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743 SNUG ISLAND ✓ � � � U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31,2012 Nadonal Flood Insurance Program Importarrt: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION Fcr k�ce Ganpe►r�rUae: A1. Building Owner's Name GREGORY DROSS pp�y y��pef A2. Buiiding Street Address{including Apt.,Unit,Suite,ancilor Bldg.No.)or P.O.Route and Box No. Compsny l�41C I�tnb4r 743 SNUG ISLAND City CLEARWATER State FL ZIP Code 33767 A3. Property Description(Lot and Blcek Numbers,Tax Parcel Number,Legal Description,etc.) LOT 30,UNIT 76 ISLAND ESTATES OF CLEARWATER PLAT BOOK 64,PAGE 70,PINELLAS COUNTY FLORIDA A4. Building Use(e.g.,Reside►nial,Non-Residential,Addition,Accessory,etc.)RESI�ENTIAL A5. Latitude/Longitude:Lat.N27.9915" Long.W82.8185° Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certif'�cate�being used to obtain fload insurance. A7. Building Diagram Number 1 A8. For a building with a crawispace or encl�ure(s): A9. For a buiiding with an attached garage: a) Square footage M crawlspace or enclosure(s) N!A sq ft a) Square footage of attached garage 529 sq ft b} No.of permanent flood openings in the crawlspace ar b) No.of permanent flood openings in the�tached garage enclosure(s)within 1.0 foot above adjacent grade iA within 1.0 foot above adjacerrt grade I�// c) Tatal net area of flood openings in A8.b NLA sq in c) Total net area of flood openings in A9.b 1�/A sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings7 ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name 8 Community Number B2.County Name 63.State CITY OF CLEARWATER 125098 PINELLAS FLORIDA B4.Map/Panei Number 85.SufBx Bfi.FIRM Index B7.FIRM Panel B8.Flood 89. Base Flood Eleva6on(s)(Zone 12103C0102G G Date EffectivelRevised Date Zone(s) AO,use base flood depth) 09/03/2003 09l03/2003 AE 11 610. Indicate the source of the Base Flood Elevadon(BFE)data or base fbod depth errtered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other(Describe)NIA 811. Indicffie elevation datum used for BFE in Rem 69: ❑ NGVD 1929 ❑ NAVD 1988 � Other(Describe) 1�lA 612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date N1A ❑ CBRS ❑ OPA SECTION C-BUILDINC3 ELEVATION INFORMATION(SURVEY REQUIREDj C1. Building elevations are based on: ❑ Cor�sttruction Drawings' ❑ Building Under Construcdon` � Finished Construction 'A new Elevation Certiflcate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,Vt-V30,V(with BFE),AR,AR/A,AR/AE,ARlAt-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to ihe buildi�g diagram spec�ed in Item A7. Use the same datum as the BFE. Benchmark Utilized CITY CLEARWATERVertical Datum 7.52T NAVD88 Conversion/Commer�ts N/A Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor)7.� - �feet ❑meters(Puerto Rico only) b) Top of the next higher floor N1A. ❑feet ❑meters(Puerto Rico only) c� Bottom of the lowest horizontal structural member(V Zones only) _ ❑feet ❑meters{Puerto Rico oniy) � Attached garage(top of slab) 7.�6 �feet ❑meters{Puerto Rico only) e) Lowest elevation of machinery ar equipmerit servicing the building 7.68 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) � Lowest adjacent{finished)grade next to building(LAG) 6.75 �feet ❑meters(Puerto Rico only) g) Highest adjacerit(tinished)grade ne�ct to building(HAG) 7.28 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest e�evation of deck or stairs,including N/A. ❑feet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION Th�s certification�s to be s�gned and sealed by a land surveyor,engineer,or architect authorized by lawto certiffy elevation ��aa��a�rrl�, �' information. /certi/y that fhe infom►allon on fhis CertiBcafe represenfs my best e!!'arts to infeipret the data availabte. �t�a, �� 6���,,' 1 undersiand that any fafse statement may be punishable by frne or imprisonmen[under 18 U.S.Code,5ection 1001. �,�����4���� ,����1��;'�r � � Check here if comments are provided on back of form. Were latitude and longitude in Secdon A provided by a ����- � �,�� ,li' lice�ed land surveyor? � Yes ❑ No =�;����� � � --,� ��� �Z_ C e r U f i e r's N a m e H E C T O R L E B R O N L i cense Num b er A I 6 6 3 4 =�• "� �;�;-=.: p TRIe PSM Company Name LEBRON GROUP SURVEYING 8 MAPPING CORP. ::�, '"�.��r4.. .,�° ,.� , � 1Zft�� � . �. Address 1055 PALOS VERDE DRIVE Cdy ORlANDO State FL ZIP Code 32822 �' � :�p�F,..