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18675 US HWY 19 #138U.S. OEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency Nationai Flood Insurance Program i. Building Owner's Name Robert Kassman ELEVATION CERTIFICATE Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A2. Buitding Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. 18675 U.S. 19 Lot 138 City Clearwater State FL ZIP Code 33982 A3. Properry Description (Lot and Block Numbers, Tax Parcel Number, legal Description, etc.) Lot 138 BAY ARISTOCRAT VILLAGE OMB No. 1660-0008 Expires March 31, 2012 For Insurance Company Use: PolicY Number Company NAtC A4. Building Use (e.g., Residential, Non-Residentiai, Addition, Accessory, etc.) esidential A5. Latitude/Longitude: Lat. N27e56'36" Long. W82943'2,� Horizontal Datum: ❑ NAD 1927 � NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Buitding Oiagram Number 5 A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enctosure(s) 137i sq ft aj Square footage of attached garage n a sq ft b) No. of permanent flood openings in the crawispace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade n/a within 1.0 foot above adjacent grade N� c) Total net area of flood openings in A8.b n/a sq in c) Total net area of flood openings in A9.b Na sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings7 ❑ Yes � No SECTION B- FIOOD INSURANCE RATE MAP (FIRM) INFORMATION Bi. NFIP Community Name & Community Number 82. County Name 63. State Clearvvater, City of 125096 Pinellas County FL Ma Panel Number B5. 5uffix B6. FIRM Index 67. FIRM Panei B8. Flood 69. Base Flood Elevation s 2 � )� FM12103C0128 G Date Effective/Revised Date Zone(s) AO, use base fiood depth) 8/03l03 8/03/03 AE 9' B10. Indicate the source of the Base Flood Etevation (BFE) data or base flood depth entered in Item 69. ❑ FIS Profile � FIRM ❑ Community Determined ❑ Other (Describe) Bi i. Indicate elevation datum used for BFE in item B9: ❑ NGVD 1929 � NAVD 1988 ❑ O[her (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Othervvise Protected Area (OPA)? ❑ Yes � No Designation Date n/a 0 CBRS ❑ OPA �" SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) � Ci . 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. �.,,, C2. Elevations — Zones Ai-A30, AE, AH, A(with BFE), VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/Ai-A30, AR/AH, AR/AO. Complete Items C2.a-h (1 below according to the building diagram specified in Item A7. Use the same datum as the BFE. �✓ Benchmark Utilized 872-6689 1 Vertical Datum NAVD,88 1 ConversioNComments Na � Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floar) 9.2 � feet ❑ meters (Puerto Rico only) � b) Top oi the next higher floor /�. ❑ feet ❑ meters (Puerto Rico only) � c) Bottom of the lowest horizontal structural member (V Zones only) N�. ❑ feet ❑ meters (Puerto Rico only) � d) Attached garage (top of slab) n/�. � feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 9.� � feet ❑ meters (Puerto Rico only) "'(�� _� (Describe type of equipment and location in Comments) f} Lowest adjacent (finished) grade next to building (LAG) �.Q � feet ❑ meters (Puerto Rico only) �'\ g) Highest adjacent (finished) grade next to building (HAG) 6.1 � feet ❑ meters (Puerto Rico only) `� h) Lowest adjacent grade at lowest elevation of deck or stairs, including �. � feet ❑ meters (Puerto Rico only) /� structural support { � SECTION D- SURYEYOR, 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 i�tormation. ! certify that the information on this Certifrcate represents my best efforts to interpret the data available. l understand that any false statement may be punishable by fine or imprisonment under 18 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 HUTCHINSON SDRVEYING AND MAPPING LLC FL Date 2/25/2014 FEMA Form 81-31, Mar 09 See reverse side for continuation. 33594 �,�-- � �'�a G f�p " . �� 3 � � • i ;, /I� +: .. .e4�`*9 Replaces all previous editions �" y . � � � IMPORTANT: In these spaces, copy the Building Street Address (i�ciuding Apt., Unit, Sui 18675 U.S. 19 Lot 138 City Ciearvvater State FL ZIP Code information from Section A. No.) or P.O. Route and Box No. For insurance Company Use: Policy Number Company SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community officiai, (2) insurance agenUcompany, and (3) building owner. Comments C2-e Air Conditioner on platfortn Date Check here if attachments SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REGIUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE), complete items E1-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. C� E2. E3. E4. Provide etevation information for the following and check the appropriate boxes to show whether ihe elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom fioor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or � below the HAG. b) Top of bottom floor (including basement, crawispace, or enGosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. For Building Diagrams 6-9 with permanent 800d openings provided in Section A items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the buiiding is ❑ feet ❑ meters ❑ above or ❑ below the HAG. Attached garage (top of siab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. Top of platform of machinery and/or equipment servicing 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 floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must ceRify this irdormation in Section G. SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFlCATION 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 Represeniative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The locai official 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 af this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. Gi. ❑ The infortnation in Section C was taken trom 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 compieted Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information {items G4-G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit issued G6. Date CeKificate Of Compliance/Occupancy Issued G7. This permit has been issued for: � New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including 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 Community Name 5ignature Comments Title Telephone Date ❑ Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions � Buifding Street Add 18675 U.S. 19 lot 138 � Building Photographs See Instructions for Item A6. ��L (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. � Poiicy tvumber City Cleanvater State FL ZIP Code If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for item A6. Identify 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. �.:. _ °�b r_ �� ' , ` � - _ y` � " � � �ep i � � � I � �� r�� :� : �- � ``� ;a. �� y � � ,�,:�. � �.� � � � � � e� y° � �. �� \ . � � � z t " - —.,.� �"�{ � ��3�� ,�at't�! ��`� —I _ � � �'��I I � —' `� _ � I�I - _ __ _ �� I -- �_.: �� .. . �. - �. _ : � �,�� u.�_--- � =-=_ _ '�-"- \\ `�� - - ��'�-�� . � � - �1� �� \ _� _ _ - �� ,- --�� -�; � �, . - - -, ��- ; � � - - - _--_- - �= _�' . _ �11 — —= � - —__ =1 =-� � - �N _ _ - ��1 -_-_ � «� . - - -- - —r_ _ ____ - � . _ . � � : : _. �,�--� � �`�� '�- : � _ I � Y � -. 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