169 MARINA DEL REY CT U.S.DEPARTMENTOF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO. 1660-0008
Federal Eme en Mana ement A enc [Expires March 31, 2012
r9 �N 9 9 Y
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 Policy�lumber
Mark Gerhart
A2. Building Street Address(includin Apt., Unit,Suite,and/or Bidg.No.)or P.O. Route and Box No. Company NAIC Number
1�9 Marina Del Ra Court
��, State ZIP Code
Clearwater F1
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) �
Lot MARINA del RAY AT SAND KEY i
A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) res I den i a 1
A5. Latitude/Longitude:Lat. Long. 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�_
A8. For a buitding with a crawlspace or enclosure(s): A9. For a buiiding with an attached garace:
a) Square footage of crawlspace or enclosure(s) ���2 sq ft a) Square footage of attached garage 79� sq ft
b) No.of permanent flood openings in the crawlspace or O b) No.of permanent flood openings in the attached garage
enciosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade 0
c) Total net area of flood openings in A8.b p�/� sq in c) Total net area of flood openings in A9.b �_ sq in
d) Engineered flood openings? �Yes Q No �-�T d) Engineered flood openings? �]Yes � No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name 8 Community Number 62.County Name 83.State
CITY OF CLEARWATER 12 0 6 PINELLAS
64. Map/Panel Number 65.Suffa B6.FIRM Index 67.FIRM Panel B8. Flood 69.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AU,use base flood depth)
�2�o3COto4 c 8/18/09 9/03/03 "AE" > > .o
610. indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑FIS Profile Q FIRM Community Determined ❑Other(Describe)
811. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 Q NAVD 1988 ❑Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? � ti'es Q No
Designation Date �CBRS �OPA
SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑Construction DrawingsY ❑ Buiiding Under Construction' � Finished 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/A0. Complete items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmaric Utilized C 1 w. B-2, e 1 ev. 4,81 NAVD 1988 vertical Datum NAVD 1988
Conversion/Comments L i ne C2 e) - i s a/c un i t i n �a ragP
Check the measurement used.
a) Top of bottom floor(including basement,crawispace,or enciosure floor) 5 .$ �feet ❑meters(Puerto Rico only)
b) Top of the next higher floor 14 .6 �feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) N .A �feet ❑meters(Puerto Rico ony)
d) Attached garage(top of slab) 5 .�,�feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building $ .0 �feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
� Lowest adjacent(finished)grade next to building(LAG) S .3 Q feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) _ � .4�X feet �meters(Puerto Rico only)
h; Lewest adjacer.t grade a!!eWes±oloyatipn nf�iack pr gtgjrg,inNi�ding 5 Ln feet n 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 archRect authorized by law to certify elevation
information. 1 certify that the informatior,on this CeK�cate 2presents my best efforts to interpret the data available. ' . -
I understand that any false statement may be punishable by fine or impnsonment under 18 U.S. Code, Section f 001. ,��.r l. S: �j l 5 4
�Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a �.� � `� 4/f}�j,/�:���
licensed land surveyor? QYes ❑No ,
.�,-
Certifiers Name � License Number � ��j�� �_°� .,,L
Edward J. Langton Jr. 3154 .��r{� ` (� �
Title Company Name --� '��
Professional Land Surveyor LANGTON SURVEYING, INC. -
Address Cit State ZIP Code ��, '`'
11647 84th ve. N. Seminole Fl . 33772
Signature Date 4/05/2011 Telephone �7�7� 545 5900
FEMA Form 81-31 ar 09 See reverse side for continuation. Replaces all previous editions
II�APORTANT: 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
169 Marina Del Ra Court
�ity State ZIP Code Company NAIC Number
Clearwater Fl . 33767
SEGTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevatio�Certficate 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 EFE),complete Items E1-E5. If the Cert�cate 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(inGuding basement,crawlspace,or enclosure)is _ ❑feet ❑meters �above or ❑below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectio,IL,A Items 8 and/or 9(see a es S-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is _Q feet ►_J meters ❑above or �below the HAG.
E3. Attached garage(top of slab)is �feet Q meters �above or � below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _Q 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 ff attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ord�nance 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 author¢ed 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 ior 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
GE. El6V2:IC^C�25-L'Jlµ�^:"J°ci fln�r linrl���iin�hacamPntl nf thP hi.iildina ❑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 Tiile
Community Name Telephone
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, Mar 09 Replaces all previous editions
.
