1760 SUNSET DR FF.DERALEMERGENCYMANAGEMEN:TAGE�lCY O.M.B. No.3067-0077
4TIONAL FLOOD INSURANCE PROGRAM Expires December 31,200�
ELEVATION CERTiFICATE
Im rtant Read the instructions on pages 1-7.
� SECTION A-PROPERTY OWNER INFORMATiON Fa�ce Canpamtlse:
BUiLDING OWNER'S NAME Pdicy Number
DAVID WADE
BUILDING STREET ADDRESS(inctud"mg Apt.,Unik Suite,and/or Bidg.No.)OR P.O.ROl3TE kND BOX NO. , Company NAIC Number
1760 SUNSET DRNE
CITY STATE ZIP CODE
CLEARWATER FL 33755
PROPERTY DESCRIPTI�N(Lot and Block Numbers,Tax Par�ei Number,legal Desaiption,etc.)
LOT 3.BLOCK 11,NORTH SHORE PARK
BUILDING USE(e.g.,Resid�dai,Non-residential,Additlon,Accessory,etc. Use a Canments area,if neoessary.)
RESIDENTIAL
IATITUDElLONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type):_
��-#�-�ae.u�r a r�.�� �w��sri p ruw�ssa p us�s ca,aa nn�v p om�:_
SECFION B-FLOOD INSURANCE RAfE MAP{FIRM)IIUFORMATtON
8t.NFtP('CNrfMl;iv�,i NAN1E A COMMUNITY NIAviBER B2 COLRJfY NAfuE 63.STATE
Ulv^�'��'.,"aRAfcl�125096 PIJELJ.AS ( FL �
84.kAAP ANO PANH. BF.FffiM PANEL &9.BASE ROOD ELEVATIp�!{S}
NUNBER 83.SUfFU( B6.FIRM A�OEX QATE EFFECTN6REVISEG UATE BB.ROOD ZONE(S) Rone A�,use deph d Aoodr9)
12509�0106 H 5ti7p5 9t11Q5 VE 14&15
610.Indpte ihe source of ihe Base Fbod Elevation(BF�daia or base Ilood depth enlered in B9.
p Fls�o�e �Flwm ❑cor�x,nity oe�ermi►�ee p ou,er(oesa,r.e):____
B».i�a,e�so�d�n,m�d�a,e eFE�a�:p rrcw i sz� �r�ti�c�ses ❑om«��>:_
Bt 2.ts ihe buikSng located in a Coastal Barier Resouraes System(CBRS)area a Obierwise Prodeaed Area(OPA)? ❑Yes �No Desgna6on Datef�A
SECTION C-BUILDMG ELEVATION INFORMATION(SURVEY REQUIREQ)
C t.Buil�ng elevalions ae based on:0 Construction Drawings' ❑8tiiking UrMer ConsUuc�on' �Frrsfted Cauhuc6on
A new ElevaUon CeAificate v�6e required when car�nx�iori of ihe bu�d'irig is c;ort�lete.
C2.Bud�iny Diagran Number 6(Select the bud�ng�iagr,xn rnost snre1ar to Ihe tnaldmg forwhid�th's ce�ficate�s being campleted-ses pages 5 and 7. If no diagran
aowratdy represents the buiking,provide a sketch a pt�ograph.)
C3.BevaGons—ZaMS A1-A30,AE.AH,A(with BFE),VE,Vt-V30,V(w8h BF�,AR,AWA,AR/AE,AR�At-A30,AR'AH,ARIAO
�, Complele Items C3.-a-i below ao�ordmg fo ihe l�ding�agram�eUfied'm ftan C2 Stale the datum used.if!he d�um is d�erent irem lhe datum used for tl�e BFE in
Section B,cornert the datum to that used fa the BFE.Show field measurerr�nis�d dalum carver�n caicula6on. Use the space provided a tlie Comrnenls area of
Sec6on D a Section�,as appropri�e,to docixnenf the daium conversion.
Datum NAVD 1968 Conve�sioNCanmems IVA
Elew�on�ererae mak used L.or.al Does fhe eleva6on reference ma�c used appe�un lhe FIRM' ❑Yes �No -
o a)Top of bottom Aoa(mdudng basert�ent or endosure) 6.5 B.(m) m �
o b)Tap of next higher floor , 15.0 ft(m} �' � �
o c)Boitan af lowest haizontal str�xlurai rt�(V za�es only) 13.3 ft.{m) �o �� � �
u d)Attached garage(top of slab) 6. 5 ft(m) �
o e)l o w e s t e l e v a ti o n a f m 2 d�i n e ry a n d l o r e q u i p m e n t �� '� � �b
se�vidng tl�e buildmg(Desaibe in a Comrnerris anea) 15.1 R(m) e W /� �` `b l�
o�Lowesl a�aoent(finishe�grade(LAG) 6.0 ft.(m) z'� ( a /�`
0 91�r ad'lacent�finistted)���G) 6.4 fl.(m) $ 1 � J
o h)No.o F Pennanent openin�s(ibod ve�s)wilhin 1 ft.abave ad�aoent grdde NA �
J
o i)raal are�a of al pem�aient apeenirgs(flood venis)in q.n Nn sq.a�.(sq.cm)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATtON
This certifrcation is to be signed and sealed by a land surveyor,engineer,or ar�hite.Ct authorized by law to ceAify etevatlon information.
1 certity that the inio►mation in Sectfons A,B,end C on this certificate represents my besf effo+ts to ir�erpret ihe dafa availa6ie.
1 understand that any ia►se statement may be punishable by fine orTm�risonment under 18 U S.Code Section 1001
CERTIFIER'S NAME David L Smith LiCENSE NUMBER 5265
TtRE Profess�br.al Sun+eyor and Mapper COMPAtv"f�ME David L Srrath Surveying�d Mappng
ADDRESS CfTY STATE ZIP CGDE
1406 W.linebaugh Ave. Tampa FL 33612
SfGNATURE � /� AT TELEPHONE
�' A t"'-- 3��� L 813-9�-1960
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� FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions