1044 MANDALAY AVE - � � EL�VA�'ION CERTIFICATE . °.h'.B.No3°6'.°°"
E�puesMay31, I993
FEUERAL EMERGENCY MANAGEMENT�AGENCY
� NATIONAL FLOOD INSURANCE PROGRAM
ATTENTIUN: Use ot Ihis ceriilicate does not prqvide a walver of the ilood Insurance purchase requirement. This lorm is used only to
�provide elevation information necessary to e�sure compliance with applicable communiry Iloodplain management ordinances,to •
c�eiorrnine tl�e propor Insurance preinlum rate,anci/or to support a request tor a Letler of Map Amendmenl or Revlslon(LOMA or LOMR).
� Instructlons tor compleling thls torm can be 1ou�d on the following pages. �
SECTION A PROPERTY INFORMATION ' FOR INSURIWCE COMPAtJY USE
BUILOINC3 OWNER'S NAME POLICY NUMBER
BEVERLY� ALLEMANN . .
STREET ADDRESS(Indudlnq Apl.,Unf4 Sulle andlw Bldp.Number)OR P.O.ROUTE ANO BOX NUMBER COMPANY NAIC NUMBER �
1044 MANDALAY '
UTNER OESCRIPTION(Lol and Bbdt Nurnben,olc.)
LOT 14 , BLOCK "68" , MAIVDALAY
CITY STATE ZIP CODE
CLEARWATER BEACH . FLORIDA
' SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the loliowing Irom lhe propor FIRM(Soe InstrucUons): .
1.COMMUNITY NUMDER 2.PANEL NUIdUER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION
(in AO Zones,use depth)
• 125096 0003 D 8-19-91 "AE" 11 .00
7. Indicate the elevalion datwn sys.lom used on tho FIRM tor f3aso Flood Elovations (BFE): ❑NGVD'29 ❑Othor(doscribe on back)
a. For Zones A or V,wl�ere no E3FE is provided on tt�e FIRM,and lhe communily has astablisl�ed a BFE lor this building site,(ndicate
llie communil,'s �FF.:L.���J.L)leet NGVD(or other FIRM datum—see Section B, Ilem 7).
SECTION C E3UILDING ELEVATION INFORMATION
1. Using the Elevalion Certilicate Instructions,Indicale.lhe d(a8ram nurnber from the diagrams lound o�Pages 5 and 6 that best
doscribes tl�e subject building's reference level �
2(a).FIRM Zones A1-A30,AE,AH,and A(wflt�BFE). The top of lfie reference level Iloor trorn the selected diagram is at an elevaUon
ot L I I _ 5,�Ieet NGVD (or olher FIRM dalu�n—see Section B, Item 7).
(b).FIRM Zones V1-V30,VE,and V(wlth f3FE). The bottom of the lowest horizontal structural member of ihe�elerence level(romF
tfie selected diagrarn,is at an elevation of� I I I I I,U teet NGVD(or other FIRM datum—see Section B,Item 7).
(c). FIRM Zone A(wiltiout BFE). The(loor used as the reterence level(rom the selected diagram is w.LJ feet above❑ or
beiow❑ (clieck one) the hlghest.grade adjacent to the building. '
• (d).FIRM Zone AO: Ttie 11oor used as tt�e.rel�rence leyel from.11�e solected diagrarn is �J.0(eel above� or below[](check
one)the hfghest grade adjacent to the building. It no tiood depth number is available,Is the building's lowest floor(re(erence
level)elevaled In accordance wilh the comrnunity's Iloodplaln manapement ordinance? ❑ Yes ❑ No ❑ Unknown
3. Indicate tl�e elovation daturn system used in deterrnining the above re(erence level elevations:� NGVD'29 ❑ Other(describe
under Commenls on Page 2). (NOTE: ll tho elevation dafum used!n measu�ing Ihe elevations is dillerenf than Ihat used on
tl�e FlRtif (sea Section B, lfem 7f, fl�en convert ll�e elevalions fo fho daturti systern used on the FIRM and show fhe conversion
equafion unde�Commenls on Paye 2.) . '
4. Elevation relerence mark used appears on FIRM: � Yes ❑No (See Instruclions on Paye 4)
5.Tt�e re(erence level elevation is based on: �, actual conslruction ❑ construction drawings
(NOTE: Use ol cons(ruclion drawings is only valid il the building does not yet have fhe reference level lloo�in place,in which
case this cerfificate will only be valid lor fhe building during(he course ol cons(ruction. A posf-construclion Elevation Ceriilicate
wifl be required once construcfion is complete.)
