750 SNUG ISLANDU.S.DF�ARTIAENTOFHONEIANDSECURITY ELEVATION CERTIFICATE
FEDERAI EaAERGEtICY MANACsEMENT AGENCY
Variona! Flood lusr�rance ProS�vm Important: Read the ir�tructions on pages 1-9.
SECTION A - PROPERTY tNF�RMATION
suae;r� owners N�,e .�nrey M. waro �r,a erza�m a
A2. Buildir►g Street Address (imcluding Apt, Unit, Suite, a�dlor Bidg. No.j or P.O. Route and Box No.
750 Snup Island
ZIP Code 33767
Cily CI�nNater
Stete Fl
q3, property pescriptbn (Lot and Block Numbers, Tax Parcel Number, L�
Lot 48. Unit 76 Isiand EMates of Clearwater Pid:05-29-1
OMB No.1660-0008
Expiration Date: Juty 31, 2015
FOR INSURANCE COMPANY USE
A4. Building Use (e.Q., ResideMial, Non-Residentlal, Add6on. Accessory, etc.) Residential
A5. Latttude/Longitude: Lat• 27.9916 N Long. 828189 W Horizontai Datum: ❑ NAD 1927 � NAD 1983
A8. Attach at least 2 photogr�hs of the building If the Certficate is being used to obtain tfood insuranoe.
A7. BuidinQ Dia9fem Numbef 1a A9. For a buiiding with an attached garage:
A8. For a buiidin9 wMh a crawlspace or endosure(s):
a� gy�� {��� o{ p��pACe or endoaure(s) Na sq R a) Squaro footape of attsched gerege 528 sq tt
b) Number of pem►sneM 11ood openings in the crawlspace b) Number of permaneM tlood openings � the atmched ga►age
or enclosure(s) wtthin 1.0 toot above ad�t grada Ma wftFdn 1.0 foot above adJacent g� 0
c) Totai net area of fbod openi�s in AB.b Na sc� in c) Total net aroa of flood opanings in A9-b nla aq in
d) Engineerad tlood openings� ❑ Yes ❑ Nc d) Enpinee�ed tlood ope�gsT ❑ Yes ❑ No
SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP Community Name 3 Commurriy Number I B2• CountY Mame
Ciry of Ckan�veter 125096 ���
64. ��103C01 2��r B5. SGufix B6. FIO 03/03 Date EtfecUve%Rtvised Date
09/03/03
63. State
�
ss, Fiood I es. sase Faoa E�evacton(s) (zone
Zone(s) AO, uae ba�:Aood depth)
610. Intl'icate the sotrce of the Base Fbod Elevation (BFEj data or base flood depth entered � Item 69.
❑ FIS Prot�e � FIRM ❑ Commur�ty Detertnhed ❑ OtheNSource: .�.
611. Indcate elevatior► datum used for BFE in ttem B8: ❑ NGVD 1929 � NAVD 1988 ❑ OthedSource: _
812. Is the buAding bcated in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes � No
��� ��; _ ❑ CBRS ❑ OPA
SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REGUIRED)
C1. Bui�ng elevations are besed on: ❑ ConsQudion Qrawings` ❑ Buiidk�g U�der ConstnicUon' (� Fin�hed ConsUudion
•A new Elevation CerUf�ate wiN be required wh� construction of the building is compbte.
C2. Elevations - Zones A1-A30, AE, AH, A(w(th BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Gompiete Items C2.a-h
bebw acoordiny to the buNdlnp diagram specitied "m Item A7. In Puerto R�o o�y, enter meters.
Benchmark UtiBzed: C�v Benehm.ark# J-03.5 Vertkal Datum: Elevation 7.527, NAVD88
In�cate eievaUon datum used for the elevatarn in items a) through h) below. � NGVD 1929 � NAVD 1988 � Other/Source: _
Oatum used for buikling elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom Aoor (indud'mg basement, crawispace. or encbsure tl�oor) 7.82 �I feet ❑ meters
b) Top of the next higher tloor Na._ ❑ feet ❑ meters
o) 9oerom orthe bwest ho�izor►ta� stnnKura� men,ber (v zones onry) nra._ ❑ reet O rneoers
d) Attactied 9arage (taP of slab) 7.08 � Teet ❑ meters
e) l.owest elevation of machk�ery � equipment servidnp the buid'inp 8.57 � teet � metere
(Descrbe type ot eQiipment and locatio� i� Gomme�b)
� Lowesc adjaceM (tfnisnea> erade �xt ro nw�'ing tLAG) s.� � net O meters
9) Flighest adjacent (flrrished) grade next to buildinp (HAG) 6.9 � feet ❑ meters
h) Lowest accljacent grade at lowest elevation d deck or stairs, indudkq struc�ural support n/a._ ❑ feet ❑ meters
SECTION D- SURVEYOR, ENGINEER, OR ARCHREGT CERTtFICATiON
This certificatlan is to be si�ed a�d sealed by a I�d sunreyor, enyi�eer, or archdect authorized by law to c�rtify ekvation
infortnation.l certify dtat the iMamation on this Csrtificate reprossnts my be� et►orts to inMrpret the data avaifabb.
