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606 SNUG ISLAND U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires MarCh 31,2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For insu�ance Company Use: At. Building Owner's Name Brent A.Berthy 8 Julie A.Berthy Policy Number A2. Building Street Address(including Apt.,Unft,Sude,and/or Bidg.No.)or P.O.Route and Box No. Comparry NAIC Number 606 Snug Isiand City Clearwater State FL ZIP Code 33767 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legai Description,etc.) ParcellD#05-29-15-43456-071-0060 A4. Building Use(e.g.,Residential,Nan-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.27.986974 Long.-82.817504 Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building'rf the Cert'rficate is being used to obtain fiood insurance. A7. Building Diagram Number 1 B AS. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawispace or enclosure(s) N/A sq ft a) Square footage of attached garage 440 sq ft b) No.of pertnanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of f�ood ope�ings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State City of Clearvvater 125096 Pinellas FL B4.Map/Panel Number B5.Suffix B6.FIRM index 67.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 12103C0102 G Date Effective/Revised Date Zone(s) AO,use base flood depth) 8-18-09 9-3-03 AE 11' 61 o. 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) B11. indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other(Describe) Bt2. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes � No Designation Date N/A ❑ 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. CL. CI6V3UOf15-LUfleS„i'i1JV,i�C,i1fi,iy\wiii�o�cj,v�,v i-v:�v,v�Wiiii o��j,nn�f�1fnLS9�/�'1NP1L�nNn 1'/�'�JV�n°�nii,n��nv. vviiNicic liciiJ V�.�a-ii below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized CITY OF CLRWT I-03.5 Vertical Datum ELEV=6.4912'(N.A.V.D.) Conversio�/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawispace,or enclosure floor)8.23 �feet ❑meters(Puerto Rico only) b) Top of the next higher floor 16.82 �feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structurai member(V Zones only) N.A �feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) 7.5 �feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 7.64 �feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 72 �feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 7.8 �feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including N.A �feet ❑meters(Puerto Rico only) structural support 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 information. I certify ihat the inlormation on this CeRificate represenis my best elforts to interpret the data available. I undersiand that any false statement may be punishable by fine or imprisonment under i8 U.S.Code,Section 1001. � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? � Yes ❑ No Certifier's Name Philip C.Stodc License Number RLS#3035 Title President Company Name Target Land Surveying,Inc. Address 516 Lakeside Piace City Largo State FL ZIP Code 33771 Signature Date 11-7-12 Telephone (727)784-0573 FEMA Form 81-31,Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Urtit,Suite,and/or Bldg.No.)or P.O.Route and Box No_ Policy Number 606 Snug Island City Clearvvater State FL ZIP Code 33767 'Gomparry NAIC Number SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERT�FICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)i�surance agenUcompany,and(3)building owner. Comments Job#121030.01 C.2.e)=A/C Unit According to the Pinellas County Property Appraiser,this structure was built in 1970. At that time,FEMA flood maps did not exist. Signature Date 11-7-12 ❑ Chedc here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND Z�NE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items Et-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement 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 adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or�below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 andlor 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platfortn of machinery and/or equipment servici�g 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 the community's fioodplain management 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 owner'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,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The{ocai officiai 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. Chedc the measurement used in Items G8 and G9. G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a buiiding located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The foliowing informatio�(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-built lowest floor(inciuding basement)of the building: ❑feet ❑meters(PR)Datum G9. BFE or(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 Title Community Name Telephone Signature Date Comments ❑Check here'rf attachments FEMA Form 81-31,Mar 09 Replaces ail previous editions � . , Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Poiicy Number 606 Snug Island City Clearwater State FL ZIP COdO 33767 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Ident'rfy all 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"—Pictures Taken 11-6-12 � »-- _ . ..r�ro,,, ..� x� � _ �:�u�wu , :::� �;�.,� _ � �...,��_ .�;.� �. � �II ;�: '����_ ,� ;.� "Rear View"-Pictures Taken 11-6-12 "_�""1 - ,� �. � ,,. �, � �fi � �. _ . . �; �_- . _. _ . � __ _ .__._ ___ __-, -... ,s� . . � -- - _ ";a �;.-,�� � ,. ...* � __ � ., , �.,, . y �! � �jl�.� ' k. ./j �4I� I �+ S.� � _t: t .� �r� � � � � ����.w ._ t`.�.. . . .. � ��• p5A .��#`` '�r'?y�' �{ �r�.�ii� � .t_q� � � r „j f ,,�_„�_,,_ . m_T_-.r_�t_ t �.. � �-;- -,�., �. r .. Building Photographs Continuation Page For insurance Company Use: Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O.Route and Box No. Po�icy Number 606 Snug Island City Clearwater StBt@ FL ZIP COde 33767 Company NAIC Nirnber If submitting more photographs than witl 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"Left Side View." 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