Buifding Photographs
See Instructions for Item A6. �I
For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number '
169 Marina Del Ray Court
City State ZIP Code Company NAIC Number
Clearwater Fl . 33767
If using the Elevation C;ertificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Iterr� A6. Identify all photographs with: date taken; "Front VievW' and "Rear View"; and, if required, "Right
Side View" and "Left Si�e View." If submitting more photographs than wil! fit on this page, use the Continuation Page on the
reverse.
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� ELEVATION CERT(F[C�i'E
�, , • • tmportant: Read the instructions on pages 1 -7.
::Y-,;:�r
• SECTION A-PROPERTY OWNER INFORMATION $F�r�ns, urance�ipa�tlse ,;.;:.; .
BUiLDING OWNER'S NAME ��ft���r��a,'��+� ' � "
Mark T. Gerhart s� ,L,�-.. ,:�n i,.
BUILDtNG STREET ADDRESS(InGuding Apt.,Unit,Suile,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. -('•ompany NX�IC N�lfiber >'
16 Marina Del Ra Ct. ; ; � '�
. �
s
CiTY STATE ZIP CODE
Clearwater F1 . 33767 _
PROPERTY DESCRIPTION(Lot and B(ock Numbers,Tax Parcei Number,Legal DescripGon,etc.)
!ot 39 MARINA del RAY AT SAN' ""' """T R
BUILDING USE(e.g.,Residential,Non-residenGal,Addition,Accessory,etc. Use a Cc 169 MA RI NA D E L REY CT E
Residential
LA7ITUDE/LONGITUDE(OPTIONAL} HORtZONTAL DATUM: BCP2009-05012
( ##°-�#'-##.##" or �#.####�°) I___(NAD 1927 �_� NAD 1983 '"""•�"`. '—' - - , ,� ,
NA NA I_,I USGS Quad Map (_�Other NA _
SECTION B-FLOOD INSURANCE RATE MAP(F{RM} INFORMATION
�B1.NFlP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME 83.STATE
'�ty of Clearwater t25o96 PINELLAS FL ___
84.MAP AND PANEL B5.SUFFIX B6.FIRM INOEX B7.FIRM PANEI B8.FLOOD 89.BASE FLOOD ELEVATION(S;
NUMBER DATE EFFECTIVElREVISED DATE ZONE(S) (Zone AO,use depth of flooding)
�2 0 6 ot04 � 9/03/2003 9/03/2003 "AE" tt .o
B10. lndicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in B9.
�� F1S Profite �X � FIRM (_J Community Determined ��Other{Describe):
611. lndicate the elevation datum used for the BFE in B9:�_j NGVD 1929 �X J NAVD 1988 ��Other(Describe):_
B12. (s the building located in a Coastal 8arrie�Resources System (CBRS)area or Otherwise Protected Area (OPA)? �_�Yes ��( No
Designation Date:
SECTION C-BUtLD(NG ELEVATION INFORMATtON(SURVEY REQUfRED)
C1. Building elevations a�e based on: (_(Construction Drawings' (_(eutfding Under Constn.�ctio�' �X jFinished Constn,rction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Bui(ding Diagram Number�_(Select the building diagram most simi(ar to the building for which this certifcate is being completed-se�
pages 6 and 7. tf no diagram accurately represents the building, provide a sketch or photograph.)
C3. E(evations-Zones A1-A30,AE,AH,A(with BFE),VE, V1-V30, V{with BFE),AR,AR/A,AR/AE,AR/A1-A30,AWAH,AR/AO
Compfefe Items C3.a-i below according to the buildi�g diagram specified in Item C2.Siate 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 ttae Comments area of Section D or Section G,as appropriate,to document the datum convetsior
Qatum NAVD 19�8 Comersion/Comments
Elevation reference mar4c used C lw. #/B-2, . 1 poes the etevation�eference mark used appearon the FIRM? �_� Yes �X � N
0 a)Top of bottom floor ' enclosure) 5 . $ ft.(m) �
❑ b)Top of next higher floor 14 1 ft.(m) � 2/O1/2002
❑ c}Bottom of lowest horizonta!siructural member(V zones only) N A n.(m) o Q P,Le S< �3154
CI d)Attacfied garage(top of slab) 5 8 ft.(m) �� � i
O e)Lowest elevation of machinery and/or equipment W`° -y�� ���
servicing the build�ng (Describe in a Comments area.) ( Water ht r) 14 1 K.(m� E� �
❑ �Lowest adjacent{finished)grade(LAG) 5 .�ft.(m) z'N
0 g)Highesf adjacent(finished)grade(HAG) 5 . 4 n•tm� c TNIS C RTIF��ATE HAS BEEN PR ARED
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade N/A � 'FOR iN un E PURPOSES oN� ND i s
� i Total area of alf ermanent o enin s flood vents m C3.h �' NoT ro usEO FOR CONSTRUCT I ON
} P p g ( )' N A sq.in.(sQ.cm)
SECTION D-SURVEYOR, ENG(NEER,OR ARCH(TECT CERT(F(CATfON
This certification is to be signed and sealed by a land surveyor,engineer,or architeci authorized by law to cectity elevation infonnation.
