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�-��-�� '���' � 2 ZOOZ NATIONAL FLOOD INSURANCE LENTRICCHIA, DOMINICK
� ELEVATION CERTIF Zoning: LMDR atlas#249A
f�`-�% t��';w=.��t•aT SERViCES
�-"o7.v �;� pE ortant: Read the instructions on a es 1 -7.
� ECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BU�LDING OWNER'S NAME Poticy Number
DOMINICK A. AND KARIN LENTRICCHIA
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
814 NARCISSUS AVE.
CITY STATE ZIP CODE
CLEARWATER BEACH FLORIDA
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
1.oT 8� BLOCK 29. "MANDALAY" PARCEL N0. 05/29/15/54666/029/0080
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.)
RESIDENTIAL
IATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: �_�GPS(Type):
( ##°-##'-##•##" or ##•#�#°) IJ NAD 1927 ��NAD 1983 L�USGS Quad Map �_�Other:
N_C;_V_n_ (19�91
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUN'TY NAME B3.STATE
CITY OF CLEARWATER,/125096 PINELLAS FLORIDA
B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(S)
NUMBER DATE EFFECTIVEJREVISED DATE ZONE(S) (Zone AO,use depth of flooding)
D 8 18 92 6/9/71-8/I9/91 "A-E" 10.00'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 69.
��FIS Profile �J FIRM �_J Community Determined �J Other(Describe):
611. Indicate the elevation datum used for the BFE in 69:� NGVD 1929 �_J NAVD 1988 �J Other(Describe): •
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Proteded Area(OPA)? �J Yes �J No
Designation Date:
� SECTtON C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. uilding elevations are based on: L�Construction Drawings' �JBuilding Under Construction' � XJFinished Construction
'A new Elevation Certificate will 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
Complete Items C3a-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 mea'surements 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 N.G.V.D. Conversion/Comments REF. MONUMENT DI SK "AURAL RM-3" ELEVATION: 6 195'
"AURAL RM-3" �
Elevation reference mark used Does the elevation reference mark use�l appear on the FIRM? �J Yes No
❑ a)Top of bottom floor(inGuding basement or enGosure) 9•02�ft.�) �
O b)Top of next higher floor �,�''ft� ,� GUY D. HALE
❑ c) Bottom of lowest horizontal structural member(V zones only) _ T �.�m �� P.L.S. �� 4 626
❑ d)Attached garage(top of slab) �'��ft.�j E°
❑ e) Lowest elevation of machinery and/or equipment W '°
servicing the building 6•5y�{�.�'j E�
❑ �Lowest adjacent grade(LAG) •Tr ft,�) Z.s� f
0 g) Highest adjacent grade(HAG) •�ft,�'j �"
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade �
0 i)Total area of all permanent openings(flood vents)in C3h 905 Sq.�� ��� JULY 3 , 2002
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 certiiy elevation information.
!certify that the information in SecSons A, 8, and C on thi5 certificate represents my best efforts to interp►et the data available.
1 u rstand that an fa/se statement ma be unishable b fine or im risonment under 18 U.S. Code, Section 1001.
CI IER'S NAME LICENSE NUMBER
IJY D. HALE P T S 4� 4626
TITIE COMPANY NAME
PROFESSIONAL LAND SURVEYOR v D ATF� 7AN STTRC�FYTN!'
ADDRESS �� �� CITY STATE ZIP CODE
iiia ovEx
SIGNATURE DATE TELEPHONE
FEMA Form 81-31,AUG 99 � SEE REVERSE SIDE FOR CONTINUATION REPLACES A1� PRFVInI IS Ff1IT1l1NC
_
IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company l.ise: '
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Policy Number
814 NARCISSUS AVENUE
CITY ST ZIP CODE Compa�y NAIC Number �
CLEARWATER BEACH �ORIDA
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official, (2)insurance agenUcompany,and(3)building owner.
COMMENTS
I—I Check here if attachments
SECTION E-BUILDING ELEVATION INFORMATION (SURVEY NOT REDUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFEj
For Zone AO and Zone A(without BFE),complete Items E1 through E4. !f the Elevation Certificale is intended for use as supporting
information/or a LOMA or LOMR-F, Section C must be comp/eted.
E1. 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.)
E2.The top of the bottom floor(including basement or enGosure)of the building is �_�_�ft.(m)LLI��•(�) I_I above or �_J below
(check one)the highest adjacent grade.
E3. For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building is
L(_�ft.(m)Luin.(cm)above the highest adjacent grade.
E4. For 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?�_I Yes �_I No I Unknown. The local oKcial must certiry this information in Section G
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATtON
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. �
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME •
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS .
I_I 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.
G1. U The information in Sedion C was taken irom other documentation that has been signed and embossed by a licensed surveyor,
engineer,or architect who is authorized by state or local law to certify elevation information: (Indicate the source and date of the
elevation data in the Comments area below.)
G2. �_j A wmmunity official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or
Zone AO. '
G3. �j The following infarmation(liems 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: u New Construction L�Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building is: _ft.(m)Datum:
G9. BFE or(in Zone AO)depth af flooding at the building site is: _ft.(m)Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE -
COMMENTS
I I Check here if attachments
FEMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS
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