206 LEEWARD ISLAND <
U��. DEPP.'JITAAENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
FedePal Emergency Management Agency Expires March 31,2012
Nationai Flood Insurance Program Important: Read the instructions on pages 1-9.
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SECTION A-PROPERTY INFORMATION < : �a�� . .,..; . ��,.�:
A1. Building Owner's Name BEAM, EDWARD �� ��,��� ��� � �;
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A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. o f" °�
206 LEEWARD ISLAND
City CLEARWATER State FL ZIP Code 33767 � ��
A3. Property Description (Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) 6
LOT 62, UNIT 1 ISLAND ESTATES OF CLEARWATER
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A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) RESIDENTIAL �`3�
A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 � NAD 983 F�-�
A6. Attach at least 2 photographs ot the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1 PL��li�plf�lC c ������ E� �� '�'°"'J�
A8. For a building with a crawlspace or enclosure(s): A9. For a buildin with an att���li�d garage'; �� =- -
a) Square footage of crawlspace or enclosure(s) N�A sq ft a) Square f tage of attached garage NL __ s ft
___.:_
b) No.of permanent flood openings in the crawlspace or b) No.of petrtfa��nTffd�5�'opernngs in the attached garage
enciosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
dl Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION
I�61. NFIP Community Name&Community Number 62.County Name B3.State
� CLEARWATER 125096 PINELLAS FLORIDA
�B4.Map/Panel Number B5.Suffix B6.FIRM Index B7. FIRM Panel B8. Flood B9.Base Flood Elevation(s)(Zone
12103C0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth)
9-03-03 9-03-03 AE 11.0
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)
Bt 1. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 � NAVD 1988 ❑ Other(Describe)
512. 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
Noo7o� N
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY RE(�UIRED) � � �(� �
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* � Finished Consti ' p �N
*A new Elevation Certificate will be required when construction of the building is complete. v � m O r
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 a 0 �� rn
below according to the building diagram specified in Item A7. Use the same datum as the BFE. m O � �
Benchmark Utilized CLEARWATER"G-04.5"***"Vertical Datum NAVD'88 ELEV.3.85 N n'�
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Conversion/Comments c�Dn �� �
Check the measurement used. z � N �
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a) Top of bottom floor(including basement,crawlspace,or enclosure floor)NLA. ❑feet ❑meters(Puerto Rico only) cs � Q
b) Top of the next higher floor 6.89 �feet ❑meters(Puerto Rico only) o � �
c) Bottom oi the iowest horizontai structural member(V Zones onfy) �. ❑feet ❑meters(Puerto r�ico only) � �
d) Attached garage(top of slab) NLA. ❑feet ❑meters(Puerto Rico only) D r
e) Lowest elevation of machinery or equipment servicing the building 7.56 �feet ❑meters(Puerto Rico only) v, j
(Describe type of equipment and location in Comments) �
fl Lowest adjacent(finished)grade next to building(LAG) 6.0 �feet ❑meters(Puerto Rico only) �
g) Highest adjacent(finished)grade next to building(HAG) 6.4 �feet ❑meters(Puerto Rico only) p�
h) Lowest adjacent grade at lowest elevation of deck or stairs,including NLA. ❑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. I certify ihat the information on this Certificate represents my best efforts to interpret the data availab/eJ �__.._�_
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 ❑ No "
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Certifier's Name WILLIAM C. KEATING License Number 1528 ' �t
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Titie LAND SURVEYOR Company Name ALLIED SURVEYING ` �--;', -
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� Address 1275 O. HLAND VE. ` City CLEARWATER State FL ZIP Code 33755 ., : , '
Sign r � Date 11-25-11 Telephone 727-446-1263
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?-EMA Form 81-31, Mar See reverse side for continuation. Replaces ail previous editions
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. " _ I�a.���lc�Nng l�N�o���r�phs
' See Instructions for Item'-A6.
For I�surance�ompany Use:
Building 5treet Address.(including Apt, Unit, �uite, �:nd/or Bldg.No.)or P.O.RouGe and Bo;c f�l�. P,otir,,y..Number� .
206 LEEWARD ISLAND
, CI�I Str�tB FL ZIP COde — -- - C°"'panyNAiGN"mbe�
CLEARWATER FLORIDA 33767
,If using the Elevation Certificate to obtain NF!t� flood insurance, affix at least iwo �>uil�+ng photographs balow according to
the instructions for ItQm A6. Identify all ptypto�r�p�►s with: date taken; "Front View" �r��Y "Rear View"; and, if required, "RighY
Side View" and "Le�t 5ide View." lf SU�mitti�•r; more photographs €.hun will fit o:-� trii;; page, use the Continua6on Page,
following.
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