612 SNUG ISLAND DEPARTMGNT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency ManagementAgency ELEVATION CERTIFICATE Expires March 31,2012
Nativ�nal Flood Insurance Pro ram Im ortant: Read the instructions on a es 1-9.
SECTION A-PROPERTY INFORMATION For Insuranee Com any IIse;
AI. Building Owner's Name MARILYN J.HUNEKE,AS TRUSTEE PolicyNurnber
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. COITlpazly NAI�NumbO[
612 SNUG ISLAND
C�Ty CLEARWATER State F� � ZIP Code 33767
A3. Property Descrip[ion(Lot and Block Numbers,Taac Parcel Number,Legal Description,etc.) 05-29-15-43456-071-0050
LOT 5,7A,UNIT 6D,7A,7C,IS.ESTATES OF CLEARWATER,PINELLAS,co.F�. Parcel Nc
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)_
A5. Latitude/Longitude:Lat. 27°59'12.0" Long. 82°49'03.1" Horizontal Datum: ❑ NAD 1927 ❑X NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1 A
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Squaze footage of crawlspace or enclosure(s) 0 sq ft a) Square footage of attached garage 52$ 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 0 within I A foot above adjacent grade 0
c) Total net azea of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b � sq in
d) Engineered flood openings? ❑ Yes ❑X No d) Engineered flood openin�s? ❑ Yes ❑X No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B I.NFIP Community Name&Community Number B2.County Name B3.State
CITY OF CLEARWATER/125096 PINELLAS FL
B4.Map/Panel Number B5.Sufflx 66.FIRM Index Da[e 67.FIRM Panel Effective/Revised B$.Flood ZOnC(S) B9 Base Flood Eleva[ion(s)(Zone
Date AO,use base flood depth)
12103C0102 G 08/18/2009 08/03/2003 AE 11
310 Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ❑X FIRM ❑ Community Determined ❑ Other(Describe)
311 Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑X NAVD 1988 ❑ Other(Describe)
312 Is the building located in a Coastal Barrier Resources System�CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No
Designation Date CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
CI 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 Al-A30,AE,AH,A(with BFE),VE,V I-V30,V(with BFE),AR,AR/A,AR/AE,AR/AI-A30,AR/AH,AR/AO. Complete Items C2.a-h below according
t o the building diagram specified in I[em A7. Use the same datum as the BFE.
Benchmazk Utilized CITY OF CLEARWATER"I-03.5" vertica��atum NAVD 1988
Conversion/Comments I-03.5 ELEVATION =6.4912' NAVD 1988
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure Floor) 8.34 �feet ❑meters(Puerto Rico only)
b) Top of the next higher floor 8.34 0 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) 7.59 X❑feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building g.00 �feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
� Lowest adjacent(finished)grade next to building(LAC) 7.0 ❑X feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 7.6 0 feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A 0 feet ❑meters(Puerto Rico only)
structural support
SECTION D-SURVEYOR,ENCINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or azchitect authorized by law to certify elevation information. /
certify that the information on this Certificate represents my best efforts to interpret the data available. -�• -
1 understand that any false statement may be punishable by fine ar imprisonment under l8 U.S Code,Section lOOL 7 �, _� ;
❑X Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Y? y 1`+N"`
licensed land surveyor? ❑X Yes ❑ No .: � �'�''�`�� �"�' ` Y
,'t r y�i%�s�1`� r�;
Certifier's Name GUY D.HALE License Number 4626 `�' ; � �``�C� -�
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Title PROFESSIONAL LAND SURVEYOR Company Name GUY HALE,LAND SURVEYING � ' � �t
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Address 111 FOREST LAKES BOULEVARDCity OLDSMAR State FL ZIP Code 34677 ` "•/''., J'� , .7�110�52 0:�r.° `
Signature , Date '06/07/11 Telephone 727-734-4266 - ;; t;? . • &� "°' �
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ELEVATION CERTIFICATE O.M.B.No3067-0077
ExpiresMay31, 1993
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
N710N:Use of this certificate does not provide a waiver o(the flood insurance purchase requirement. This form is used only to
de elevation informat(on necessary io ensure compliance with applicable community floodplain management ordfnances,to
determine the proper Insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision(LOMA or LOMR).
Instructlons ior completing thls torm cen be tound on the foliowing pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDINO OWNER'3 NAME POLICY NUMBER
Pauline Bratton'
STREET ADDRES3(Includlnp Apt.,Unit,Suite end/or 61dg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
612 Snug Island _ ___V___
�DTHER DESCRIPTION(Lot a�d Block Numbers,etc.)
T.oi- S� tni 7A, Talanr� atP� Q�_Clearwater
CITY STATE ZIP CODE
Clearwater FL
SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the►ollowing from the proper FIRM(See Instructions):
1.COMMUNITY NUMBER 2.PANEI NUMBEFi 3.8UFFIX 4.DATE OF FIRM INDEX B.FIRM ZONE 8.BASE FLOOD ELEVATION
(In AO Zonee,uae depth)
125096 0007 D 08. 19.91 AE 12. 0 '
7. Indloaie the elevatlon datum system used on the FIRM for 9ase Flood Elevations(BFE): �NoVD'29 ❑Other(describe on back)
8.For Zones A or V,where no 9FE Is provided on the FIRM,and the community has establfsh�ed a BFE for this building site,indicate
the community's BFE:�.U.0 feet N(3VD(or other FIRM datum-see Section B, Item 7),
SECTION C BUILDINCa ELEVATION INFORMATION
1 '�c(ng the Elevation Certiticate Instructions, indicate the diagram number(rom the diagrams found on Pages 5 and 6 that best
cribes the subject building's reterence level_1__ .
2 .FIRM Zones A1-A30,AE,AH,and A(with BFE). The top ot the reference level floor trom the selected diagram is at an elevation
oi L I I I I 91.U feet NGVD(or other FIRM datum-see Section B, Item 7).
(b).FIRM Zones Vi-V30,VE,and V(with BFE). The bottom of the lowest horizontal struct�ral member oi the reference level irom •
the selected diagram,Is at an elevation oi L__L.�_1_.�I.0 feet NGVD(or other FIRM datum-see Sectlon B, Item 7).
(c). FIRM Zone A(without BFE). The tloor used as the reierence level irom the selected diagram is UJ.(J feet above❑ or
below❑ (check one) the highest grade adjacent to the bu(Iding.
(d).FIRM Zone AO. The tloor used as the reference level trom ihe selected diagram is �J.U feet above❑ or below�(check
one)the hi0hest grade adjacent to the building. If no(Iood depth number is available,is the building's lowest tloor(reterence
level)elevated in accordance with the community's iloodpiain managernent ordinarce^ [_] Yes ❑ No ❑ l.�nknown
3.Indicate the elevation datum system used in determining ihe above reference level elevations:� NGVD'29 ❑ Other(describe
under Comments on Page 2). (NOTE: 11 the elevation dafum used in measuring the elevations Is different fhan tha�used on
the FIRM (see Section B, Item 7J, then convert tlie e.levations to Ihe datum system used on the FIRM and show the converslon
equaflon under Comments on Page 2.)
4. Elevation relerence mark used appears on FIRM: I I Yes �)No (See Instruclions on Page 4)
5.The reference level elevation is based on: �X) actual r,onstruction �7 construction drawings
(NOTE: Use ol consfrucfion drawings!s only valld il llie building does not yet have ihe reference leve!lloor in p/ace,ln which
case this certflicate will only be valid for the building during the course ol construction. A post-constructlon E/evatlon Certlficate
wiil be requlred once r,onstruction!s complete.)
6.The elevation of the luwest grade immediately adiacent to the building is:�_��U.0 teet NGVD(or other FIRM datum-see
Section B, item 7).
SECTiON D COMMUNITY INFORMATION
1�community ofiicial responsible for verifying building elevations specHies that the reference level indicated in Section C, item 1
� ot the"lowest tloor"as detlned in the community's floodplain management ordinance,the elevation of the building's"lowest
tloor"as detined by tl�e ordinance is: I_.1_I_�.._..L_�.I..� ieet NGVD(or other FIRM datum-see Section B, Item 7).
2.Date of the start o}construction or substanNal improvement — _.
FEMA Form 81-31�MAY n0 REPLACES ALL PREVIOUS EDI110NS SEE REVERSE SIDE FOR CONTINUATION
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NO�i a 3 ��02
�PLANNI T SVCS
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SECTION E CERTIFICATION
This certilication is to be signed by a land sun�eyor,engineer,or architect who Is authorized by",state or(ocal law to certify elevation •
iniormation when the elevation information for Zones Ai—A30,AE,AH,A(with BFE),V1—V30,V�,and V(with BFE)is required.
Communfty oNlclals who are authorized by local law or ordinance to provide(IoodplaiFl management information,may also sign the
certification. In the case of Zones AO and A(without a FEMA or community issued BFE),a building oHicial,a properly owner,or an
owner's representative may also sign the certification.
Reference leve)diagrams 6,7 and 8-Distingulshing Features—If the certifier is unable to ce�tify to breakaway/non-breakaway wall,
enclosure size,locatlon o(servicing equipment, area use,wall openings,or unfinished area Feature(s),then list the Feature(s)not
included In the cerlitfcatlon under Comments below. The diagram number,Section C,Item 1,must still be entered.
!certily that fhe!n(ormation In Sections B and C on this c�rtilicate represents my best ellorts to Interpret the data available.
1 undersfand that any lalse statemenf may be punisliable by line or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME LICENSE NUMBER(or Allix Seal)
Phil�p C. 5tock R.L:3. #3035
TITLE COMPANY NAME
President Target Land Surveying Inc.
ADDRESS CITY STATE ZIP
P.O. Box 663 Dunedin Florida 34697
310NATURE
:��� �./��.�� O 9AT Z S 9 9 784 E0573
Coplea ahould bo made ol thls Certiflcete for: 1)community oNlclal,2)insurance agenVcompany,end 3)bullding owner.
COMMENTS: 990921 . 06 Benchmark= TBM"cit�� 0 1 arwat'Pr 7��, =s��,��� - �.�� �,.�_,—�, 2�5
•
ON WITH ON PIlEB.
8LA8 BASEMENT PIERS,OR COLUMN9
q •y A A V
ZONES 20NES ZONES 20NE3 ZONES
HEFERENCE
PEfERENCE BASE IEVEI REFERBNCE
IEVEI - FLOOD LEVEL
ELEVATION
1:
+ ',i;.�i),�(;Si�;: � :•i%�,.t�'�il� BASE
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F��� ••+ ..ADJACENT :;:"� '' REFERENCE ELEVAiION
. �'. OMDE .y�} LEVEL
EIEVATION qEFERENCE AOJACENT '��t;
LEVEL ORAOE �
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The dlagrams'above illustrate the points at which the elevations should be measured in A Zones and V 2ones.
Elevations tor all A Zones should be measurod at the top of the reference level Iloor. •
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
Page 2
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