201 PALM ISLAND SW -�iCPp �( - 0t547
FEDERAL 81AERGENCY MANAGEMENT AGEI�Y O.M.B. No. 3067-0077
NATIONAL FLOQD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
trnportant Reaa n►e�or�s on 'i-7.
SECTION A-PROPERTY OWNER IPIFORMATION Fa Insuranee Canpany Use:
ING a1IVNER'S NAME ��Y M��
dBERT AND ROSEMARY LONGENECKER
BUILDING STREET ADDRESS(Induding Apt.,Unit,SuRe,anci/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NA1G Number
20'!P�1La1�SW
�Ry STATE Z!P CODE
CLEARWATER FLORIDA
PROPERTY DESCRIPTION(Lot and Blodc Numbers,Ta�c Parcel Number,Lega1 DescripUon,etc.)
LOT 10 ISLAND ESTATES PB 60 PG 90
BUILDING USE(e.g.,Residerrtia�,Non-�r�esidential,Add'Rion,A�,etc. Use a Comments area,if�ary.)
RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##'-##.�R' or ##.#1(�°} �NAD 197T ❑NAD 19�i ❑USGS Quad Map �Other:
SEC'T10N B-FLO�1NSURANCE RATE MAP�Ffii�INFORMATIOTd
B1.NFIP COMl40.JRNTY NAME&COMMUNITY(�AA�ABER B2 COl1�JTY NAME B3.STATE
CLEARWATER PINELLAS FLORIDA
84 MAP Af�PANEL B7.FIRM PANEL 89.BASE FLOOD ELEVATION(S)
NUMBER B5.SUFFIX B6.FIRM If�EX DATE EFFECTIVE/REVISED DATE 88.FLOOD ZONE(S} (ZoneAO,use depih offloafng)
0007 D &1&92 8�19-91 A E 12.0
B�o.�nc�he me sa�ce a�Ihe 6ase Flooa Etevation{BF�da�a ar bese tbod ciepm er�red in Bs.
❑FIS Ptofile �FIRM ❑Canmunily Determ�ned ❑C�r{Desa�be):
611.Irxf�e the elevation dahm u�d for the BFE in B9:�NGVD 1929 ❑NAVD 1988 ❑dlher(Desak�e):
B12.Is�e buiding bcaled in a Caastal Bxrier Resar�es Sysbem(CBRS)area ar�Pr�ed Area(OP{�? ❑Yes �No Designation Dafie
sECnoN c-sui�r�E�ranor�ir�oww►noN�su�r�caui�n�
c1.euiaing elevations�e based«,:p cons�ctio�Drawing�' ❑Bu�dms lMder c«�tuc1ion• �F�Ca�tudia�
*A new Elevation Ce�tifica�e wil be�ired when�of the bu�ng is carr�ple�e-
•.Buikf�g Diagram t�unbe�8 (Select tl�e builcing d�ag�n rnost sintl�to tt�e buiking for which ttis certificate is being canpleted-see pages 6 and 7. If no ciagr�n
aa�uatelY represenls the bu�g,praide a ske�ch or�ho�ogaph.)
cs.�ra�or�-zones A�-a3o,�,�+.A M�,�,vE,v1 v3o.v�wrtn��,aR av�,aw�.awA�a�o,Awai,avao
comp�ete Iterrs c3.-a-i belaar aocorcing to U�e b�ng dragarn s�fied n Iterr►c2.S�e rie dahrr►�sed�the daarr�is�erent iran the dahm�ed for C�e BFE in
Section B,convat the da�urn fi�tFrat t�sed for Uie BFE.Shaw field rneasuranenQs and da�m con�sion c�CUlation. Use Uie space pro�ided or U�e Carmen��a�
Secbon D or Section G,as appnpriate,to docunent tlie dabm conversion.
