6 SEAGRAPE CIR (2)Page 1 of 3 not valid withoul all three pages
U.S. DEPARTMENT OF HOMELAtdD SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insuranu Progmm
A1. Buildin� Owner's Name
Building Street Address (including Apt., Unit,
/ 6 a� l ro o�f9o�ocxa va3c�
ELEVATION CERTIFICATE
IMPORTANT: Fqllow the insiructions on pages 1-9.
SECTION A - PROPERTY INFORMATION
and/or Bidg. No.) or P.O. Route and
' OMB No. 1660-0008
Expiratiom Date: luly 31, 2015
FOR INSURANCE COMPANY USE -
Policy Number:
Company NA!!'., 94�rrhur :
State ZIP Code
Cit I
A3. PKOpesty Descrlption (l.At and Block Numbers, Tax Parcel Number, Legai De5crfption, etc.)
TAX PAR EL ID: 16-29-16-04902-000-0 0
A4. Building Use (e.g., Residential, Non-Residentiai, Addition, Accessory, etc.}R I T
��� �61 Long. 92°' �� � Horizontal Datum: ❑ NAD 1927 � NAO 1983
A5. Latitude/Longitude: Lat. Z.�.
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number �A
A9. For a building with an attached gara;ge:
A8. For a building with a crawlspace or enclosure(s): NiA sq ft a) Square footage of attached garage 684 sq ft
a) Square footage of crawlspace or enclosure(s)
b) Number ofi permanent riootl openings in the cr2wlspace by Num4�ec oi permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade d1A within 1.0 foot above adjacent grade A? .�
c) Total net area of flood openings In A8.b �ILA sq in c) Total net area of flood openings in A9.b ��� — sq in
d) Engineered fiood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No
SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
62. Count Name 83. State
B1. NFlP Community Name & Community Number y _,._. ,_ � Fi oRI�A
CITY OF CLEARWAi tK tzouyn
64. MapJPanel Number 85. Suffix 98. F1R1� lndex Date B7. F4RM 4anet EffectiveJ H8. Flood Zone(sj B9• AOsuse base flood
Revised Date
12103C - Ot 29 G 811812008 n9ms103 X SHADED
610. Indicate the source of the Base Flood Elevation (BFE} data or base Nood depth entered in Item 69:
❑ FIS Profile CX� FIRM ❑ Community Determined ❑ OtherjSource:
611, indicate elevatfon datum used for BFE in Item 89: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source:
612.Is the building located in a Coastai Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? [] Yes � No
Designation Date:p�}$y41 / ❑ CBRS ❑ OPA
SECTION C- BUfLDING ELEVATION INFORMATION (SURVEY REQUtRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* nX
Finishe�d Construction
*A new Elevatatt Certlficate wiH be required when construction of the building is complete.
C2. Elevations - Zones A1-A30, AE, AH, A(with BFE}, VE, V1-V30, V(with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/A0. Complete items
C2.a-h below according to the building dfagram specified in Item A7. In Puerto Rico only, enter meters.
r �^� T���� ",GT�NORK (�PS.) � ' VerttCal Datum: "'"""'°�8 —
Benchmark Utilized: � ^ ^� �
Indicate elevation datum used for the eievations in items a) through h) helow. ❑ NGVD 2929 � IVAVD 1988 ❑ Qther/5ourCe:
Datum used for building elevations must be the same as that used for the BFE. Check the measurement used.
� feet ❑metters �'�������,� �.�
a) Top of bottom floor (including basement, crawlspace, or enclosure floor ---�-- •�---- � feet ❑ me�ers
b) Top of the next higher filoor �— '�"'-- �
NlA , � feet ❑ meters � � � �
c) Bottom of the lowest horizontal structurai member (V Zones only) �— 18 ��� � �i
� feet ❑ meters
d) Attached garage (top of slab)
� �� p feet ❑ tn2ter5
e) Lowest eievation of machinery or equipment servicing the building --�- • �,�� ,���,��Sz�
(Describe type of equipment and tocation in Comments)
rade next to buildin LAG} �-.— •�---- � feet ❑ meters k��?t�PF�'�'� �3� Pg�: �.�� ��'.
f) Lowest adjacent (finished) g B(
g) Highest adjacent (finished) grade next to building (HAG)
g . 71 � feet ❑ meters
h) Lowest adjacent grads at 4areest etevaiion ot deck or statrs, inctuding N/A . �J feet ❑ meters
structural support
SECTION D- SURVEYOR, ENtiiNEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and seated by a tand Surveyor, engineer, or archlteci authorized by law to cert�fy elevation
information. 1 ceriify that [he information on [his Certi6cate represents my best etforis to interpret the data available.
I understand thai any false siatement may be punishable by fine or lmprisonment under 18 U.S. Code, Section 5001.
� Check here if comments are provided on back of form. w ensed land surdveyor?tudeo Yes 16nQ Novided by a
j� Check heTe iS attachments.
