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1846 VENETIAN POINT DR FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 ���ov��p�D / _� NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 "� ELEVATION CERTIFICATE Im rtant: Read the instructions on a es 1-7. SECTION A-PROPERTY OWNER INFORMATION Far insurance Corripany Use: UILDING OWNER'S NAME Policy Number - CHAD RICKETTS BUILDING STREET ADDRESS,SIncluding t.,Unit,S te,and/or Bidg.j►lo.)OR�.O.I�OUTE AND BOX NO. Company NAIC Number RESIDENTIAL l�7� e,cl,� �!!���( /o,,v /,J,� , , CIN STATE ZIP CODE CLEARWATER FL 33769 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Paroel Number,Legal Description,etc.) LOT 12,BLOCKA,VENET�AN POINT BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) RESIDENTIAL LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type): ( �i#°-##'-##.##" or ##.� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad AAap ❑Other. SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNIN NAME 8 COMMUNIiY NUMBER 62.COUNTY NAME B3.STATE CITY OF CLEARWATER 125096 PINELLAS FLORIDA B4.MAP AND PANEL B7.FIRM PANEL B9.BASE F100D ELEVATI S NUMBER B5.SUfFIX 86,FIRM INDEX DATE EFFECTIVEIREVISED DATE 88.FLOOD Z 12103G0106 G 9✓3�03 g/,�p3 � 610.Indiqte the source of the Base Flood Eleva6on(BFE)data or base flood depth en6ered in B9. ❑FIS Profile �FIRM ❑Communily Determined ❑Olher(Desaibe):_ B11.Indicate the elevaUon datum used fur the BFE in B9:0 NGVD 1929 �NAVD 1988 ❑Olher( F�� � � 2fl Q6 � B12.Is the buildi located in a Coastal Bamer ResourCes stem CBRS area or Ofhervuise ProlecGed Area OPA? ❑Yes ' nation Date SECTION C•BUILDING ELEVATION INFORMATION(SURVEY REQUI _ 7 C1.Building elevations are based on:�Construction Drawings* �Building Under Construction* ❑Finished Cons n �lT�! QP I.�Af�WA1E�R 'A new ElevaUon Cefi6cate will be required when conshuc�ion of the building is complete. •Building Diagram Number 6(Select the building diagram most similar to the building for which this certificate is being comple0ed-see pages 6 and 7. If no diagram aa:urately represents the building,provide a sketch or photograph.) C3.Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,W-V30,V(with BFE),AR,ARIA,AR/AE,ARIA1-A30,AR/AH,AR/AO Complete Items C3.-a-i below according b the building diagram spea6ed in Item C2 State fhe datum used.If the datum is different from the datum used for the BFE in Section B,convert the datum to that used for the BFE.Show field measur�ments and datum conversion calculaUon. Use ihe space provided or the Comments area of Section D or Section G,as appropriate,to document fhe datum conversion. Datum NAVD 88 ConversioNComments ;��'" Elevation reference mark used AURAL F Does the elevation reference mark used appear on the FIRM? ❑Yes �No n K�,,,�• o a)Top of botbom floor(induding basement or er►dosure) 5. 87 ff.(m) �; �.��`�� i,� �w`;��., o b)Top of next higher floor 17.92 ft.(m) �' �`'� �' { �' •�`` � 1 I o c)Bottom of lowest horizontal structural member(V zones only) 15.18 R(m) o o -.y � '� ;3, o d)Attached garage(top of slab) 5. 87 fl(m) E� • F s�r o e)Lowest elevation of machinery andlor equipment W� ` ; `. , � servidng the building(Desaibe in a Comments area) 16.01 ft(m) �� ���. o �Lowest adjacent(finished)9����) 4.8 ft.m z � �' `` `` � � ) o�� ' ���`(:�,� ....• �.�,,�, .� o g)Highest adjacent(6nished)grade(HAG) 5. 1 ft.(m) � #25?2..�a��o�ros� o h)No.of permanent openings(flood venLs)within 1 R above adjacent grade NA � ° o i)Total area of all perm�ent openings(flood vents)in C3.h NA sq,in.(sq.cm) SECTION D-SURVEYOR,ENGINEER,OR ARCHRECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I certify thaf the information in Sections A,B,and C on fhis certificate represenfs my besf effo►fs to interpret the data available. 1 undersfand that any false statement may be punishable by fine or imprisonment under 18 U S Code Section 1001 CERTIFIER'S NAME GEORGE A.SHIMP II LICENSE NUMBER 2512 TITLE PRESIDENT COMPANY NAME GEORGE A.SHIMP II b ASSOC.,INC DRESS CIN STATE ZIP CODE 3301DES0 OULEVARD PALM HARBOR FL 34683 SIGNAT DATE TELEPHONE 0. 