450 PALM ISLAND SE , — --
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t. �RAI. EMERGENCY MANAGENit AGENCY E�►�«s 1t,�y 3�, �`�'��'
��ATIONAL FLOOD INSURANCE PROGRAM
•�Tl ENTION: Use ot tlns cerGlicalo cfoes no1 provicle a wa�ver ol Ihe Ibocf i�surance purchase reyuireinenl.Tl:�s(on��is useJ or�ly io��w
vKle'�t�wation in(otmation necessary to ensurg compiiarxo with applicaWe communify fioodptain manayerneni orcHnarxes,to cJelernur�o
tt�e p�oper irwwrance prc+miurn ►ale, anci/or lo supporl a reyussl 1vr a �etter of Map ArtiendR�enl or Revision(LOMA or LGMf7).You are �+���
requ{red to respond to this coqeciion of u�(ormation unless a valicl OME3 cornrol r,umber is cfispiayed in Ihe upper rght corner ol tlus lon�
Instructione for completing thi• lorm cen be found on the following peges.
SECTtON A PROPERTY INFORMA710N �t�n u+SUtt�N(:E Cc.�'u�v USE
BUQ,()tNC;OWFtER 5 t�tMaE vcx�cr rxtMeEn
Ra l ph & Vanessa Roph i e — - -- ----- -
51REE i AOOfaESS(M�dud•+q�W•U�'N•Sude�^a'a�dG r'�u'^tx`�O�P U.RW 1 E ANU DOX NVMpER GcM1o1WY NArC►K1u0E�
450 Palm Island SE
OTHER OESC�PTION(�01 a�d 8bck N�xnbsrs.e1c)
L�t 31 . Unit 6A Island Estates of Clearwater
�l� STA1E ZIP CODE
Clearwater Florida 33iG7
SECTO�N 8 FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
prov�de the fotlowing Iror.��he�oFer FIRMS(See Instructions):
1.GOi�411lI�ITY MA.�BER ?.PM7EL►lU:�0E�1 7 SUfFtX t.O�f E OF FtRt.t:NDf X 5 �I�20��E 6 �AO Zo�es.use deV�ha�
125096 0007 • o au ust 18, 1592 nE 11 .0
7. Indica:e the elevation datum syslem used on the FIRM lor Base Flood Elevations{BFE): �NGVD'29 U Other(descnbe on ba :
3.For Zones A or V,whe°e ra BFE is provided on the FIRM,and tl�e commun�ty has establisheci a f3FE lor th�s twildmg s�le,mo•.
_.,.�_. __
!he community's BFE:�_��J.0�eel NGVD(or other FIRM datum-see Section F3. Item 7;_ _
SECTION C BUILDING ELEVATION INFORMATION
, Using the Efevation Certif�ca!e tnstructions,indicatg the diagram number trom the diagrams found on Pages 5 and 6 U�a1 best
descr�bes the sui,�ect buitding's relerence�evel __t� .
2(a). FIRM Zones A1-A3U,AE,AH,and A(witt�BFE). The top ot the relerence level floor(rom ttie selected d�agram is al an elevat���
of U_LL��•��ee�NGVD(or olher FIRM datum-see Section B, Ilem 7).
(b). FIRM Zones Vt-V30,VE,and V(with E3FE). The bottom ol the lo�+est honzontal slruclural member of the relerence��. '
U�e selected diagram,is at an elevation of LLl__�__LJ.0 feet NGVD(or olher FIRM dat �m-see �eclion B.Item "'
� , , , ,
(c). FIRt�A Zone A{witt�vvt BFE}. T��e floor used as t1�e re'erence Ievellrom the s?'ected d�agra:n�s i �.� ;feet at�
betow❑ (check one) the h+ghesl grade ad�acent to the buddmg.
(d). FlRM Zor►e AO. The ftoor used as the relerenco►evef!rom the se�ected d�agram is W.U leet above❑ or below L,�check
one)tttie higfiest grade adjacenl to tt�e bwding. II no Ilood deptti number is availabte,is lhe building's towest Ifoor(relerence
fevel)esevaled in accordance w�ll�ttie commun�ty's Iloodplain management ordinance? ❑ Yes [� No ❑ Unknown
3.tnd+cate the e�evation cfatum system used in determ,nmg the above relerence level etevations:� NGVD'29 ❑ Oltier(describe
under Co,nments on Page 2). (NOTE: 1!!he e/evaUon da�um used m measu�ing the elevalions is dif:erenl►ltan ll�af used on
!he FIRM (see Section B,ltem 7J, Il�en convert tl,e e/evaUOns/o tl�e da(um syslem used on U�e FIRM and sl�ow t!►e convers�on
eqvaGon under Comments on Page 2.)