�°���,�`~ \ Sg�ature �'' Date 08/Z4/Z012 Telephone 407 781-9329 r�;�//��f�/� � ��\���\4 �'ri�,;�,i, FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces a0 previous editions IMPORTANT: In these spaces,copy the corresponding inTormation from Sedbn A. Far k�oe C�Us� ' Building Street Address(including Apt.,Unit,Sufte,arxilor Bidg.No.)or P.O.Route and Box No. p�y p� 743 SNUG ISLAND Clty CLEARWATERState FL 21P Code 33767 �q�y��� SECTION D-SURVEYOR, EN(31NEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides oi this Elevation Certificate for(1)communiry official,(2j insurance agertt/company,and(3)building owner. Commerrts NOTE:THIS EIEVATION IS NOT FOR CONSTRUCTION PURPOSES,THIS IS ONLY FOR INSURANCE PURPOSES.THE ELEVATION C2 E IS A A/C PAD. CROWN:4.15'NAVD 88 Signature (--' Date 08/24t2012 � Check here if�hmerds SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND 20NE A{WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is iMe�ded to support a LOMA or LOMR-F request,complete Sections A,B, and C. For ttems E1-E4,use natural grade,if available. Check the measurement used. In Pueho Rico only,errter 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 adjace►�t grade(LAG). a)Top of bottom floor(including basement,crawlspace,or e�losure)is ❑feet ❑meters ❑above or❑below the HAG, by Top of bottom floor(incl�ing basement,crawlspace,or er�cloeure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A items 8 a�/or 9(sce ages&9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the buiiding is ❑feet ❑meters ❑above or �below the HAG. E3. Attxhed garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of m�hinery andlor equipment servicing the buiiding is ❑feet ❑meters ❑a6ove or�below the HAG. E5. Zone AO only: If no flood de�h number is available,is the top of the battom floor elevated in accordance with the commu�ity's floodplain managemerrt oMinance? ❑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 owner's authorized represeritative who completes Sections A,B,and E fa Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statemeMs in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Reprpsentative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is autharized by law a ordmance to administer the community's floodplain management ordinance can complete Secti�s A,B,C(or E), and G of this Elevation Certificate. Complete the appiicable item(s)and slgn below. Check the measurement�ed in Rems G8 and G9. Gt.❑ The information in Section C was taken from other dxumentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is suthorized by law to certify eleva6on infamation. (Indicate the source and date of the elevation data in the Commer►ts area below.) G2.❑ A community off�ial completed Saction E for a buiiding iceated in Zone A(without a FEMA-issued w community-issued BFE)w Zone AO. G3.❑ The following infamation{Items G4-G9)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of CompliancelOccupancy Issued G7. This permit has been issued for: ❑Ne+nr Construction ❑Substarrtial Improvement G8. Elevatio�of as-buift lowest floor(including basement)of the building: ❑feet ❑meters(PR)Datum G9. BFE w(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name TiNe Community Name Telephone Signature Date Commer�ts ❑�heck here if attachmen#s FEMA Form 81-31, Mar 09 Repiaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(induding Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Paicy Number 743 SNUG ISLAND Clty CLEARWATER StBte FL Z1P COde 33767 C°mpany N'vC Number If using the Elevation Certificate to obtain NFIP flood insurance, a�x at least two building photographs below according to the instructions for Item A6. tdentify al! photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. FRONT VIEW-OSl23l2012 , .�r . .. � �� , : � i "` a ,. `s ..£t .,. .. �Yed, ,�..,, .. . .:. L � } � � � . ` g� �� :o ��� " � � �� ? �y"`i�' " " 7 : a�� k �+e'... ��;r *.?' lz E � � �: - � .. e_ �.,. _�.�:.;�� . .,. n`� '';�'', -aa ._n � . . . ,_ . ,� �_ .. . ..�. 1 , � ...., � ._ .. - . ..�.. . . �^� - _ .. � �; '� �� .YCS�f`.> _ ��:=,a, �� �'""`;�.`` '�� J xrt^ °�;,rrs �+k«.a�rt.;a�� . � £° ' � ,e„. , .. .. . Building Phatographs Continuation Page For Insurance Company Use: Building Street Address(inciuding A�., Unit, Suite,and/or Bldg.No.)or P.O. Route and Box No. Poiicy Number 743 SNUG ISLAND City CLEARWATER State FL ZIP COd2 33767 CompanyNAlCt�mber If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and °Rear View"; and, if required, "Right Side View" and "�eft 5ide View." REAR & SiDE VIEW-08/24/2012 �: �. ,.�..�-° _" � _: '��r t�.; �� '=arter�� � - - ���s E#Y►r �'.v.. 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