License Number
Certifier's Name �.,�a
Title
Address
11940I
Company Name
City
� Signature - Date Telephone
%"` I 2I17/2014 P(R ��9-ttt147 I 1 u i r�cv iY
FEMA Form 086�033 (Revised 7/12)
See reverse side for continuation. �2eplaCes all previous editions.
(REVA 2(t$/2014) °
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Aage 2 of 3 not valid without all three pages
ELEVA710N CERTIFICA7'E, page 2
fMPORTANT: tn these spaces, copy the correspondtrtglnforrrratiorr trom Sect�on A.
Buiiding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box
City
State ZIP Code
1402.1238EC
FOR 1NSURANCE COMPANY USE
Policy Number:
comuerry Na�c
VLC/lnrrn�� ♦ —.....
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATIQN (CONTINUECI)
Copy both sides of this Elevation Certiflcate for (1) community o�cial, (2) insurance agent/company, and (3) building owner.
Comments C.2.E. EQtli�ME1VT t5 A/C t1fV1T OU7SIDE OF 8t11ZDfNG. TFIIS El.EVAFlON oER� AF�CAT s!S 0 nL� nNn1D�NORT�HnFPWERON(S) NAMED.
THE INFORMATION SHOWN �R,�N SHALI NCIT BE1JhGI
DETERMINEO BY GPS. THERE IS A FINISHED fNCL05URE IN THE LOWER LEVEL THAT APPEARS TO BE A LIVING AREA.
SignetUfE ✓; " Dete 211712014 CENTERLINE ROAD ELEVATION: 7.68
�T,�.
SECTION E- BUILDINQ ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For 2ones AO and A(without BFE), complete Items E1-E5. if the Certificate Is intended to support a IOMA or IOMR-F request, Compfete Sections A, B,and C.
For Items E1-E4, use natural grade, if availabie. Check the measurement used. In Puerto Rico oniy, enter meters.
E1. Provide elevation information for the foliowing 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 �`1�� • � feet � meters ❑ abave or T] below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is �l/A- . � feet ❑ meters ❑ above or ❑ below the LAG.
E2. For 9uilding Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8--9 of instructions),
the next higher floor (efevation C2.b in the diagrams) of the building is �1V/A (� feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of siab) is �lA. � feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servlcing the building is —�IL6. �X] feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zovtie PA ori4y: tf no flnod depth numher is available, is the top of the bottom floor elevated in aecordance with the communtty's fioodpiain management
ordinance? � Yes ❑ No ❑ Unknown. The loeal official must certify this information in Section G.
SECTION F- PROPERTY OWNER (OR OWNER'S REPRESENTATIYE) CERTIFICATION
The property owner or owner's authorized representative who compfetes Secttons A, B, and E far Zotte A(w�ihoui a FEMA-issued or community-iSSUed BFE) or
Zone AO must sign here. 7he statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner or Owner's Authorfzed Representative's Name
Address
Signature
Comments
City
Date
State ZIP Code
Telephone
❑ Check here if attachments.
SECTION Q - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance io administer the community's floodplain management prdinance can complete Sections A, B, C(or E), and
G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in items G8-G10. In Puerto Rico only, enter meters.
G1. 0 The information fn Section C was taken from other documentation that has been signed and sealed by a licensed suwveyor, engineer, or architect
who is authorized by taw to certify elevation infurmatio�. (Indicate the source and date of ihe elevatfon daia in the Comments area below.)
G2. ❑ A community o�ciaf completed Section E for a buiiding located in Zone A(without a FEMA-issued or community-Issued BFE} or Zone RO.
G3. ❑ The foilowing information (Items G4-G10) is provided for community floodplain management purposes.
G4. Permit T3umber G5. Date Persnit 4ssued Gfi. Date Certificate Of Compliance(OccupanCy tssued
L..
G7. This permit has been issued for: ❑ New Construction ❑ Substantiai Improvement
G8. Elevation of as-built lowest floor (including basement) of the building: . ❑ feet ❑ meters Daturrn
G9. BFE or (in Zone AO} depth of ftooding at the buitding site: . 0 feet ❑ mete�s Dalum
G1d. Community's design flood eievation: . ❑ feet ❑ meters Datum
Local Official's Name
Community Name
Signature
Comments
Title
7elephone
Date
❑ Check here if attachments.
FEYtA Form 086-0-33 (Revised 7/12) Repleces ali previous editions.
(
ELEVATION CERTIFICATE, page 3 BUILDING PHOTOGRAPHS
Page 3 of 3 not valid without ail three pages See Instructions for Item A6. 1402.t238EC
IMPORTANT: In these spacea, copy the corresponding informatlon trom Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. Policy Nurnber:
6 SEAGRAPE CIRCLE
City State ZIP Code Company fVAIC Number:
CLEARVbATER F�. 33759
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 buiiding photographs below according to the instructions
for Item A6. Identify ail photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left
Stde View:' When appticable, �hotographs must show the foundation with representative examples of the fiood openings ar vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
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ELEVATION CERTIFICATE, page 4 BUILDING PHOTOGRAPHS
Continuation Page
fEMA Form 086-033 (Revised 7/12) Replaces ali previous editions.