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1062 CHARLES STU.B.DEPARtIU�NTORtttSMELANdBECURI7Y ����(ATION CERT(F�CA�`E — ��o�t�n� �w�QENav r�nrvnaEM�►r nQ�NCY (�MB Nc�. 968U-U008 Na�t�rnnlFlcxx//nsurnriccJ�'+•c�grorn (rp�?�p1�8nt, R$ad the instructions an pages fi»9. Expi1'etiatt DBte: ,lU(y 31, 2Q15 At. Building Oumet`a Name {^�r { � �� � (` Ff A2. 6ufiding 5treet ress pnc4udi A�: �p� � � � (--� cny Ci��(�...vtil���� A3. PropertY t?eecriptlon (Lat and Blogk Nt SECTION A- PRQR�RTY tNFORN N �. �. � �..r� � C.,�/L o �.� Init Suite a�ur 81dg. Na.) os P,b. Route atxi 8ox � 7��. � � �� eoa� �,3°7 5,�' A4. 6utiding U�e te,g., �t�sld ntial�, o-�teeldentie{ Addltlon,l4 ese� eto.} �+�'� ����'`�T i7� 4"" A5. Latikude/lonflltude: Lat. `� ���. �� �` Leng, 2. �� 32 �'"'�' Haixott�al Daturrt: (� NAD i927 NA01'9�93 ' A8. Attacfi at ieast 2�otopraph� f�he buildlnq it the Ge�tRicate is belnq used t� obtal� fload insurenee. ' A7. BuAding AIaD�am Numher � A8; For e truikl�t�} wkh a art�v�lepece or errcloeure{s): �t9. Fw a hulkfing wNh an ailech�l ge�a�e: �1f aj 8quare fa�age of crawispnce or anctasure(s} (� aq ft a) Squaro toott�e af aRteohad qara�pe� N/'� sq R b} Number ot pe�rnanent fluad openbrga in the crawixpece bj Numbar � petmaneM tkrod opet�t�a in ttre tt�he�f �era�e ar er�clasta�e(s) wtithin i.Q taat above adjacst�t gr�de � Q wifh� 1.0 tooE a�anra atljap�t �1d1� cj Tdat net area ot flaod openlnpa In A6b ' Z�� sq In ' c} Totat net ares. d ttaod'apeninge kn AB.tr ' ec� � , d} Englneerod 8aad opcninps� p Yea �a d} E��rsaer�d itood opsnfn{�a? � Ye� ❑ No 3ECTIQPI H� FI.C?OD IN3URANGE FtAT� M;4R {FtRM� INFORMATICIN 81. NFIP Communit N e& Co Nu�mb B2. Crninty Ngme 83. 5tate c.c�.�.�R�'�-r �'�i�" ��.�`�a� �► P� r� � �.c.,� � �, R � c�,4 84. MeplPanei Numbar 85. 3uffix B8, FiRAA index aate B7. FIRM partel 68. Floc�d 66. Base Ftoad F_teva#onts) { ! 2( aa ��, C? ( O 1� j.� �, _ ���-b� ����e ae�d ��e z��> nc�. u�e� �g nooa a�pn, B10. !ndlcete the sa�rce atthe Be Fbad Elevatbn (9FE} data or baea t(aud depth entered In ftem B9. tfo ❑ F1S Proifle PIRM Q Community Qetermined �p��Iherl3ource: 81 t. �Indfo�te �rlevation datum used tw BFE M item ��: C? NC3VD 192� t� NAVD 1968 �� Cj Otfiert�ouroe: � / Ei13. ts ihe bt►�dinp loc�ed !n a Caastal 6atder Reaou{cea 5y�#em (GBR�t ercea or (?thervvise Protected Are� (OPA)? 0 Ye� ;, C5�' Na Qesignation qete: ❑ C�RS . I� QPA � SECT{QN G- BU1LDtNt3 EI.EVATION INFOFtMATiON (�URVEY REQUIRED) ' Ct. BuiktMp ekvation�s ere bns�d on. p Construct�n CTrewinQa' G1 Butlding Unde� Conslructlan' Fint�tred Cor�tn�ctto� •A new �levetlort GertNieate wNl be raq�red whan canatruction of tha buiWiny ls complete. ' C2 Elevations - Zanea At-A30, AE, AN, A jwkh BFEy, VE, Vt-V3p, V(wiith BFEj, AR, ARtA, Af2JAE, ARlA1-A30, ARtAH, AR//4t�. Gompiete ftams G2.s-h below accorcli to the buiidM dia ram a ecified in Item A7. t� Ruettb Rica oni e er ett�,� /���� ��+� Benchmark Utlltzsd: �-4�.� �, - z- C�(v Vettic� De1um: YI �� �� t� t � ' Ind�te elevallon datvm used for the eieveQo�a in ftems �} thrau�li hj bekrw.' 