G.Tfie elevation o(lt�e lowesl grade Immedialely adjacenl to the building is:�_-Se J (eet NGVD(or olher FIRM datum-sea
Section B,Ilem 7). . . . �
' SECTION D COMMUNITY INFORMATION
� t.il 1he community olticlal responslble lor verllying bulldinp elevaUons speclties that the relerence level indicated In Section C.Item 1
is not the"lowest tloor'as delined In the community's floodpla(n managemenl ordinanca,lhe elevation ot the bulldlnB's`lowest
floor'as delined by the ordinance Is: �J.(J leet NGVD(or alher FIRM datum—see Seclion B, Ilem 7).
2. Uate ol the slart ot construcUon or subslant(al Improvement . .
FEMA Form 81-31�MAY 90 REPIACES AlL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
� ' � SECTION E �CERTIFICA710N —-
l l�is ce�U(icaUon Is to be signed by a land suiveyor,enginaer,or archltect.wtio is autliorized by state or local law to certify elevation
in(orrnatlon when the elevatlon intormatlon ior Zones A1-A30,AE,AH,A(with BFE),V1�-V30;VE,and V(with BFE)Is required. • �
Corrimunity ot(icials who are sulhorized by local law or ordlnance to:prov(de tloodplain iT�;anagement informalion,may also sign the .
certilica0on. In the case ol Zones AO and A(wlthout a�EMA or community(ssued BF[),a building otlicial,a property owner,or an
owner's representaGve may also sign the certlficatfon. �
� .
Relerence levei diagrams 6,7 and 8-Distinguishing Features-It the certilier is unable to certity to breakaway/non-breakaway wall,
enclosure slze,location ot'servlcing equlprnent,area use,wall openings,or un(inished area Feature(s),then list'the Feature(s)not
included In the certificatlon under Comments below. The diagram number,Sect(on C, Item 1,must still be entered. '
I certify thaf the inlorniaflon!n Sections Q and C on tl�is cer�ilicale represenls my best etlorts to interpret(he dala available.
1 understand that any(alse statemenf rr�ay be punisl�able by line or imprisonment under 18 U.S. Code, Seclion 1001.
, CERTIFICR'S NAME �
LICEN4F NI ltv�BER(o�Allix Seal)
WILLIAM C�." KEATING ' �k152n �
TITLE Q
REG. SURVEYOR � '�L���A�IIRVEYING
AUDRESS
2124 S [VlY 1tL � `LVU� CITY STATE ZIP
'CLEIUtWA`i'ER � FLORIDA �.34,6,v"�5 �`yM ti°: ;
SIGNATURE i
� JANUARY 16 199'7oATE �
,�" , /"/ , 81�"��6�-�1�2.�3` �
Cop es should bo mado p thls Certillcate for:�)communlly olficlal,2) Insurance agenUcompa�y,and,�'�buil;k�ng'�own�r'.ry� '
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lONES ZONES A A y
ZONES ZONES
ZONES
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7t�e diagrams above illustrale the po(nts at whlch the elevations should be measured in A Zones and V Zones. �
Elevations tor all A Zones should be measu�ed at the lop.o(1he re(erence level tloor,
Elovalions tor ali V Zones should be measured al the bottom o(the lowest horizontal structural member,
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