370 PALM ISLAND DR SE__ __ _
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� ELEVATION CERTI�ICATE E�"�3','v�a
FEDERAL EM�R(�ENCY MANAGEM�NT AGiENCY
NATIONAL FLpOD INSURANCE PRO(3RAM . ,
ArfENTtON: Use oi this certllicate doea not provlde a waivor ol the Ilood {naurancs purchase requtrement. Th�s lorm is used only co
�rovide alevation informAtbn necestery to onwro oompUancp wlth qppllcebl6 oommunity floodpkaln me�nspemenl ordinances, to
deiermine the propqr lnsurance pramlum rats, snd/or to auppon q raqueet ior e Letlsr bl Mpp Amendment or Revislon (LQMA or LOMR).
InstrucUons for oompl�tlnQ thls lorm oan ba iound on Ih� lallowlny pagea.
SECTION A PiiOPERTY INFORIYIATION
ElUiLDING OWNER'$ NAME '
IVAN T. SMImH •
STREET AODREg$ pndudlnp Apt„ Udt, 8ult� u�d�or Bldp, Numba) OR P.O, ROUTE ANO 84% NUM9ER
370 PALM IS[,AND DRIVE S.E.
FOti INBURANCE COMPMIY UIDE
POLIGY NUMBEFI
CO�IPANY NAIC NUTABEH
O7MEq�ESCRIP7�qN (�ot md Bbck NumWrt. Nc.►
UNYT 6A ISLAND ESTATE$ OF CL�ARWATER, LOT 25, PB 60, PG 90
CiTr FL�T� I�P CODE
Cl�arwater,
SECTION B FLOOp INSURANCE RATE MAp (FIRM) INFORMATION
Provide the lollowing frOm I�e proper FIRM ($66 In8lruGlons�: _
7. Indicate the etevation datum ayelem ueed on Iha FIRM lor Bp�a Flood Elevatlons (BFE): � N(3VD '28 0 Other (desctibe on back)
e. For Zones A or V, where no BFE ia provided on Ihq FIRM, and Me communiry haa astabliehed a AFE for thls buliding site, Indicate
tha communiry's BF�: LL�LL�L� .LJ fAAt NOVO (or qihqr �1RM ddWm-se6 Sectlon B, Item 7),
SECTION C BIfILDINO ELEVATION INFORMATION
t. Using Ihe Elevation Cerlilicele In6truCUonS, IndlCale tha dia�ram number irom Ihe dlaqrama f0und on Pepes 5 and B that besl �
descrfbes th6 eubjeCl buildinp'e reierencs Iw�l !�,
2(a), F1FiM Zones A1 •A30, AE, AH, and A(wlth BFE), 7he top oi the rslersncs level Iloor Irom tho oeloctad dlapram ka at an alevelion
ot L1.�L_l7 f. L� �eet NGVD (or other FIRM daturn�ae Sectlon B, Item 7).
(4). �IRM Yones V1 •V30, VE, and V(with BF�). 'Cha boltom ot the 1owe8t horizontel struCkural member o1 the reterence fevel from
the selected dlagram, Is at an elav�tlon ol ��..� .i,J t�at NQVD (or other FIRM datum-see Section B, Item 7),
(c). FIRM Zone A(wllhout BFE). The tloor u4�d ae the reterence level trom the salqcted diA4ram Is �.0 feet above ❑ or
below L} (check one) the hlghest grada �djaceM to the bullding. ..
(d). FIRM Zone AO. The floor used as the relerenae level irom the selvded dla�ram is W.0 teet above 0 or below ❑(check
ona) ihe highest grade e,dJaCent to the building. 11 no ilood depth numbar Is avallable, Is the building's lowest iloor (�eference
level) elevated ln accordance with the communfty's floodplaln mana�ement o►dinanca? Q Yes [� No ❑ Unknown
3. �ndicate tha eleva►lon datum system uaed In defermininp the a4pvs r�foroaCi level elevatlo�s: C NdVD '29 [� Oth6r (describe
under Commems on Peqe 2). (NdiE: !1 fhs e►evallon datum uaed In mapsur�n� the eleveli�ns is differenf fhan ihat used on
Jhe FIRM (seo Sectbn 8, ltem �), thpn conveA the elev8Nort6 to th� datum system used on the FIRM and show the conversion
equarion under Comments on pape 2.) .
a. �ievation raterence mark used eppeara o� FIRM: ❑ Yes � No (See lnatrucdona on Pape 4)
5. Tha rglerance level elevali0n IS basad on: � eC[u81 CqnStruClloR 0 oonetrucUon drawiapa
(►vOTE: Use ol consirucflon d►awinps !s only valid 1t �he buAdfna �osa rrot yaf have the referencs level �oor In place, in whlch
case rnis cenlpcare wf!! onfy be vaNd !or rhe bulld)n8 durbep rhe cour� of c�onstrucNan. A pos6consNUCrlon Elevarion Cerrillcare
wit� ba required once wnstrucNon la oampl�te.) '
fi. The elevatlon o� the lowest grad� Immedlately ad)ac�nt lo Ihe bullding is; (�1�, �.faet NGVD (or other FIRM datum•aee
Section B, Item �.