0 NC3VL7 f929 AVD t�8 � Clthert&ou�e. [3atum uaed f� buAding ele�tatlons mu�! be ttra aame as that used fo� tha BF�� Chedc tha meaevrement used. a) Top of bottam tloar ¢naludk�p �a��m�nt« crawispace. or m�iosure t►aor) � Z � uEr r et �7 m+�t!� kp e) rop or tne r�aM f+�her noo� ' ` �.� ��t � C) rn�lten� . �a : c) eotturn or tne u�gt nc�izonta� stnmlarer momtrer (v tanee� o��y} �,�+c,_____ �k Eeat ' i� met�ra •�fj Attec#�ed g�rrege (tap of eltsb) ' t"`I+� . [� f�et 0 mett�`s ' e� Low�t e(evatfan a# macMinery or equipmeht aesrvi�ir�p the bc�itdfnp ���� �� C� mat�a (Des�ribe type ot equipmenl and lucation in Gvtnmrnts) !� ;�� .„� f} Lowest adJacetr! (tinished) grede ne� ta buflc�r� {LAt�j �t �� istt'►eet C3 metera �) Niphest adJdc+etd (tlnished) grade next to buikftng (HAO) �,�� Q'�eeE GI met�s h} Lowest adJacent grade at kawest etevation oi deok a� ataq�a, ItrdudEnQ stn�ott�et st�p�tt i��, � teet' ❑ me#er+� � SECTtCtN D-� SURVEYOR, E1�tN�E'�t, (}Fi ARCHIi�GT GERT{�ICATION �� � � This ce�titicatlon fa to be signed snd sealed by e land eurveyar, enqineer, or �chitect euthorized by taw to oe�ity elevakk+n Y-""'- In(amalion. ! cerftly that the /nforrtter(lon an this GerGtPcaf� reproaents my 6esf et�vrts ta Inferpref the date av�atrle. - t urt,a�erstend that any tatse staternant m�y be purrfstfa6la by Bner arlm�arisar�►nentunder t8 U.S. C�de, Sacttw+ l001. � Check here it cammenta a�e provlded an beok ot torm. Were latitude a�xi io�gttude Mn 5�ion A pravlded by a .}r# °y;;� �Check here if attachments. Acensed land sutveyor� Q'Ye�s CI hlo � gti� _�...__. _.._� Cedifier's Fiame LARRY L. EVANS i.�ense Number P�S # 2937 �. �~���m __ ---__ _.._..._. litte LANO SUf�VEYUR Company Ndme EVAN9 LANC? 8UftYEYiNG, iNC. - Addresa 146D �ELTRF�ES�T �TE. 9 CHy QUNEDIN, State Fl ZIP Goda 34698 Sfg�ature �,�'� VTOate �p � Telepirane (727} 7343Ft21 rv -° � � 1a- �� 3 .^ % - ._... _. _ _ _._ � . . _ �r�Cud'� Ap#�, Unit, Su�e, andlcsr 9Ectg �la.} or P.O. Ro�t� and Box hlti_ �� �.���� ��-� � �.�� t �7"�..1`�?,. , stat� � � z4� �oa� 3 3 �i � � �: ' fi�CiEt�N Ci - SUFtVEYt)R, EN4INE�F2, C��t Al�GHiT�Ci CE�tTIFiCAI`IE�N (Gt7NiiNtlEDj �, ' _ ° �ap� �t , r� ttiha �lex�tti� CertYttcets fo� (t ) �ommun4ty oftksial, �2) kr�uranc� aqent7campar�y, and (3k b�lding �wner. � � � � �.�.'�:.��3,��� : 15� '' �t�1 � �+� t..t.�S �.� t�� �!� ZE W.l���_ �.r�t c �.ti`�� � � �� ��'s:E- r �.� �� ��.,� ; �� �}�' �� �.�►�'+�, .� �. �.���? r���.��� c�� ��p��c� �.�.�/�.t.. p,r�� �,.. �. � � � ; � c?`�� � � �`�"�,�„'��� � �'�S � �t� t�� � ur� ~r� �,C'�.Gv t'..c�S. _. ���� �� t`��.������"�c�� �� �.t�i�� �� � (��,` � � oa�e E p - � _ i .� � , 3�:: �:.., �� �� ��1`t�M�' � «� ��f� ��, � I1��1R�A'TtQ�i �StF�t�Y �It3i` Ft��2UiR�[?) F'C}i� ZQ�iE A{� A4�t} �ON� A �1�i0U BF�j �r°,�a� �d A�tt�� ��„ �rspte� �� E1��5. `#f the Get#ttici�t� ialr�Qncfed tu �p�xrrt et L01V�A or LQMt2-F Ir�que�k, cort�siete Se�ccttksna A, B, ' �.1�+� £t—E� ct�e trattu�aa �do� if aVa�eb�e: Check the tnensurement vsed. in Pue�io ft�cv onty, e�er metera Et. Provide alevation tnE�rrmation /�r the IaAawing end check the appra�riat$ boxea io ehvw wh�ther the elevation Ea ebave ar below the hl�heat �clj�e�t 9(ada (HAC3} and the lovrest �djacenE Q�etda (�ACi). � �� � � a} T�a �+� #�aa�r ttc�r {�ludtt� b�s++emm�st. cte�rlaqa�e, ar encic$ur�) la ❑ feet Q met�e Q�vd ar [� bek�N U?