Dahm �
Elevation reference mark tsed LO(',AI..Does the eleva�on reference madc used appear an the FIRM? ❑Yes �No
Xo a)Tap d t�otbm floor(ndu�ng b�rrient a�re} 12. 3 FEEf m �
Xo bj Top of t�ct higher Aoor 71.9 FEET �'
o c)Bottan of bwest haQatlal str�uct►aal membe�(V mnes only) NA._R(m)
Xo r�A�h�9ar'age(ioP of slab) aa 8.7 FEET �� FL �t�A 4 r ''��36.
� ;
Xo e)Lawest eleration�machinery and�or eq�rr�ent m m ,;� ,��" , �=
servicting the buik�ng{Des�e in a Carm�enls azea) 11.8 5 FEET E; � 6�T�.'�8 2�Q� �
� _
� s
Xo f}LoweSt a�a�t�9'dde(LAG} 5.7 FEET m N ; �y M �„ ;" r.,, �
N t-� �, r.. �
Xo 9)Hi�hest a�ac�t(fttished�9"ade(�G1 8.7 FEET �
o h)No.of perrr�ar�ent openirgs(fl�d ver�sj wiEhin 1 ft abwe ac�acer�grade NONE '.�j . � �°r�� '�f �°� f,
o )Total area of al permanent opeaings(flood venls)in C3.h N(N�E sq.in.(sq.an) ." W ' .�:
'� `� "��,"'�w,.r...��
SECTtON D-�JRU�YOR,ENGINEER,OR ARCIiITECT CERTIFlCATION ��, `� W+��''
This cefification is to be signed and sealed by a land swveya`,engineer,or architect authonzed by law to cerfify elevation informa6�on. ;� , `
1 ce►tify that the inform�ion in Sections A,B,�►d C on tfris ce►ti(�c�e represents my best elfoifs to interpret fhe data av�lable.
f understand th�any false staternent rrray be puncslsabte by�rne or imprisanment under 18 U.S.Code,Secfia►fQQS. � ,..�_. .
CERTIFIER'S NAME BILL HYATT LICENSE NUMBER 4636
TITIF PRESIDENT COMPANY NAME KNOW 1T NOW,INC.
-
,qpp�� CITY STATE ZIP CODE
(MAIL)1497 MAIN ST#K321 QUNEDIN FL 34698
SIGNATURE DATE TELEPHONE
�� �28-0'� 727 415�i05(CELL?27 64127251
�
IMPORTANT: In these spaces,oopy the comesponding information from Section A For ins�rance com�ry use
Bi11LDI(Vl3 STREET ADDRESS(including Ap1,Un�,Suiie,andta Bia�.fJo)OR P U RGUi E AfJCi�sOri i'J0 Pdicy P3umber
201 PALM ISLAND SW
GITY STATE Z�PCODE Compary NA1C Numb�
CLEARWATER FL
SECTION D-SURVEYOt�Et�INEER,OR ARCI�TECT CERIIFlCATION(CONTINUED) •
Capy bdt�sides of ths Elevation Ce�tificate for(1)cormiunity ofiaal,(2)insuranoe agen�on'panY,and(3)bui�ing owner.
COMMEM`S
C3-E ELEV ON EQUIPMENT IS BOTTOM OF AC UNITS OUTSIDE OF BUILDING—ELECTRIC HOOKIJP MAY BE FNGHER
WE DID NOT REMOVE COVERS TO CHECK HOOKUF'ELEVATIONS
❑Check here'rf attac�xnents
SECTION E-BUILDING EL.E1/AT10N INF0IZMATION(SURVEIf NOT REQINRED)FOR ZOt�AO AND ZONE A(WITHOUT BFE}
For Zone AO and Zone A(witha�t BFE),canple�e Iterrs E1�xough E4. If the Elevation Certi6cabe is in0erided fi�r use as s�porting infamation for a LOMA or LOMR-F,
Section C must be carpl�ed.