4,Ekrvation reference mark used appears on FIRM: U Yes ❑No (See Instructions on Page 4)
5.The reterence level elevation is based on: � actuaf construct�on ❑ co�sUuclion drawings
(NOTE: Use o1 con5lrucGan drawings is only val�d d the buJlding does nol yef have Ihe�elerence level lloor;n place.,n wlri�h
case lhis certilica�e►v+��onty be val;d la lhe bwld�ng dwing 1he course ol consr�ucGor, A pos!-conslrucGon Elevahon Cerld�cale
�yr1/�iequiied once cons(iucfion,s complete.)
6.The elevation o1 ihe bwesl g�ade imrnediately ad�acenl to the bw�ding�s:���J.0 ►eet NGVD(or oll�er FIRM datum-see
Secuon 8.Item 7).
� SECTION D COMMUNITI'INFORMATION �
�,�1 lhe Wmmunily ollicia�responsible b::verify+ng bw�d+ng etevaGons speahes Ihal lhe reference level indicated�n SecUOn C, Item 1
i5 nol tlte'fOwesl t(oo�"as cfelined in tfie comrnunity's Itooclplain n�anagernenl ordmance.Ihe elevabOn ol Ilie bu�kJiny;'lowesl -
tk��'a,defined by U►e wdinance is: ����_J•t._J leet NGVD{or olher FIRM dalum-see Seclion 8, Item 7). _
2.Oale o1 U�e slart ol Construction a substanl�al imwovemenl ________�__.__._�_____� =
FEMA Form 81•31,AUG 98 REPt/►CES At1.PREV10V5 Eai►Ot�S SEE REVER;E S�pE f�R CONIIMJAIION
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SECTION E CEHTIFICATK '�f
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Z'hrs c�ert�fication is to be sqned trj a�and surveyw,engmeer,or aruu�ect who�s avuanzed by staie o�bcat�aw to cert�ly etevat�
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a�m�tion wh�n U�e elevation infamation for Zones A1-A30,AE.AH,A(wilh BFE).Vt-V�O,VE.arxl V(wrlh BFE)is requned
C�neot�du�ity o4dicials who are auU�orizetl by lota��aw ot wdinante lo provide Ibodplain management�nlo�maUOn,may also s�y��t• {
ces4ef�tan. I�the case of Zones AO and A(witfwut a FEMA or tommurnly�ssued 8FE),a bu�ld�ng ollic�at,a Rxoperty owner,vr 'I��
Own�r'8 re�xe5eMa4ve may a15o Sgn Ihe Ce►Uticalion.
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��ance�evel�ieprams 6.7 and 8•Oistinguishing Features-II the certifier is unable to cerlily to breakaway/rwn-breakaway w. �'a�
s,,,,,, v�c0o�we aize;loq�ion o1 semcinq equipmenl,area use.watl openings,a unfinished area Feature(s),then bsl Il�e Fealure(s�n. ;,
i' entp�ded in the cerWicalio�unde�Comments below. The diagram numbe►.Section C.ttem t.must sUU be enlerecl. � �,�,
a r ,
' . ,,:��,ify�St ttee inlQonnafiore af Section.s B and C on this oerlil'icate represenls my besl ellats lo inte�p�el the da�a avarlabte.
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rme a� sonrnenr und�� Ja u.s. code.secrwn ► .
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��` Ei�eder.ick 5: Bachawnn 1517� - — - �'��
�:: nn� co��+,rw+� Nef e son, Inc. ��
�' ��Florida Professional Surveyor b Mapper C. A. r , _
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;' Tha d'imyrams ahove iMustrate ths pointa at which Ihe ebvations shoutd be measured in A Zones and V Zones.; . ��
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• " Elevauons for aN A Zor�s tfauld be measured al the top ol lhe referer�ce bvel ltoor. , _
,�...,. Elwalions 1vr aN V ZonK sho�d b�messured sl U�boltom ol the lowef!hori:oMal sUuclural member.
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c,E�"'� M��� 3„� { � Bxplres: June 1984
�`�� �.Oc;'�� M ''' F�D i�l#� E GENCY MANAGEMENT AGENCY
�`�. ��" N�CTI(�NAL FLOOD INSURANCE PROGRAM
����, �.� ��
�y�� �* ,;T,����ION CERTI FICATE
This form is to be used for:"`1) l�e4v�i8'�,cT�ogram construction in Special Flood Hazard Areas; 2) Pre-FIRM construction after
September 30, 1982; 3) Post-FIRM construction; and, 4) Other buildings rated as Post-FIRM rules.
� .
BUILDING OWNER'S ADDFiESS
NAME
Timothy R. Quigg 450 Palm Island, NE; Clearwater, Florida
PROPERTY LOCATION (Lot and Block numbers and address if available)
Lot 87, ISLAND ESTRTES OF CLEARWATER UNIT 6-B
I certify that the information on this certificate represents my best etforts to interPret the data available. I understand that any false
statement may be punishable by (ine or imprisonment under 18 U.S. code, Section 1001.