I w�derstand that any �a/se stetemarN may be purtishable by Bne or impriswrrnsnt under 18 U.5 Code, SscNon 1001. `,���uNr����qi
� Chedc here if Comments are provided on back ot torm. WEte 18tihlde end 1o11gihtde b1 SeCtbn A provided by a �.�` .,jgE NII,j�., ���i�
❑ Check here if attachments. Ncensed iand surveyoR � Yes ❑�`10 �_ �/.'��er,o.asn 8M�'_'�,
c�n�rs
Title Lice
Address I
Joaeph E. WiAiamson, PLS
i.icenae Number 6573
FLSurveya Comparry Name Vision Land Service
FEMA Fam 086-0-33 (7112)
Winter padc State FL ZIP Code 32789
Date 02/10/15 Telephone (888) 399-8474
See reverse side for contirtuation.
STATE OF
�oawa
Replaces all previous ed�tions.
ua�u � r► i avi� a.ua� a ar ��.n a ur Y°tic �•
IMP�RTANT: In these spaces, copy the corresponding informadon hom Section A.
Building Street Address (induding Apt•. Unit. Suite, andlor Bldg. No.) or P.O. Route and Box No.
750 Snug Islsnd
Ciry Ciearwete� State FL ZIP Code 33767
FpR INSURANCE COMPANY USE
pofcy Number:
CanPanY NAIC Number:
SECTION D- SURVEYOR, EN(iINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy baah sides of this Eisvation Certificate tor (1) oommunity otficiai, (2) insurance ageM/compe�y. and (3) buading owner-
Comments Item w� bcated on the Air Conditioner Pad
Date 02l10/15
Signat�e
SECTtON E- BUILDING ELEVATION INFORMATION (SURVEY NOT REOUIRED) FOR ZONE AO AND ZONE A(vnTr+uu i �sr��
For Zanes AO and A(wiQwut BFE). complete Items E1-E5. N C►e CaRHicate Is Intended to support a LOMA or LOMR-F request. canPlete Sedions A, B,
and C. Fa items E1-E4, use natural grade. if ava�able. Chedc tl�s measut a� boxes�to snhow whether th�e elevatbn � Sbove or below the highest adjacer►t
E1. Provide etevation informafion for the fdbwing and chectc the aPP�
grade (t�qG) ar►d the �wrest a�acMt grade (U►Gi-
or andoauro) is _: _ ❑ feet ❑ meters ❑ above ot � bebw the HAG.
a) Top of boteom tloor (indudin9 basement, crawispace. feet meten ❑ above or ❑ below the LAG.
b) Top of bottom tloor (N►dudin9 basement, Crawlspaoe. or endosure) is __ ❑ ❑ te
E2. For Buidirp �iayrama 6-9 with pertnaneM flood opemnps provided in Sedion A ttema S srxilw 9(see pages 8-8 of Ir►sductana). the next higher 11oor
E3. Attac�►ed 9ata9e (WP of sfab �� ot the b�tdirp �❑ teet � met� � a�bamva or ❑ bebw the � below the HAG.
E4_ Top of platlorm ot mac�nery and/or equipment servicing the builiding is . ❑ feet ❑ meters � above or O befow the HAG.
E5. Zane AO oMy: If no tbod depth number is avadable, is the top of the bottom Ifoor elevated in acxcManae ww�h the community's tloodpiain management
ordiriance? ❑ Yes ❑ No ❑ UNu�own- The bca! otficial mud c�tity this iMorrt�ion i� Sectbn G.
SECTION F- PROPER'fY OWNER (OR OWNER'S REPRESENTATN� CERTIFICATION
The propehy oMmer or owner's autla�ized representative `Nho �ompl°tes Sectlons A, B. and E Tor Zone A(without a FEMA-Issued o► commun+ty-issued BFE)
or Zone AO must sig�t here. The statements a� Se� A, B. end E arc carect to the beat of my kiwwkd9e•
propertY Ownei's or Owners Autl�oAted Repfesertative's Name
�e� � State ZIP Code
Signawre
Comments
Date
Telephone
Chedc here it attaChments.
SECTION G - COMMUNITY INFORMATiON (OPTIONA�)
The bCai oficisl wta is a�At�otized by law or ordk�anc� to adrt�iater the oomrtx�Y�s �oo� ��^e� � can oomplete Sections A. B. C(or E). and G
oi tlds Elevation Certificate. Comple4e the aPP�icable ite�►K8) ��9^ belo�w. Chedc the measw'emeM used'n ICems G8-G70_ In Puerto Rico onlY, enter meters.
