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430 MIDWAY ISLANDU,S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -9. OMB No. 1660 -0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION For tnsuranoe Company Use: Al. Budding Owner's Name DEBORA McCREERY Policy Number A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 430 MIDWAY ISLAND Company NAIC Number City CLEARWATER State FL ZIP Code 33767 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 62, ISLAND ESTATES OF CLEARWATER UNIT 3 A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) A5. Latitude /Longitude: Lat. 27°58'57.99" Long. 82 °48'49.30'W A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawispace or enclosure(s) N/A sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes ® No RESIDENTIAL Horizontal Datum: ❑ NAD 1927 ® NAD 1983 to obtain flood insurance. A9. For a building with an attached garage: a) Square footage of attached garage 44 sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade Q c) Total net area of flood openings in A9.b Q sq in d) Engineered flood openings? ❑ 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 12103C0102 B5. Suffix G B6. FIRM Index Date 9/3/03 B7. FIRM Panel Effective /Revised Date 9/3/03 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 11' 810. 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) B11. Indicate elevation datum used for BFE in Item 89: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Describe) B12. 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building 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, ARJAH, AR/AO. Complete Items C2.a -h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized 1-1-04 CLEARWATER Vertical Datum NAVD 1988 Conversion /Comments NONE a) b) c) d) e) 0 9) h) Top of bottom floor (including basement, crawispace, or enclosure 11000 6.5 N /A. N /A. ¢.06 7.0 Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) Highest adjacent (finished) grade next to building (HAG) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.2 6.4 N /A. Check the measurement used. ® feet ® feet El feet ® feet ® feet ® feet feet ® feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) 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 on this Certificate represents my best efforts to interpret the data available., understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0,7,'.- 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 ,��• ", Certifiers Name JOHN R. BEACH License Number 2984 Title P.L.S. Company Name JOHN R. BEACH & ASSOC., INC. Address 911 ST. PETERSBURG DR W City OLDSMAR State FL Signature ) Date 02/09/2012 Telephone 813 -854 -1276 �' ►' FEMA Form 8�i 31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 430 MIDWAY ISLAND For Insurance Company Use: Policy Number City CLEARWATERState FL ZIP Code 33767 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments C2(e) = a/c elev Signature Date 02/09/2012 ❑ Check here if attachments SECTION E BIJILDIN r. ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) ( For Zones AO a witho E), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Items El -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. 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 (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8 -9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment servicing the building is ❑ 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 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 am 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 if attachments 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 and G9. 01. ❑ 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-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 G8. Elevation of as -built lowest floor (including basement) of the building: ❑ 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 Title Community Name Telephone Signature Date Comments ❑ Check here if attachments FEMA Form 81 -31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 430 MIDWAY ISLAND City State Zip CLEARWATER, FL 33767 Policy Number Company NAIC Number If using the Elevation Certificate to obtain NF1P flood insurance, affix at least two 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.' If submitting more photographs than will fit on this page, use the Continuation Page, following. ALL PICT URES I AKEN ON 2/9!2012 LOT 62, FRONT 1.0F 62, REAR LOT 62, RIGHT LOT 62, LEFT U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Ir�surance Gompany Use: A1. Building Owner's Name DEBORA McCREERY Policy Number A2. Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No. Company NAIC Number 430 MIDWAY ISLAND City CLEARWATER State FL ZIP Code 33767 A3. Property Description(Lot and Blodc Numbers,Tax Parcel Number,Legal Description,etc.) LOT 62,ISLAND ESTATES OF CLEARWATER UNIT 3 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude: Lat.27°58'57.99" Long.82°48'49.30"W 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. Bui�ding Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 483 sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8 Community Number B2.County Name B3.State CLEARWATER 125096 PINELLAS FLORIDA 64. Map/Panel Number B5.Su�x B6.FIRM Index B7. FIRM Panel B8. Flood 69. Base Flood Elevation(s)(Zone 12103C0102 G Date Effective/Revised Date Zone(s) A0,use base flood depth) 9/3103 9/3/03 AE 11' B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe) 611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervrise Proteded Area{OPA)? ❑ Yes � No Designation Date N/A ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building 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/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized H-04 CLEARWATER Vertical Datum NAVD 1988 ConversioNComments NONE Check the measurement used. a) Top of bottom floor(inGuding basement,crawlspace,or enGosure floor)6.5 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N/A. �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N/A. �feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) 6.06 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 7.63 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent(finished)grade next to building(LAG) 6.2 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 6.4 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of dedc or stairs,inGuding N/A. �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 archited authorized by law to certify elevation information. I certify that fhe information on this Certificate represents my best efforts to interpret the data available.! .� �•:_.�-� understand that any fa/se statement may be punishable by fine or impnsonment under 18 U.S. Code, Section 1001� �"� � �` ` �, Check here if comments are provided on back of form. Were latitude and longitude in Sedion A provideii b�r a +,�"� _•��°°"''aa � t� ., , ..y ptr e.0�x licensed land surveyor? � Yes ❑ No ��,. • , ^ � %.'� ," r ; ,'"�` � ,�/ CertifiePs Name JOHN R.BEACH License Number 2984 - �' �� �� :, �':� �'`'� t Title P.LS. Company Name JOHN R.BEACH&ASSOC.,INC. ��, �� wµ � � � �, Address 911 ST.PETERSBURG DR W City OLDSMAR State FL ZIP Code 34����:° ,��X �~.�T��"�4J �� ,r ', Signature A��� � Date 02/09/2012 Telephone 813-854-1276 � '�;%� ` ,��� Y � � a„a„ �a � _ � F�MA Form 8 :�31, Mar 09 See reverse side for continuation. Replaces all previous editions F. IMPORTANT: In these spaces,copy the carresponding information from Section A. For Insurance Company Use: Building Street Address(inciuding Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 430 MIDWAY ISLAND City CLEARWATERState FL ZIP Code 33767 Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)c:ommunity officiai,(2)insurance agenUcompany,and(3)building owner. Comments C2(e)=a/c elev Signature � . Date 02/09/2012 � �' ❑ Check here if attachments SECTION E-.BUILDIN ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) �' For Zones AO a�, witho E),complete Items E1-E5. If the Certificate is intended to suppoR a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4, use natural grade, if avail�able. 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(including basement,cr�awlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (e�evation C2.b in the diagrams)of the buildin��is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is _ ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or 0 below the HAG. E5. Zone AO only: If no flood depth number is av�ilable,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 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,8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Represent<ative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECI�ION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinanc�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 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 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-G9)is provided for community floodplain management purposes. G4.Permit Number G5. Date F�ermit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basernent)of the building: ❑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 Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt, Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy Number 430 MIDWAY ISLAND City State Zip Company NAIC Number CLEARWATER, FL 33767 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page, following. ALL PICTURES TAKEN ON 2/9/2012 LOT 62, FRONT LOT 62, REAR �,�'}� . ` .y�.. 1 , � N� � + � � �., � . ��. ( r 4' � .. ,. � N. .. � : I . ._ ..'.' �.r R�• ' ��^ �' ,.B � � �- . YF.w� � �,.' ' ....•' � . � � .. y,�W. � � - s .. � . � r, q � _ � 3 � � � � .:� �- � ' a � . s _ ,, � � � r . . . 4 ..-_�'°=3� , `+ i I ;. A„'���:•' ~���I�1 I�. � l � � k• i""� t � , \ - � LOT 62, RIGHT LOT 62, LEFT R, � x � i. . `^��� .`;� , •. � .,� . , . . �, �w�,�i - � � t,�� � �\ � �� � ..� �€ � \ -- .. :�- � �:� . '°� " � ��. .., - � - �- . . � r� , _ �,, , . � ; r , _ . �F, _. __ �, � E: ! ? ,�� � a 'an����+��ah. � � .�--N.;,.* ;�wdc � ��` � ���