1828 VENETIAN POINT DR onnB rvo. �ssaoaos
.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE �pires Februarv 28. 2009
leral Emergency Management Age�cy
:tior�al Flood Insurance Pr'ogram Important: Read the instructions on pages 1�.
_ ___ __ __ _
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. Building Owner's Name Policy Number �
PLM CONTRACTORS and ROWLAND &KATHY MILAM �
A2. Building Street Address(induding Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Company NAIC Number �
1828 VENETIAN POINT DRIVE Z
C� State ZIP Code �
CLEARWATER FLORIDA 33758 O
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
FOLIO 04/29/15/93894/001l0030 LOT 3 BLOCK A,VENETIAN POINT SUBDIVISION, RECORDED IN PLAT BOOK 27,PAGES 26 AND 27 �..
A4. Building Use(e.g.,Residential,Non-Residential,Addfion,Accessory,etc.) RESIDENTIAL Z
A5. LatitudelLongitude:Lat.N27°59'14" Long.W82°47'S5" HorizoMal Datum: NAD 1927 ❑NAD 1983 � Q �
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. �- r-
A7. Building Diagram Number ONE W �
A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: Z O
a) Squa�e footage of crawl space or enclosure(s NA sq ft a) Square footage of attached garage 400+/- Sq ft W �
b) No.of permanent flood openings in the crawl space or b) No.of permaneM flood openings in the attached garage �
enclosure(s)walls within 1.0 foot above adjacent grade NA_ walls within 1.0 foot above adjacent grade NONE > �
c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b NA sq in � N
a
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION ��
61.NFIP Community Name&Community Number 62.County Name Q3-��
CLEARWATER 125096 PINELLAS COUNTY FLORIDA
B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel 88.Flood B9.Base Flood Elevation(s)(Zone
Date Effectinre/Revised Date Zone(s) AO,use
12103C 106 H 5-17-05 5-17-05 VE 15.00
B70. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69.
❑FIS Profile �FIRM ❑Community Determined ❑Other(Describe)
611. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 �NAVD 1988 ❑Other(Describe)
812. Is the building located in a Coastal BaRier Resources System(CBRS)area or Othervvise Protected Area(OPA)? �Yes � No
Designa6on Date �CBRS �OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. 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 Ai-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete ttems C2.a-g
below according to the building diagram specified in Item A7.
Benchmark Utilized CITY OF CLEARWATER BM I-O6 -Vertical Datum NAVD 1988 PUBLISHED ELEVATION OF 11.5778
a) Top of bottom floor(including basement,crawl space,or enclosure floor 5.35 FEET � � � � a � �
b) Top of the next higher floor 6.70 FEET
c) Bottom of the lowest horizontal structural member(V 2ones only) SLAB ON GRADE I
d) Attached garage(top of slab) 4.66 feet � JqN Z 6 2009 i
e) Lowest elevation of machinery or equipment servicing the building 4.85 feet
(Describe type of equipment in Comments)
� Lowest adjacent(finished)grade(lAG) 4.40 feet DEVELOPMENT SERVICES DEPT
g) Highest adjacerrt(finished)grade(NAG) 5.25 feet CtTY OF CLEARWATER
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation ".£•a;'
information. I certify thaf the infom►afion on this Certificate represents my best efforts to interpret fhe data available. ° a �, ;„-
1 understand that any false stafement may be punishable by fine or impnsonment under 18 U.S. Code, Section 1001. B ILL �°����;q���+,,,. �
❑Check here if comments are provided on back of form. P LS, ��¢�.3�0/��,*� �.
Certifier's Name License Number P " , '��`- �y,�„;
BILL HYATT FLORIDA LICENSE#4636 O 1 '�.���2��,��� �. ,'�
Title Company Name r�_ .; ,,4 , "�-
PRESIDENT KNOW IT NOW WC. ° ° `°" '
Add�ess City State ZIP Code ��. ,. ���
MAIL=1497 MAIN STREET#321 DUNEDIN FLORIDA 34698 � • � , � . ��°� , ;_
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DATE: t-2&2009 TELEPHONE: 727-415-8305 ,
FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions
�ORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use:
— _ _ _
;ilding Street Address(includi�g Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Pdicy Number
828 VENETIAN POINT DRIVE
;,ity, State ZIP Code Company NAIC Number
CLEARWATER FLORIDA 33758
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sid�`s 4f t�►iS Elevation Certificate for(1)community official,(2)insurance agenticompany,and(3)building owner.
Co tits �,�4. /.�}, A�r
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'r����� � - , Date 1-26-2009
.,s , •o"�,+�, • �,r '�j`. , Check here if attachments
".�EC fDl�-�fL G ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
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For��q�g;A�ar1��¢(�irithout BFE),complete Items E1-E5. if the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C�"'�o�'�e��,�1 EA,'ase natural grade,'rf available. Check the measu�emerrt used. In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacerrt grade(LAG).
a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑ meters ❑above or ❑below the HAG.
b)Top of bottom floor(including basement,crawl space,or enclosure)is _❑feet ❑meters ❑above or ❑below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 andlor 9(see a e 8 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is _Q feet ❑meters ❑above or �below the HAG.
E3. Attached garage(top of slab)is �feet Q meters �above or � below the HAG.
E4. Top of platform of machinery andlor equipment servicing the building is _�feet �meters �above or �below the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with tfie community's floodplain managemerrt
ordinance? ❑Yes ❑No ❑Unknown. The local official must certify this information in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owne�'s authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements in Sections A,8,and E are correct to the 6est of my knowledge.
Property Owner's or Owner's Authorized Represerrtative's Name
Address City State ZIP Code
Signature Date Telephone
Commerrts
❑Check here if attachmeMs
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),
and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measuremeM used in ftems G8.and G9.
G1. � The information in Section C was taken from other documentation that has been signed and sealed by a lice�sed surveyor,engineer,or architect who
is authorized by law to certify eleva6on information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7.This permit has been issued for: � New Construction ❑Substantial Improvement
G8.Elevation of as-buift lowest floor(including basement)of tfie building: ❑feet ❑meters(PR) Datum
G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum
Local Offiaal's Name Tdle
Community Name Telephone
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, February 2006 Replaces all previous editions
i
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Buitdir�g Street Address(including Apt., Unit, Suite,andla'Bldg. No.)or P.O. Route and Box No. Policy Number
1828 VENETIAN POINT DRIVE
City State ZIP Code �y�N�
CLEARWATER FORIDA 33758
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the
instructions for Item A6. Identify all photographs with: date taken; "Front Vievd' and "Rear Vievd'; and, if required, °Right Side
Viev�' and°Left Side View." If submitting more photographs than will fit on this page, use the Continuation Pa e, following.
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