G1. ❑ The information in Section C was taken from other doeumentntion that haa been signetl and aealeQ by a Nce�ed surveyor. e�ineer. or architect who
is autlwrizad by law to certlfy ekvation intormation. (Indieate the aource and date of ths elevation data in the Cortttner►ts area below.)
G2_ ❑ A commwnty officia� competed Sectior► E for a bWdi�g bcated in 2one A(wflhout a FEMA-issued or community-issued BFE) or Zone AO.
G3. ❑ The foNoNrin9 in(orma6on (items G4-G10) is provided for communily AoodPlain management purposes•
G4. Permit Number � G5. Date Permit Issued
G6. Date CeNificate oi
c7. This permit has been issued foc ❑ New Cor►struction ❑ Substantial Im�xovement
G6. Elevation of as-buiQ lowest floor {induding basement) of the building: -- ❑ teet ❑ mecers
G9. BFE a(in Zone AO) depth of tfooding at the buli�ng site: __ ��et ❑ meters
G10. Community's design flood elevatlon: __ ❑ teet ❑ meters
Locai Officiai's Name
Community Name
Si�ature
Comments
Tttle
Tekphorro
Oate
Datum _
Datum _.
Datum _
Check here If attachments.
FEMA Form 086-0-33 (7l12) Repiaces all previous editions.
ELEVATION CERT[F[CATE, page 3 guilding Photographs
See Instructions for Item A6.
IMPORTANT: in these spaces, copy the co►responding information from Section A.
Buikiing Street Address (inciuding Apt, Unft, Suite. and/or Bidg. No.) or P.O. Roule and Box No.
750 Snug tsland
City Clearvvater State FL ZIP Code 33767
FOR INSURANCE COMPANY USE
Pd'ecy Number.
Company NAIC Number.
►f using the Elevation Certficate to obtain NFIP flood insurance, affix at least 2 buiiding photographs below according to the instructions
for Item A6_ Identify all photographs with date taken; 'Front Vfew" and `Rear View"; and, if required, 'Right Side �evil' and 'left Side
Vew." When applicable, photographs must show the fou�datian with representative examples of the flood openings or vents, as
indicated in Section A8. if submitting more photographs than will fit on this page, use the Continuation Page.
Front of House
FEMA Form 086-0-33 (7l12) Replaces all previous editions.
�R QR,;g,n�
ELEVATIONCERTIFICATE,page4 Building Photographs
Continuation Page
IMPORTANT• In these spaces, copy the corresponding information from Section A_
Building Straet Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
750 Snug Island
City Gearwater State FL ZIP Code 33767
FOR INSURANCE COMPANY USE
Policy Number.
Company NAIC Number.
If submitting more photographs tfian will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; `Front �ew" and "Rear �ew"; and, if required, "Right Side �ev�f' and "Left Side View' When applicable,
photographs must show the foundation with representative examptes of the flood openings or vents, as indicated in Section A8.
Rear of House
FEMA Form 086-0-33 (7/12) Replaces all previous editions.
Pc10� �J1���1n�
FRQM : �YS.1�N._.:="�RlIG FA?C ND. : 727 344 4640 May. 17 2002 08:58AM Pl
. �
D AL�MERQEAICY MANAGEMENT AGENCY O.M.B. No. 3067-0077
MAY 212002 �ONA�FLOOD tNSURANCE PROGRAAA Expires July 31,2002
• EVATIQN CERTIFICATE
M: Read the i�structions on es 1 -7.
F 5ECT N A-PROP�RTY OYYNER INFORMAYION Fa Il�su�aMtB CompBny USB: ;
BUIIDMiC3 Policyr Number
Ckmsa
BUfLDtNG S7REET ADDRESS(�ndudis�g Apt..Unk,Suile,andlor Bidg.No.)OR P.Q.ROUTE ANO SOX NO. Company Nw�ber :`
750 Sau Island
C�'ry STATE 21P C�DE
arwater FL 33767
PR DESCRIpTWN(lot and Bbck Numbers.Tax Paroel Nwnber,Lepsl Oescriptiw�,etc.y
Lot 68 UI�iIT 7B ISLAND ESTATES OF CLEARWATLlt
BUlLDM1G USE(e.g_.Resiesnt�al,Noa-reai�+tia�Addition.Aaoestory,eta tJ6e Cortur�ents sscbon if necessary.)
l�esidential
LA7'ITUDE/LONGITUDE(OPTIONAL} HORIZONTAL bATUM: SOURCE: �_�GPS('fype):
� ss°-�pr•x�.�ar or �re.� I_i w���s2� �,_,�NAD 1983 u USGS Quad Map �o�n�r:
S�CTION B-Ft.00D lNSURANCE RAtE MAP(FIRNn INFORMATtON
91_I�IP CpAAMUNi7Y NAME 3 COMIYHJ1+1t1'Y NUMBER BZ.COUNT1f NAME 83.STATE
17�096 Pinellas Flarida
84.MAP AND PANEL 85.StJFFIX 96.FIRM INOEX 87.FIRM PANEI B8.FLOOD B9.BASE FL L�1/ATION(S)
NUMBER W1TE EFFECTIYE/REVISED DWTE ZONE(5j (ZonA AO,use depM W Iboding)
0007 b 8/19/91 8I19/91 A–E 11,0'
810,Indicate tt�souroe o4 the ease Fbod Elevation(8FE)data os base Aood depth BMered In 69.
�F!S Profilm LXJ FIRM �J Community Detem►irted j_I�er(Describe):
B11.lndic�te Mtie devation datwn used br the BFE in B9:(x J NGVD 1929 u NAVD 1968 �_�Other(pesc�fbe):
812.ts the bu�ding loceted'm a Coastal B�iar Resources System(CBRS)area or OthenNise Proteeted Area(OPA)? ��Yes LX,J No
DesiQnaGon bate:
SECTIQN C-BUILOING ELEVATION INFORMATION(SURYBY RECU112ED�
Ct.Building etevetions are based on: �Consttuction braw►ngs' �BuNding Ur�der Construction• u�'inished Construdion
`A new Ekwation Cehificate will ba requited when con6t►udion of the auilding is complzte.
•C2.Builc&�g Diagram N�mbe� 1 (Select the birlding diagram most simila►to the buUding tor which thla certificaie is being completed-aee
�ges 6 and 7. tf no diagram accur�ely tepreseMs the buiiding,provide d sketch or photograph.)
C3.El�ratiorts–Zw�es At-A3U,AE,AH,A(with BFE),VE,V1-V30.V(with BF�j,AR,AR/A,AR/AE,AR/A1-A30,AR/AH.AR/A0
Complele Items C3a-i bebw according to the building diagram specibed in ttem C2.Stste ihe dalum used. IF the datwr►is diHereM trom
ihe daWm used�or tl�e BFE in Section B,owiveA the datum to thet used for the BFE.Show fMeld measurements and datum conversion
calculaGon. Use tha spaGe providad or the Comment8�a af Sectian D or Section G,as apprt�piriate,to document the datum oonve►sior�.
Datum CornersioMCorm►e�ts
Elevation relerenoe merk used_SFF:E CK��T15 Does the elevation reference mark used appear on the�IRM? �Yes �x�No
0 a)Top ofi bottom 800r(including basement or endosure) 8 .5 R.(m) v —"–
!] b)Top o(nexi tHghAr Roor N .A ft.(m) �
O c)Bottam oi lowest hocizontal structural member(V xones only) N.A R.(m) �o
❑ d)Attached��e(top o1 slab) 7 .$R.(m) �g
0 e}�o w e s t e l e v a t i�o f m�e ry a x M t a r e q u i p m e n t ��° C�
servicing U�e buddin9 8 .�tl.(mj �� �1
O �L o w e s t a d}"a o e r+t g�a d e t i A G) 7 .5 R.(m) z'� .�+>' �l j����
O g)Highest adle�e�t gtade(HAG) 7 .�ft.(rr►) �� � � !.��'_
O h)No.of pem►�anent openings(fload vents)witttin 1 D.ffiove adacent c�ade 0 � t/J
O )Tobl area of aM perm�nt openir►gs(�ood veMs)i�n C3b Q sq.in.(sq.cm)
SECTtON p-SLJRVEYOR�ENGlNEEit.OR ARCHRECT C�RTIFICAT�pN �
This c+e�ti�is to be sgned and sealed by a land swveyor,e�gineer,or�hitect authaized Dy taw io c�wti/y elevation information,
!ce�dtat the infamstian at Sections A,B,erld C An this CBttiRc��+9p►eeents rr�y best efloris fo irrterpret the data eveflabls.
I understand tha!�ty lalse statenrent may be punishabls by�ine or impn�nment rmde�fe U.S.Code 5ectlon 1001.
c.tK 1 u-�ER'S NAME uCE�IS��60 R
F.d�aard D. �ptri�. R..�..�.
P�+eSident � AMY NAME � °_ — __
r�rphy'� I�-uyd Surveviny. Itirs
�57 0 11 ue N. ��t. Peters srnl'I, ziP cdo
33�11d
S�� TElEPHO E
5 17102 �/ 347-8740
•FEMA Fp►m 81•31,AUG 99 S RSE SIQ�FOR CONTlRtUATI(1N pea�arca w�� ooc..�n���.-...T�......