� NAt�, ..... � ~ - �} �+a�� �' � �l�� t�. �',+���'� � .�,,.,..,_ L7 ��! �,j met� L7 �b�rre or C� below �he LAC3. � �r.�� �B-� � ��t+�w� �i �r+�a js�ld�t � �ecttat� �r ��na s �e�drvr 9 (se��s agere 8-� ot tr�stnrctlans>, tne rrext nigher rlcro� .�° � �r �"t� k�p �e e�e ; ��" c� is . �1 f�ef II m�#ers CI above a' C7 t�etaw ttta l�tAC�, �. �4 �tp a� ai�b} �s C� fei�t Cj tr�tet+a Q abmRa or C�. betow Che H�t3. E4: T�s c� �i�r�`rt� erf tr�hit�s}r ared��rt +wqt�ipm+�tt ec�y�tg tt�+� la�.fin� �S , C� teet I� metera Cj $bvve or [i beivw the N�l{�. E5� �� ��+: !F n�r �d d�pth a�m�r i� avui�able, is ti�e #op uf Nte b�tom i#aat �levated �r acoatdar►ae w�h #he communify's �o�ti�ain menagent�nt `' �srsf�r�fi �1 Y�s C� Ncs Ci ttnkna�vin: Tha tocet � m?�� cettlCy ih1�e �nforrn�r,�ion In �eciion C3. ���Ttt?�t F�- �'RQF'�R�'�' UWN��t {C?R C1tNtVEii'& R�Pt2�E1VTA7#VE C�RTIFI�ATit��! , •, The p�rpp�at� ot�ner �r vwnEr's authar#asd reprea�eMativ� who coinpEetes 9eodon� A, B, ami E tor Zone A(v�tthuut e F�MI�t-iset�ed ur �mnntnity-f�ucd E3FE} ' ar Zane fl€'� �+us# sf�n here. Tfie stetemenis tn 3ecfions A, 8, arrct E ara curr�ck to the b�ss! t�f my knnwiedge. T t�roperty dwner"s ex t}nmer's Aukhorfaed Represenkativ�'s Mame 3 A,ddres$ �fty State ZIP Cpde I Signeture , ; D�te telephane �_. � _- _____ � ... .w..�.. __ _�._ � � � � � ��� � � � � � � ; Gommer�s� � � � � � � � � � � � i� �'iil�i�fe 1/ BK�chmeTtts. ' � � � . . . � .... . . .. �7�4�i�(+t Q r�" VQIFIFi#V��1� 11•�"�R{l1�Ii�I�l11�,.{tifr" 1lM��k.� . .. �.�. . .. . . . . . c��. i� The ir�[ormetton in S�lion C was tnken ffam ather+do��merttattrm Ihat hns been signad atxtl seat�i'! by a Acettae�d awv8ytx, e��neer, c� �r+�,rteat wtm ie autttorized 6y Iavr Qo �arkify �iavatioit I�tomtr�fir�iT. (indi�t� t�re ¢ource ead ddE� o( the e{svailan datte i� the CammeF�ta are� betaw } t32. C] A commu�fty of8claf complated 8action E tor a buiklir�g located fn Zans A(withotit a FEMA-lgeued ar aomc»t��iry-laa�ed BF�) q' Z�e AO. t33. ❑ The tollawing ►Morma�tior� (itema G4-C3t 0} es �ravtded iar commun�ty fl+oadpieln ma�na�ement pufpas�ae. Ca4. Pe"rmk Nurtrbee G5. C7ate Permft tssued G8. �ate Cert�et+� Ot Comy�al��/C)cr.�ancy is+aued f�T. Thie perm� has been issued Car. CI New CunaUUCtivrt ❑ 3ul�st��ttal,tmp�`nveme�t G8: Etevalion of as-twilt.lowe�t �aar (�r�eiuding bassrnent) of the buils�g . C� !e� �<l meters . Retusn C9.: BFE a{tn zane AO) depkh of lfoadFnq at the i��ding efte: . CI le�t CI meterrs Detum i310. Cammut#y"s deslph tic�oc! elsvetiwt:' . ❑ leet Cl metara datu�n � I.aCa! Oftic4�t's Nams �$ : _._... �nmmunity N�me 1`elephvne Signature ' D�tr. _.�.. Cv�rttnettis � Q �he�lc h�s � atttta�hments.