060009 01/09/06 727-784-5496 : FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding infortnation from Section A. Fa insur�ce canpany use: BUILDING STREETADDRESS(Induding Apt,Unit,Sui�,and/or Bldg.No.)OR P.O.ROUTE AND BOX N0. PdicyNumber ' 1846 VENETIAN POINT DRIVE CITY STATE ZIP CODE CanpanyNAIC Number J CLEARWATER FL 33769 SECTION D•SURVEYOR,ENGINEER,OR ARCHRECT CERTIFICATION(CONTINUED) • Copy both sides of this Elevation Certificate for(1)oommunity ofiaal,(2)insurance agent/company,and(3)building owner. COMMENTS - _ =— - — --° __ — SECTION 3C.e) AIR CONDITIONER PAD ������A � A „�r :�:.s�''�1=�l������.�:�'3� RICKETTS, CHAD Zoning: �MDR atlas# 259B ❑Chedc here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zone AO and Zone A(wifhout BFE),oomplete Items E1 through E4. If the Elevation Ce�tificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1.Building Diagram Number_(Select the building diagram most similar to the building for which this cerfificate is being compleDed-see pages 6 and 7. If no diagram aa;urately represenls the buikling,provide a sketCh or photograph.) E2.The top of the boltom floa(induding basement or end�ure)of the building is _ft.(m)_in.(cm)0 above or ❑below(chedc one)the highest adjacent grade. (Use natural grade,if available). E3.For Building Diagrams 6-8 with openings(see page�,the next higher floor or elevated floor(elevation b)of the buikJing is _�.(m)_in.(cm)above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4.The top of ihe platform of machinery andlor equipment serviang the building is _ft.(m)_in.(cm)�above or ❑below(chedc one)the highest adjacent grade. (Use natural grade,if available). E5.For Zone AQ only: If no flood depth number is available,is the top of fhe bo(tan floor elevated in accorclance wiG�the communitys floodplain management ordinance? ❑Yes ❑No ❑Unknown. The bral otf�ial must cerGfy ihis informatlon in Sec6on G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The properiy owner or owners authaized representative who completes Sec:6ons A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community- issued BFE)or Zone AO must sign here. The statements in Sedans A,8,C,and E are cor►ect to the best of my krrowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME • ADDRESS CITY STATE ZIP CODE S�GNATURE DATE TELEPHONE COMMENTS ❑Chedc here if attachments SECTION G•COMMUNITY INFORMATION(OPTIONAL) The local ofiaal who is authorized by law or ordinance to administer the communit�s floodplan management adinance can oomplete Sec6ons A,B,C(a E),and G of this Elevation Certificate. Complete the applicable item(s)and sign below. G1.�The information in Sec6on C was iaken fran other documenta6on that has been signed and embossed by a licensed surveyor,engineer,or architect who is authorized by state or local law to certify elevation information. (Indicate tl�e source and date of the eleva6on data in the Comments area below.) G2.�A community offiaal completed Sec6on E fo�a building located in Zone A(without a FEMA-issued or community-issued BFE)a Zone A0. G3.0 The following information(Items G4-G9)is provided for community floodplain management purposes. G4.PERM!T NUMBER G5. DATE PERMIT ISSUED G6. DATE CERT�FICATE OF COMPLIANCE/OCCUPANCY ISSUED G7.This pertnit has been issued for.0 New ConsUudio� ❑Substantial improvement G8.Elevation of as-built lowest Aoor(induding basement)of the building is: __ft(mj Datum:_ G9.BFE or(in Zone AO)depth of iboding at the building site is: _._R(m) Datum:_ LOCAL OFFICIAL'S NAME TITLE COMMUNIN NAME TELEPHONE SIGNATURE DATE i COMMENTS ❑Chedc here if attachments FEMA Form 81-31,January 2003 Replaces all previous editions � , : FEDERA�EMERGENCY MANAGEMEN7 AGENCY O.M.B. No, 3067-0077 NATIONAL FLOOD INSURANC� PR�GRAM Expires.luly 31, 2002 ELEVATION CERTIFICATE important: Read the instructions on a es 1 -7. ION A-PROPERTY OWNER INFORMATION Forineuranc�Compsoy Uae - BUILOlNG OWNER'S NAME � , :�dic�*Numbe:r * � .