SECTION I ELIGIBILITY CERTIFICATION (Completed by Local Community Permit Ofticial ora Registered Professional Eng(neer,
Architect, or Surveyor) '
COMMUNITY NO. PANEL NO. SUFF�X DATE OF FIRM FIRM ZONE DATE OF CONSTR. DASE fLOOD ELEV. BUILDING IS .
1?_5096 � 0007 � B � 6/1 /83 � A-1 2
(In AO Zone, use depth) ❑ New/Emergency
1 1 O Pre-FIRM Reg.
❑ Post-FIRM Reg.
YES NO �t is intended that the building described above will be constructed in compliance with the community's ilood plaln
❑ ❑ ordinance. The certifier may rely on community records. The lowest floor (including basement) will be at an elevation
of ft, NGVD. Failure to construct the building at this elevation may place the building in violation of
the community's flood plain management ordinance.
YES NO The building described above has been constructed in compliance with the community's flood plain management
Cl ❑ ordinance based on elevation data and visual inspection or other reasonable means.
If NO is checked, attach copy ot variance fssued by the community.
YES NO The mobile home located at the address described above has been tied down (anchored) in compliance with the
❑ ❑ community's flood plain management ordinance, or in compliance with the NFIP Specifications.
MOBILE HOME MAKE MODEL YR. OF MANUFACTURE SERIAL NO. DIMENSIONS
_. X •
--------------------�- � --- i i
(Cc�rnmuniry Permil Of(icial or Heyistered Professionai Engineer, Architect, or Survoyor)
NAME Gordon F,rr^;Killion ADDRESS 2170 Sunnydale Boulevard, Suite ��S'�
TITLE Own
SIGNATURE �1
Clearwater
Florida Z�p 34625 •
5/16/89 PHONE �813) 443-7067
SECTION II �; L ATION CERTIFIC/iTION (Certifled by a Local Community Permit Official or a Rogistered Professional Engineer,.
Architect, or Surveyor.)
FIRM ZONE A1-A30: I certify that the buildin at the property location described above has the /owest lloor (including basement)
at an elevation of 9.�2 feet, NGVD (mean sea levol) and the average grade at the building site (s at
an elevation o(�„8.30 feet, NGVD. Garage Floor Ele�ation - 8.41
FIRM ZONES V, V1-V30: I certify that the building at the property location described above has the bottom ol the lowest lloor beam
at an elevation of feet, NGVD (mean sea level), and the average grade at the building site
is at an elevation of feet, NGVD.
FIRM ZONES A, A99, AH and EMERGENCY f'ROGRAM: I certify thatthe building at the property location described above has the lowest
floor elevation of feet, NGVD. The elevation of the highest adjacent grade next to the building is feet, NGVD.
FIRM ZONE AO: I certify that the building at the property location described above has the lowest floor elevation of
feet, NGVD. The elevation ot the highest adjacent grade next to the building is feet, NGVD.
SECTION 111 FLOODPROOFING CERTIFICATiON (Certification by a Registered Professional Engineer or Architect)
I certify to the best of my knowledge, information, and belief, that the building is designed so that the building is watertight, with
walls substantially impermeable to the passage of water and structurai components having the capability of resisting hydrostatic •
and hydrodynamic loads and effects of buoyancy that would be caused by the flood depths, pressures velocities, impact and uplift
(orces associated with the base flood.
YFS ❑ NO f_.1 In the event of flooding, will this degree oi floodproo(ing be achieved with human intervention?
(t-luman intervention means that ���ter will enter thc buildi;iy when tloods un to the base flood i���del oc-
cur unless measures are taken prior to the flood to prevent entry of water (e.g., bolting metal shields over
doors and windows).
YES Cl NO I] Will the building be occupied as a residence?
If the answer to both questions is YES, the fioodprooting cannot be credited tor rating purposes and the actual lowest tloor must be
completed and certified instead. Complete both the elevation and floodproofing certificates.
FIRM ZONES A, A1,-A30, V1-V30, AO and AH;
Certified Floodproofed Elevation is feet, (NGVD).
THIS CERTIFICATION IS FOR O SECTION II ❑ BOTH SECTIONS II AND III (Check One)
CERTIFIER'S NAME COMPANY NAME
Gordon F. Killion
TITLE
ner
Killion & Associates
ADDRESS
2170 Sunnydale Boulevard, Suite "S"
SI�p�ATURE : / _ DATE CITY
LICENSE NU. (or Aifix,Seal)
R.L.S. �3138
ZIP
34625
STATE PHONE
� 5/16/89 Clearwater Florida (813) 443-7067
-The sur nce agent should atiach the original copy of the completed torm to the tlood Insurance policy appl(catlon,
the second copy should be supplied to the pollcyho�der and the third copy retained by the agent
•� INSURANCE AGENTS MAY ORDER THIS FORM
FEMA Form 81-31, SEP 83 REPLACES FEMA FORM 81-31, nPR a2, WHICH IS OBSOLETE. •