!certily ihat the informa6on in Sections A, 8,and C on this certificate represenfs my best eNoris lo interpret ihe data available.
I understand that any fa/se statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LfCE1YSE NUMBER
Edward J, Lanqton, Jr �3t54
TITLE COMPANY NAME
Professional Land Surveyor � LANGTON SURVEYfNG INC,
ADDRESS tTY STATE ZIP CODE
6285 Park lvd. - Pinel�fas Park Flo 33781
SIGNATURE DATE TELEPHONE
2L01/2006 ( 727 ) �S-�9�n
.-r••• .- n. ... • ..n.. ' `.__ __"____ _ �_ �__ ___t._.._I.__ [)....I..........tl..r.,......�
c nrlifinn
. - _-_-_ _
E:7tLDtNG"STREET ADDRESS(InGuding Ap.., Jnit,Suite,andlor Bldg.No.}OR P.O.ROUTE AND. _�C NO. Policy Number
C�Ty STATE ZIP CODE �Company NAIG Number
Clearwater Fi . 33767
SEC710N D-SURVEYOR,ENGINEER,OR ARCHITECd'CERTIFICATION(Cf�NTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2}insurance agent/company,and(3)buifding owner.
COMMENTS
� (Check here if attachments
SECTION E-BUILDING ELEVATION {NFORMATION(SURVEY NO7 REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zone AO and Zone A(without BFE),complete ltems E1.through E5. If the Elevation Certificate is intended for use as supporting
information for a LOMA or LOMR-F, Section C must be completed.
E'!. Building Diagram Number (5elect the building diagram most similar to the building for which this certificate is being completed—
see pages 6 and 7. If no diagram accuratety represents the building, provide a sketch or photograph.)
ci.i he tup o(the bai�om(roor(+ncluding trassmen:or e,zG'osure)ef t.he b��ilding is �_�_�ft. (m)�_!_�in. (cmt �_!above or�_I below
(check one}fhe highest adjacent grade. (Use natural grade, if available.�
E3. For Building Diagrams 6-8 with openings (see page 7),the next higher floor or elevated floor(elevation b)of the building is
(_��ft. (m) �_�_�in. (cm)above the highest adjacent grade. Complete Items C3.h and C3.i on front of form.
E4.The top of the platform of machinery and/or equipment servicing the building is �_�_�ft. (m)��_� in. {cm) �_� above or f_J below
(check one)the highest adjacent grade. {Use natural grade, if available.)
E5. �or Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's
floodpfain management ordinance? �Yes � � No � � Unknown. The loca!official must ce�tify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owners authorized representative who compietes Sections A,B,C(ttems C3.h and C3.i only),and E for Zone A
(without a FEMA-issued or community-issued SFE)or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to
the best of my knowledge
PROPERTY OWNER'S OR OWNER'S AUTNQRIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
�_I Check here if attachmenis
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local o�cial who is authorized by law or ordinance to administer the community's floodplain management ordinance can comptete
Sections A, B, C(or E),and G of this Eleva6on Certificate. Complete the app{icable item(s)and sign below.
G1. �_�The inioRnation in Section C was taken from other documentation that has been signed and embossed by a i'rcensed surveyor,
engineer,or architect who is authorized by state or local iaw to certify elevation infoRnation. (Indicate the source and date of the
elevation data in the Gomments area below.)
G2. �_J A community official completed Section E for a buiiding lacated 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 CERTIFICA7E OF COMPLIANCE/OCCUPANCY
1SSUED
G7.This permit has been issued for: �J New Construction �J Substantial Improvement
G8. Elevation of as-buiit�owest floor(including basement)of#he building is: _ft. (m) Datum:
G9. BFE or(in Zone AO)depth of flaoding at the building site is: _ft. (m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNfTY NAME TELEPNONE
SIGNATURE DATE
CaMMENTS
� �Check here if aitachments
FEMA Form 81-31,January 20o3 Replaces a8 previous editions