3ECT10N D COIiAMUNITY INFORMA7'ION
1. It the community ofllCial responaible for verltylnp bulldln� elevalbne epeCifle� thAt the relarence level indlcated In Se�tbn C, Item 1
is nol the 'lowesl t�oor" na dellnid In the community'� tl0odplain manap�mont ordlnance, tha alevallori of the bu(Idlnp's "lowest
Iloor" as deflned by the ordlnpnce Is; ��.�.� feet NdVC (oK other (=1RM dalum-�ee Sectton B, ltpm 7),
2, Data af tha start of constructlon or wb�tpndal (mprovpment �
FEMA Form B1 •31, MAY 93 RE%AC,ES A!1 PREVIOiJ$ Epll'IOiNS 5EE REVERSE $IOE fOR COrlI1NUATION
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8EC'ffON � CERTIFICAI'14N
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Th�s certificat�on Is to be ai�ned by A land �uNeyor, �nqinssr, or uohlt�ot who t� wllw�is�d�y �t�te or loc.l t�w to cartly elevation
inlarmation when lhe elevaqon InformeUon tor Zonss A1—/(30, AE, AH, A(wfth BFE),Vi—V30,VE, snd V(wlth 8FE) la required.
Communily oHicieis whp �re autho�ixed by loca) law or ordinanoe lo �ovide AoodplMn Inahspement informatlon, may alw �Ipn the
certil�catlon, In the caee of Zan�e� AO And A(without a fEMA or commul�ty Issued 8RE); e► 4ulldlnp ollidal, a property owner, or an .
owner's representatfve may also a�n the certiticetlon, �
pelerence ievel dlagrams �, 7 and 8• Dietinpulahlnp Features--If tha co�lliar ie unabls to osrtlly to breakawsylnon-breakaway wall,
enCloSUre s�ze, Iocatio� ot aervk�ng eq�lpment, area use, well openinqa, or un(inished area Fealure(s), then Ilgt th8 Fealure(s) not
included in �he cenil'rcation under Commenta below, The diepram number, 3ectfcn C, Item 1, must Still be entered.
I cerrily rh�1 the inlormAlian !n Secflona B and C on fhla Csrdllcete r�sprs�snta my bs�t e1lorta� fa Mterpret the data evallable.
i unders�and that any false afatemenl may bs punlahable by llne orlmprlaonmsnt undsr t8 U.S. Cods, SecNon t0U1.
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CERTu1Eg�S.NAMep�NNY UGEN9ENUM{BER�aAMIzS�aq �,�p31
LA fitFl f{
T�L%�NO SUF3VEYQR �MP�Y��.R. PENNY � ASSOCIATES. (NC.
`����� �02 11Y6NU6 N. °m SEMINQLE FL�r�.93778 zia
S�c3NATUpE
DATE PIIONE
/n7 /4Q � ��_aaa_e
Coplss �hould bs mads ot this �o�t� 10�:1) Conitnunity oHIcW, 2) Insur�no� �p�nt/Cqmppny� and 3) bulldlnp qwn�r.
CoMMENTS: gASIS OF BENCI3I�ARK: . Q BRIDGE WINDWARD PASSAG6 �00' ± EA$T
OF MIDWAY �LEVATION 6.93
HENCHMARK: 240 SKIFF pOINT L.PL.EL. 6.84
NOT�: GARAGE FL. EL. b.53 '
oi+
uA�
A V
ZONES iOHEb
AEfER(N�l
LEVE4
��!! 1 ii •• ,},}x
flL10b
{LlvATqN 111/I��NCI ACJ►A!M
UVLL OMO�
wrc►�
M�IArMC
A
OM MW,
PIlM� 011 COLUMNe
A V
The diaprams above ulustrate the polata �t wFdch ih� rl�v�do�� stwuld b� msawrsd in A Zones and V Zones.
Elevatlons for all A Zane; 4hould bo meaeured et the lop of the retere�ce IwN Iloor.
Elevations tor ell V Zonea should bs meeisund �t th� bottom ot th� low��t horl=onid nruaurai mambof.
pape 2
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