
- �J"' ��` " � ttUtKAL tMtKVtNI:Y MANAC�tMtN i At�tNI:Y
� ���'- O.M.B. No. 3067-0077
�6��',,,J t 1 NATIONAL FLOOD INSURANCE PROGRAM �xpires December 31, 200�
�� �� ELEVATION CERTIFICA"�� ; ` �.- _,`� ;.�,.
Im rtarrt: Read the instructions on a es 1-7.
SECTION A-PROPERTY OWNER INFORMATIbN - = + • or►ns�'ir�rt`c�,�ompany Use:.
? BUILDING OWNER'S NAME " ` Pobc�I u�"�i iber;:_; `
,,.. . ... . - �, " .
MODEST SYLA ��� ��� �"�., ;
BUILDING STREET ADDRESS(Induding Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE A�D`BbX NQ: ' r �Cr� MI��1umF�f
�
P i ��3
1007 LEE STREET _..W.�...�� w__.,�w_ _._..'. .u,� ,. .
CITY L STATE ZIP CADE
C��et hLcicE%T�f— FL 33755
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parcel Number,Legal Desaiption,etc.)
NORTH 45 FEET OF LOT 4,BLOCK H,PLA7�4 PARK -
BUILDING USE(e.g.,Residential,Non-residential,Addition,Aa�ssory,etc. Use a Comments area,if necessary.)
RESIDEIVrIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( #f�'-##'-##.##" or #{#.�) �NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD IN$URANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&CONMAUNITY NUMBER 62.COUNTY NAME B3.STATE
CLEARWATER 125096 INELLAS FL
B4.MAP AND PANEL • 67.FIRM PANEL B9.BASE FLOOD ELEVAl10N(S)
3 NU ER 85.SUFFIX 86.�INDEX DATE EFFECIIVEIREVISED DATE 88.FLOOD ZONE(S) (Lane A0,use depih of flooding)
�106 G � 9,3�03 AE 24
�� B10.Indicate the source af the Base Flood Elevafion(BFE)data or base flood depth entered in B9.
❑FIS Protle �FIRM ❑Community Determir�ed ❑Other(Desaibe):_
11.Indicate the elevation datum used for ihe BFE in B9:❑NGVD 1929 �NAVD 1988 ❑Olher(Desaibe):_
2.Is ihe building bcated in a Coastal Bartier Resouroes System(CBRS)�ea a Olherwise Prot�ted Area(OPA)? ❑Yes �No Designa�ai Date_
SECTION C•BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Buiiding elevations are based on:❑Construction Drawings* ❑Building Under ConsUucbon" �Fnished Construction
'A new Elevation Certificate will be required when construcUon of the building is canplete.
C2.Building Diagr�n Number 1(Seled the building diagram most simil�to ihe building fa which this certificate is being oompleted-see pages 6 and 7. If no diagram
accurately represents the building,Provide a sketch or Photo9�aph•)
C3.Elevations—Zones A1 A30,AE,AH,A(wrth BFE),VE,V1-V30,V(w'rfh BFE),AR,AR/A,AR/AE,AWA1 A30,AR/AH,AR/AO
Canplete Items C3,-a-i below accading to the building diagram speafied in ftem C2.State the datum used.ff the datum is different from t�e datum used for the BFE in
Section B,convert the datum to that used fa the BFE.Show field measurements and dah�m conversion calculation. Use the spaoe provided or the Comments area of
Section D or Sec�on G,as approp�iate,to document the datum conversion.
Datum 1988 Conversion/Comments_
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes �No ' i� ''
��� -� 14�,
o a)Top of bottom floa(induding basement or endosure) 25. 7 ft.(m) � n F ,,
o b)Top of next higher floa N.A ft.(m) � •}� ' �; "�, f
o c)Bottom of lowest haizontal strudural member(V zones only) N.A ft.(m) o o ,�1��� �, ?� ,,
o d)Attached garage(top of slab) N. A ft(m) E� �� "; :� �a
o e)Lowest elevation of machinery andlor equipment �„` " ` ,��t�,.�
senriang the building(Desaibe in a Comments are,a) N,A ft.(m) � � �'�,. � ��- `4 , `�
o fl Lowest adjacent(finished)grade(LAG) 24.2 ft,(m) �z'�N � ' , �, �' `' .,`�
o g)Highest adjacent(finished)grade(HAG) 24, 2 ft.(m) _ ,` t ' ,' ,,t
o h)No.of perm�ent openings(flood vents)within 1 ft.above adjaoent gratle 0 J `�; 8- �'
o i)Total area af all pemianent openings(flood vents)in C3.h 0 sq.in.(sq.an)
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 in Sections A,B,and C on fhis certificafe represents my best efforts to interpret the data available.
undersfand fhat any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001.
CERTIFIER'S NAME M.G.MAYER LICENSE NUMBER 4495 •
TITLECEO COMPANY NAME FLORIDA BENCHMARK
ADDRESS CITY STATE ZIP CODE
1298 LAKEVIEW RD. CLE4RWATER . FL 33756
SI(;NATI IRF d"°°1,,.. .. .t ''!._ s� f1ATF TFI FPHONE
IMPORTAN7': In these spaces,copy the corresponding information from Section A ��i�,,,�„��,�„y u�:
BUILDING S�ZEET ADDRESS Qnduding Apt,Unit,Sui�,andla Bklg.No.)OR P.O.ROUTE AND BOX N0. p�y���
10f�1 LEE STREET .