E1.Buiking D"ragam Nur�er_(Sefect tl�e buil�ing�iagarn most sKril�r to the btrlc�g for wtrch this�is being c�rnpt�ed—sce pages 6 and 7. If no ciagam aocuatey
represen�the buiding,prwide a ske�ch or photogaph.)
E2_The fiop of the bot�Om floor(mclucfing bas�neM or endosure)�the build�ng is _ft.(m)_in.{an)�abwe or ❑t�ow�r.n�o�)me►�t�,t srade. (u�
natu�grade,if av�lable).
E3.For Buildrg Diagarns 6-8 wifh opemrx�(sce page 7},the next h�floor or eleveA�d Aoor(elevation b)of the bwlding s _R(m)_in.(an)abwe the high�t a�acent
gade. Cornplete�ans C3.h and�3_i on fror�of form_
E4.The bp of the pl�fam of machinery and'or e�ipment se�vicing the buddmg is _ft(m)_in.(an}❑�owe a ❑bebw(ct�ck a�e)the t�a�jacent gade. (Use
nahral gade,iF a�r�lable).
E5_For Zone AO only If no flood depth rnrnber is available,s ihe top of the bottom floor elevated in accadarxe with the communrty's floodplain managernent ord�rr�ce?
❑Yes ❑No ❑Ur�cnov�n. The bc�ofidal must certity Urs i�ortnation in Section G.
SECTION F-PROPER'iY f)VVNER(OR 04VNER'S REPRESENTAl1N�CERTIFlCATION
The propaty owner or owr�s aWia¢ed�preseni�re wha cmiple�s Sec6ar�s A.B,C(i�ms C3.h and C3_i antyj,anci E�r Zane A(without a FE{�Aa-ssued or carmm�atiityr-
i�ued BF�a Zone AO must sign here. T'i►e statements in Sectias A,8,C,and E are carect to the best ofmy knowtedge.
PROPERIY OWNER'S OR OVIMER'S AUTHORIZED REPRESENTATNE'S NAME •
B1LL HYATT—SURVEYOR -KNOW IT NOUV INC
ADDI�SS CIN STATE ZIP CODE
1497 MAIN ST#'321 DUNEDIN FL 34698
SIGNATURE DATE TELEPH01�
���� &28-03 727�15�8.'i05
COMMEMS
❑Check here if attachments
SECTiON G-CC)1w41tlMfY II�ORMATiOI�ii(OPTiONALj
The local o�al who is authamed by law a orc6nance G�acinirus�r the carrriunily's flooc�ain mar�agerr�ent orcinance ca�corr�plete Sec�a B,C(or E),arxi G of this Elevation
Certficate. Complt�e the app6c�le item(s)and sign bebw.
G1.�The nfom�ation in Secti�C wes�aken from other docur�n Urat I�as be�sgned and�by a licer�sed sunreyor,en�neer,or ar�r�ct wtio s at�xx¢ed by sfate
or bcal laur to c�rtify elevation ir�ortriation. (Irx�cate the sarce�d da�of�e ele►ration data in the Corrrnenls ar�bebw.)
G2.0 A cmmuni�offiaal�Section E fa a bu�j bcated in Za�e A(vritlwut a FEFAA��ed or carmuniiy�ssued BFE�or Zone A0.
G3.❑The foNowirx�i�tamation(i�err�s G4-G9)�s P►����Y���PuP�•
G4 PERMtf NtJ�ABER G5.DATE PERMIT ISSUED G6.DATE CERTIFICATE GF COMPUANCFIOCCUPANCY ISSUED
G7.Tt�s pertrit has been issued�r:�N�v Cor�struction ❑Substantial Improvanent
�S.E�vabon d�I�+�t noor�ir�du�g ba�rnen�of the buiking s: _—tk(m) Daarr►:
G9.BFE a(�n Zone AO)depth of 9oaing atthe 6�r�g site's: _._ft(m) Dahm:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE •
SIGNATURE DATE
COMMENTS
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