> � CHAD RICKETT .:-. ,.. _... . ::. �,> < ; BUILDING STREET ADDRESS(I�cludlnp Apt„Un�t,Sulte,a�dlor Bldp,No.)OR P.O.ROUTE AND BOX NO. �Cmpe�9y NA1C N�Ilttpe[ .,,;;. ' : 1846 VENETIAN POINT DRIVE ,.. . ....... ,::............::........>...,......,.:>,.»,,..,. , ,:.:,,., .........;:,::.:............ STATE ,. ZIP CODE CLEARWATER ������ �,�� ' �� c � F� PROK�ERTY DESCRIPTION(Lot end Blxk Numbe�s,7ax Parcel Number,Legal Deacriptlon,etn.) LOT 12,BLK,A,VENETIAN POINT �UIL�INo U5E(e.g.,Raslcfential,Non•resldenftal,Additlon,Acceswry,etc. Use Commenls eectlon If nece6sary,) � RESiDENTIAI �lAT1TUDE/IONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Type); ( q#°-�NN'-�f#.##" or #M.�°} �NAD 1927 Q NAD 1983 ❑ USaS Quad Map ❑Other: SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION � 61.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2,COUNTY NAME B3.STATE j CITY OF CLEARWATER 125098 PINELLAS 4 � FLORIDA i 64.MAP ANb PANEL B5.SUFFIX B6,FIRM INDEX 87.FIRM PANEL B8.FLOOD 89.BASE F1,000 ELEVATION(S) NUMBER OATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,usa deplh of flooding) � �� D 8ii9/91 8119/91 VE 13' �. _ �i10, Indir,ate the source of the 6ase Flood Elevation(6FE)date or hase flood depth entered in H9, � ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe): L�11. Indicate the elevation datum used for the QFE in B8: � NGVO ?928 ❑ NAVD 1988 ❑Other(Deacribe): (.312. Is tlie bullding (ocated in a Coastal Barrier Resources System(CBRS)eree or Othennise Protectad Area(OPA)?❑ Yes � No Designatlon Oate SECTION C -BUILDINa EIEVATION INFORMATION(SURVEY REQUIREO) C 1. Building elevations are based on: ❑Construction Orawings' ❑Bullding Under Construdion' � Finlshed Construction 'A now Efevation Certificate witl be requlred when constructlon of the building is complete, , . Bullding piagram Number 1(Select the bullding dlagrem most simllar to the building for whlch this certificate is being oompleted-see pages B and 7. If no diagram accurately represents the building, provlde a sketch or photograph.) C3. Elevations—Zones A1-A30, AE, AH,A(with 8FE), VE, V1-V30, V(wlt� BFE),AR, ARlA, AR/AE,AR/A1-A30,ARlAH,AR/AO Complete Items C3a-i below according to the bullding dlagram specified in (tem C2. State the datum used. If the detum Is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements ahd datum converslon calculation Use the space provided or the Comments area of Section D or Section G, as appropriate,to document the datum conve�slon Datum Conversion/Comments Elevation reference mark used_Does the elevation reference merk used appear on the FIRM? ❑ Yes � No o a)7op of bottom lloor(including basement or enclosure) ¢.Qft,(m) � u b)Top of nsxt higher floor 6 . 5 ft.(nn) '" � o c) Bottom of lowest horizontal structural member(V zones only)�.�ft.(m) 9 m o d)Attached garage(top of sleb) �,Qft�m� �� �`� 0� o e) Lowest elevstlon of machinery end/or equipment �� servfcing the buildin g a � � 9 6. 1ft.(m; �� (Q1 � f)Lowest adjecent grade(LAG) 5, 9h. m �t n g)Highest adJacent grade(HAG) ¢, 4n.�m� Sy o h) No. of permanent openings(flood vents)within 1 R. ebove adjacent grade_ � � i)Total erea of all permane�t openings(flood vents)in C3h sq, in, (eq.cm) SECTION D-SURVEYOR, ENpINEER,OR ARCHITECT CERTIFICATION This certification is to be slgned and sealed by e land surveyo�, engineer, or architect autho � y 'I�vat` � I f tlon. !certlty thet the information!n Sections A, 8, and C on fhls ceni�icate repr�sents my best e r � I undersfand that anx false stetement mey be punishab/e by llne or im�r�sonmonl under 19 de, Section 100i. CERTtFIER'S NAME GALEN K:BELL LICENS �RA�� 2000 �TLE PROFESSIONAL SURVEYOR 8 MAPPER COMPANY NAM6 AME SURVEYING 8 MAPPING,( . DRESS CITY � �, EY : 32Q E_SOU7H 5 RE T �i 6 ORLAND�_ ` .,?.F�,.' ' ��-EA, SIGNATURE /� DATE TELEPH�NE _ - P � 6/9/00 407-428-7979 � �=EMA Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITION: ZO 'd ibL6 9Z�b LOb JNIJl3/�2if1S NtY�I�i3Wtf d00= Z0 00—�Z— L�C' .IMPORTANT; In tfieae apeces,copy the corraspondlttg informatlon /rom SeCtlon A. Eori��rd�cACnmpally'lJsa BUILDING STREET AO�RESS(I�cludinfl Apt,Unit,Suibe,and/of Bldg.No,)OR P.O.ROUTE AND BOX NO, 'Pohry Numbrt>` ";M '•- >� � �....w....... �.