1837 VENETIAN POINT DR ELEVATION CERTIFICATE O.M.B. No. 3067-0077
. FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999
" NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waivar of the flood insurance purchase requirement.This form is used only to pro-
vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to determine
the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision(LOMA or LOMR).You a�e not
.equired to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form.
Inatructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER
ROY EUGENE FLEMING
STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
1837 VENETIAN POINT DRIVE
OTHER DESCRIPTION(Lot and Block Numbers,etc.)
LOT 31 BLOCK A VENETIAN POINT SUBDIVISION
CITY STATE ZIP CODE
CLEARWATER FL.
SEC�IOi� B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the following from the proper FIRM (See Instructions):
1.COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION
(in AO 2ones,use depth)
125096 0008 D 8-19-91 VE 12
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE): ❑NGVD'29 ❑Other(describe on back)
8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site,indicate
the community's BFE:��.U feet NGVD(or other FIRM datum—see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions,indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level_1_ .
�(a). FIRM Zones Ai-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation
of(_�_�__��.0 feet NGVD(or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1-V30,VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram,is at an elevation of��,/(J feet NGVD(or other FIRM datum—see Section B, Item 7). SEE BACK
(c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is W.0 feet above❑ or
below❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W.0 feet above❑ or below❑(check
one)the highest grade adjacent to the building. If no flood depth number is available,is the building's lowest floor(reference
level)elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:❑ NGVD'29 ❑ Other(describe
under Comments on Page 2). (NOTE: If the e/evation datum used in measuring the elevations is different than ihat used on
the FIRM (see Section B, Item 7J, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: ❑ Yes ❑No (See Instructions on Page 4)
5.The reference level elevation is based on: ❑ actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the re%rence/evel floor in place,in which
case this certilicate will only be valid for the building during the course of construction. A post-construction Elevation Certificate
will be required once construction is complete.) �
6.The elevation of the lowest grade immediately adjacent to the building is:��.U feet NGVD(or other FIRM datum-see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for veritying building elevations specifies that the reference level indicated in Section C, Item 1
• is not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest
floor"as defined by the ordinance is: �J.0 feet NGVD (or other FIRM datum—see Section B, Item 7).
2. Date of the start of construction or substantial improvement .
FEMA Form 81-31, AUG 96 REPLACES All PREVIOUS EDI710NS SEE REVERSE SIDE FOR COMTINUATION
SECTION E CERTIFICATION .
This certification is to be signed by a land sunreyor,engineer,or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones A1—A30,AE,AH,A(with BFE),V1—V30,VE,and V(with BFE)is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information,may also sign th
certification. In the case of Zones AO and A(without a FEMA or community issued BFE),a building official, a property owner,or�
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8-Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment,area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
l certify that the inlormation in Sections 8 and C on this certiiicate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.,,
....� 1MY�t�l1, .
CERTIFIER'S NAME LICENSE NUMBER(or AHix Seal) <<k �ti ; ' °"� v!),t' '
GEORGE A. SHIMP II 2512 � .
TITLE ,� o,�.�'.. ,�:,�' ._.., .
COMPANY NAME " ' „°F_. r t• �� ��, ��_
PRESIDENT GEORGE A. SHIMP I I & ASSOC. �� N tv :�-� �'�=�''��
AD�RESS CITY � � ..-- � A
3301 a �OTO BLVD. �,•� r��. A��, ' :�.�.. ,z�P, _
PALM HAFt�30k •, �� , 3�#683
SIGN `
980364 DATE PHON��'•.,,,.•" ,.�",''
6-29-98 784=�54�,9� - -� `, ,
Copies should a e of thls Certlficate for: 1)community official,2)insurance agenUcompany,and 3)building owner.
COMMENTS: THE HOUSE APPEARS TO BE BUILT PRE-FIRM THE LOWEST F R - �
ON WITH
ON PILES,
S�AB BASEMENT PIERS,OF COLUMNS
A � A A V
ZONES ZONES ZONES ZONES ZONES
HEFEHENCE
REFERENCE LEVEL REfERENCE
IEVEI BASE
FLOOD IEVEI
EIEVATION
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FIOOD •''::`�'�':�'. ADJACENT :�.;:.`;�,:�;'. REFERENCE FLOOD
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The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor. •
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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