C� STQT� ZIPCODE �ompanyNAlGNumber
SAFETY HARBOR FL 33755 F � '...�,. .-;: ...� ;,. � ... -::, .,, ,R.,:.._...,
rt ,. . �
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINU ) i:
y both sides of this Elevation Cerbficate for(1)community oifidal,(2)insurance agenUcompany,and(3)building owner. " °"'� "� , ,° �
COMMENTS k z
; � � , . �. .b�
� � , , }
❑Chedc here if attachmenls
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
Fa Zone AO and Zone A(without BFE),oomplete Items E1 through E4. If the Elevation Certificate is intended fa use as supporting ir�ormation fa a LOMA a LOMR-F,
Section C must be completed.
E1.Building Diagram Number_(Select the building diagram most similar to the builtling fa which�iis certificate is being oompleted—see pages 6 and 7. If no diagram aocurately
re{xesents the building,provide a sketch or photograph.)
E2.The top oF the bottom floor(indu�ing basement a endosure)of the building is _ft,(m)_in.(cm)�above a ❑below(chedc a�e)the highest adjacent grade. (Use
natural grade,if available).
E3.For Buildirg Diagrams 6-8 wiih openings(see page�,the next higher floor a elevated floa(elevation b)of tt�e twilding is _ft.(m)_in.(an)above the highest adjacent
9rade. Canplete items C3.h�d C3.i on front of fam.
E4.The top of tl�e platf�am of mad�in�y and/a equipment servicyng the building is _ft.(m)_in.(cm)�above a ❑below(chedc aie)the highest adjacent grade. (Use
nalural grade,iF available).
E5.For Zone AO only: If no flood depth number is avalable,is the top af the bottan floa elevated in accordance with tlie community's floodpl�n managerr�ent ordinanoe?
❑Yes ❑No ❑Unknown, The local o�'icial must certify tt�is ir�ortnahon in Secfion G
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFICATION �
The property owner or owne�s au�oriz�r�pr��Ve�������A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or c�ommunity-
issued BF�or Zone AO must sign here, The staterr►en(s!n Sedions A,8,C,and E are ca�ct to ihe best of my knowledge,
�PERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
' �� CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Chedc here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The bc�oft'idal who is authaized by law or ordinance to administa the community's floodplain management adinance can complete Sections A,B,C(or E),and G of this Elevation
CerGficate. Complete the appficable item(s)�d sign below.
G1.�The ir�amation in Section C was taken from other documentaGon that has been signed and embossed by a lic�ensed surveya,engineer,or archited who is aufhorized by state
a bcal law to cefify elevation infamation. (Indicate tlie source and date of the elevation data in the Comments area below.)
G2,�A c�nmunity offiaal completed Section E fa a building lorated in Zone A(without a FEMA-�ssued or community-issued BFE)a Zone A0.
G3.�The fdlowing ir�ama6on(It�ns G4-G9)is provided for community floodplain management purposes.
G4.PERMIT NUMBER G5. DATE PERMff ISSUED G6.DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7.This permit has been issued fa: ❑New Construction ❑Substan6al Improvement
G8.Elevation of as�uift Irnuest floor(induding b�serr��t)of 1he building is: ._ft(m) Datum:,
G9.BFE a(in Z:one AO)�of flooding at the building site is: __ft,(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONF
� r�s�i� � r=� � -s-
�NATURE � �::a� � :��� ;,? $
�IMENTS � ! DATE ������`�'��� ��
Sd
REPAIR �
MODEST, SYLA
Zoning: MDR atlas#278A
FEMA Form 81-31,January 2003 Replaces all previous edikions
. • � �
� ����� � �
���� y c� �` ��
���������"P Y"��� = C I T Y O F C L E A R W A T E R
� ��,� ,s ; �'�� � „,
��" t������ DEVELOPMENT & NEIGHBORHOC�D SERVICES DEPARTMENT
�s*� = "��,w� �
4 �i;`•,
�,�°�x� y � x a '�" �: POST�FFICE BOX 474g� CLEARWATER� FLOa�Dn 33758-4748
�����������`E�
�p ¢fi � q ,� MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�uDn 33756
'�`��''`�`�Y TELEPxorrE(72� 562-4567 Fnx(72� 562-4576
MEMO OF REVIEW FOR CORRECTNESS 8� COMPLETION
In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
The attached elevation certificate is complete and correct
X Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. BUILDING OWNER'S NAME Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. COmpany NAIC Number
CITY:CLEARWATER STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDiNG USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:�GPS(Type):
(##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map 0 Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE
64.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S)
NUMBER g5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B$•FLOOD ZONE(S) �Zone AO,use depth of flooding)
12103-106 5-17-05
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑Other(Describe)
B11. Indicate eievation datum used for BFE in 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
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction* ❑ Finished Construction
'A new Elevation Certificate wiii be required when construction of the building is complete.
C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no
diagram accurately represents the building,provide a sketch or photograph.)
C3. Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO.
Compiete Items C3.-a-i below according to the building diagram specified in item C2.State the datum used. If the datum is different from the datum used for the
BFE in Section B,convert the datum to that used for the BFE.Show field measurements and datum conversion calculation. Use the space provided or the Comments
area of Section D or Section G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1 ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community Official:
�vation certificates shall be maintained by the community and copies with the attachedmemo made available by request
. FRANK H[RBARD,MAYOR
GEORGE N.CRE7'EKOS,COUNCILMGMBER JOI W DORAN,COUNCILMEMBER
PAUL F.GIRSON,COUNCILMEMRER � CARLEN A.PE'PERSEN,COUNCILMEMBER
��EQUAL EMYLOYMENT AND l�FFIWv1A'PIVE AC7'ION EMPLOYEK