�? ' . , r. 1846 VENETIAN DRIVE ' ` �' ���� --� . ,.. . CITY STATE TJP CODE �ompehy�^NAiC�,Numher.. -•.�; CIEARWATF.R Fl :::.,: :.,,,,.; . SECTION D-SURvEYOR,ENaINEER. Oi2 ARCHITECT CERTIFICATiON(CONTiNUED) Copy b�th sides of this Elevation Certiticete for(1}community ofiicial, (2) Insurance agenUcompany, and(3) building ovmer. _ COMMENTS ELEVA710NS SHOWN HEREON ARE BASED ON PINELLAS COUNTY DATUM;MAP�t132_„__, -—" � '� ❑ Check here If attachments SECTION E-BUILDINO ELEVATION INFORMATION{SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(W17HOUT BFE) I'or Zone AO anC Zone A(without BFE),complete ltems E1 through E4. If the Elevation Cerfificate!s inlended for use as aupporting i��fsormatio�for a LOMA or LOMR-F, Section C must be completed. - I:�. Building �iagram Number_(Setect the building diagram most slmilar to che building tor which lhis ceRificate is belnq campleted-see peges f3 and 7. If na diegram accuretely represents the building, provide a sketch or photograph.) �2, '�he top of the bottom (loor(including basement or enclosure)of the building Is_ft.(m)_in.(cm) ❑ above or ❑below(check one) the highest adjacent grade, k':3. For Building Diagrams 8-8 with openings(see page 7), the next higher floor or elevated floor(elevation b)of the bullding is _ft,(m)_in.(cm) ebove the highest adjacent grade. �4, For Zone AO only: If no flood depth numbef Is avallable, is the top of the bottom floor elevated In accordance with the community's flood laln mana ement ordinance��Yes ❑ No [] Unknown. The local official must certi this informatlon in Section G. SECTION F-PROPERTY OWNER.(OR OWNER'S REPRESENTA7IVE)CERTIFICATION The property owner or owner's euthorized representative wl�o completes Sec�tlons A, B, end E tor Zone A(without a FEMA-Issued or community-issued BFE)or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME •AD�RESS CITY STATE ZIP CODE —� ' " DATE TELEPHONE SIaNATURE COMMENTS r ' ' ❑ Check here If attachments 5ECTION �-COMMUNITY INFORMAT101V(OPTIONAL) 7he local afficial who is authorizeC by law or ordinence to administer the community's floodplain menagement ordinenca can complete Sections A, 8, C (or E),and G of this Elevetion CeRlflcate. Complete the appllcable item(s) and slgn below. c.�1. (]The informatlon in Section C was taken from other documentetlon that hes been signed and embossed by a licensed surveyor, enylneer, or architect who is authorized by state or local law to certlfy elevation lnformatlon. (Indlcate the source and date of the elevatlon data in the Comments area below.) (�2. ❑ A community official completed Section E for a building loceted in Zone A(without a FEMA-issued ar community-issued BFE)or Zone AO. G3, ❑ The fo{lowing information (Items G4-G9)is provided for community floodplain manegement purposes. G4.P6RMIT NUMHER G5. DATE PERMIT ISSUEO SS EDTE CERTIFICATE OF COMPLIANCE/OCCUPANCY C .. . c:7. This permlt has heen issued tar: ❑ New Construction❑ Substantlal Improvement C:;8. Elevatlon of as-built lowest tloor(includfng basement)of the Duilding Is: _ft.(m) Datum: C�9. BFE or(In Zone AO) depth of flooding at the building site is: _ft.(m) Qatum: LOCAI OFFICIAL'S t+IAME 7l rLE ;_._.., � _..._.,,..,�..... � COMMUNITY NAME � TELEPHONE i i�i; 51GNATURE � DATE COMNIENTS • � :�, - � • ttachmen4 'r':.�f`rar„. ����:�� _ . . : . ...:.:.r..:,�; c:,. F EMA Form 81-31, AUG 99 REPIACES ALL PREVIO S EDITION: EO ' d Zt�L6 9Zb LO�b JNI.l3/��ff15 Ntf�I2�3Wtf dI0 = Z0 00-bZ- L�C