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3129 OYSTER BAYOU WAY �� ' , ��„ FEDERAL EMERGENCY MANAGEMENT AGENCY , ��l� _ 6�� NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 + Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on ages 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 3129 OYSTER BAYOU WAY CITY STATE ZIP CODE CLEARWATER FL 33759 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT#19 BAYSHORE TOWNHOUSES BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type): ( ##°-##'-##.##" or ##.#�###°) � NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NF�P COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE 125096 PINELLAS COUNTY FL 64.MAP AND PANEL B5.SUFFIX 66.FIRM INDEX 67.FIRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) 0018 D 08-19-91 AE �� B10. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in 69. ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other(Describe): B11. Indicate the elevation datum used for the BFE in B9:� 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 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. Building Diagram Number 7(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 measurements 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 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes � No ❑ a)Top of bottom floor(including basement or enclosure) 23.03 ft.(m) m ❑ b)Top of next higher floor 33 .48 ft.(m) � a�04yj5�"""''• ❑ c)Bottom of lowest horizontal structural member(V zones only) ._ft.(m) o o }��'�a�� '"`,`��'� ❑ d)Attached garage(top of slab) 13.49ft.(m) w� ',�e,w,`� ; �, ,��, ;• ❑ e)Lowest elevation of machinery and/or equipment -� '' �`��= �'x "�� '- `- �� .a . ;1g L; ;":.•. F servicing the building 15 .63ft.(m) j � r� •; ❑ fl Lowest adjacent grade(LAG) 12 .5ft.(m) ��,' � �r��,z°��f�� ` ❑ g)Highest adjacent grade(HAG) 12.7ft.(m) � e, ;f�;�' v; '�� .• �.<, .. ❑ h No.of ermanent o enin s flood vents within 1 ft.above ad'acent rade 4 � `�,�,/�}� " °'` � _. ❑ i)>Total a ea of all permanen�t penings(fl od vents)in C3h 514Jsq. in. (sq.cm) ��"'�� `y 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. 1 certify fhaf fhe information in Sections A, B, and C on this certificate represents my best efforts to interpret the dafa available. !understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME MICHAEL E.JENKINS LICENSE NUMBER 5720 TITLE: SURVEY MANAGER COMPANY NAME American Consulting Engineers,PLC ADDR S CITY STATE ZIP CODE SI E DATE TELEPHONE FEMA Form -31,AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS MPC�RT�NT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: BU'ILDING STREE"�ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Policy Number 3129 OYSTER BAYOU WAY CITY STATE ZIP CODE Company NAIC Number CLEARWATER FL 33759 SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community officiai, (2)insurance agenUcompany,and(3)building owner. COMMENTS A/C PAD=13.1 WATER HEATER=15.59 ❑ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(without BFE),complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Secfion C must be completed. 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 enclosure)of the building is _ft.(m)_in.(cm)❑ above or ❑ 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 _ft.(m)_in.(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?�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. 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. G1. �The information in Section C was taken from 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. ❑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 SSU DTE CERTIFICATE OF COMPLIANCE/OCCUPANCY G7.This permit has been issued for: ❑ New Construction� 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 of flooding at the building site is: _ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachments FEMA Form 81-31,AUG 99 REPLACES ALL PREVIOUS EDITIONS