223 PALM ISLAND SW, LOT 6, UNIT 6A' . ' ELEVATION CEI��'IFICATE - . e.M.e. n,�o6�-00»
. xn%�es May 3t, I993
FEDERAL EMEqGENCY MANAOEMENT AGENCY
NATIONA� rLOOD INSURANCE PROGRAM
A7TENTION: Use ol lhis certificate does not provlde a waiver of the Ibod Insurance pur�hase requfremenL This form Is used only ►o
provide elevation inlormalion necessary to ensure complianCe with applicab:e ccmmunity tloodplain managemeni ordinances, to
delermine !he proper insurance premium rate, and/or lo suppoA a �equesf fw a Letter ol Map Amendmenl w Revisbn (LOMA or LOMRj.
tnsinietlons lor eomplNing thl� lorm etn be lound on the tollowhig pages. •
SECTIONA PROPERTYINFORMA11dN rOnnaSVnA►iCECOMrANrUSE
RUil01M13 OWNERS IW1ME � nGl�r-r NI1r�MEA
Dale Crsistensen � U `7 6 � ��J
SrREET ADDpE$g ��, �ry. �s ��. ��1 OR o.0. NQUTE AND pOX NUl�IgER Cd�"ANV NAIC NUAA9ER
223 Palm Island S.w.
On+ER DESCR�PTqN M1e� and ebd M�mbps. ek.)
Island Estates of Cleaiwater Unit 6 A, Lot 6.
� Cleaiwater sTnre zRCOO�
Florida
�ECTION 8 FIOOD INSURANC� RATE MAP (FIRM) INFURIAkT10N
Provide the fdbwing irom the proper FIRM (See Instructions):
�• �TY �ER 2. PANEL NUM6EN j, $"'�'FI% �. DATF OF FI'i7M INC�EX 5 FIRM Z(xJE C. BASE �LOGO cLEVATION
125096 0007 B 6/1/83 A72 rm�ozo�.weeeoe��
,� �p�
7. Indicate the elevaCwn datum syslem usod on the FIRM lor Base Flood Elevatlons {BFE): � NGVD '29 � O!her (desaibe on bacic)
8. Fa Zones A w V, whcrg rw BFE is providey on the FIRl�A. and Ihe community has established a BFE tor thk buildmg sNe, k�d�ate
the rnmmunity's BFE: �.�.j . U leet NGYD (a olher FIRM datum-see Sectton B, Item 7)_
SECTION C BUILDING ELEVATICN INFORMATIpN
1. Using ihe Elevalion Certificete Instructions, indicate the �agram number Irom the diag�ams found on Pages 5 and tiai best
desa�bes lh9 subjecf bui�ng's reference levei 1
2(a). FiRM Zones A1-A30, AE. AH, aM A(Nith BFEy. The lop of lhe reference tevei ilcor from !he selerted diagram Is at an eiavatbn
o� LL_LLIJ.LI feet NGVD (or other FIRM dalum-see Sedion B, Item 7).
(b). FIRM Zorres V1-V30, V�, and V(with BFE!. The bo(lom of the lowest horizontal structvral �ember of ;he reference level f.rom
t'.e Selected �agram, is a1 an elevation ol �� � .;! feet MGVQ (or other FIRM dah �m-see Section B, Item 7).
(c). FIRM Zone A(withoul BFE). The Iloor used as the reterence level fro^i the selected �:rgram !s �� . J feet above � or
below �(ciiedc one) the hlghest grede adjacent to the buiiding.
(�. FlFiM Zone AC. The 6ow used as the relerence level irom the selected diagram is i�J . � � leei above [� or below � tcheck
one) the hi9hest grade adacenf +o Iha building. 11 no tlood depth number is avai;abla, is the buildfig's lowest floor freferer:ce
levell e�evated in aecadance wilh the communi!y's iloodplain managemerl ordinance? ❑ Yes ❑ No � Unknovm
3. Ir�cate Ihe e�ev8tian d8:Um aySt4m used in detertnining 'he above refArence level elevations: � NGVD '29 [� Olher (describe
�^da► CommeMs on Page 2I• (NiOTE. +' �he eJerafion dafum used Jn measuring the eleva!ions is diNerent than fhaf used on
fhe FlRM (see SecLion 9, Item 7j, lhen oon• �rf fhe elewdfrons to MB dalum system used on the FlRM and show the convsrslon
eqwfan under Commenfs on Page 21
4• EM�vatlon ►elere�oe rt�ar1c used �pears en F��M: � Yes �!Jo (See InsMicilons on Page d)
5. The reference level elevation is based on: � actual construction ❑ construction draw(ngs
(NOTE: Use oI COnsln�cfion drawings is only va;id N fir5 buAding does rat yef have Ihe relere.�rce Ievel lloar in place. 7n whkh
ea:e this cartiflcafe w� only be vslid Ior rhe buiJtlFng Auring the cou�se ol conshucfion. A posf-cronslrvcfan E�evafion CeriN7qfe
wrA te reqrared once cronsnucrron is co,�!ete.)
6. The elevation of lhe lowesl grade immedatefy adjacent [o Ihe buNding Is: � I I� I.. US feet NGVD (o� other FIRM datum-see
SeC'�on B. Ilem �
SECTION D COMMUNITY INFORMATION
t. If the community ofticial respc,ns��le 1cr veritying build�g devatio� specitles that ri+e relere� Ve level Indicated in SecHor, C. Item
is nat ihe 'lowest floor as defined ir, ;he community'S tlooaplain management or�nance, !he elevalron ot the bt�dirg's 'lowest
Iloor' as deGne�i by the ordinance is: i i i! iJ.l_j feel N^VD (or other FIqM datum-see Sec?:an 8. ttem 7).
2. Date of the sfari ot eonst: uclion or su::stantial imRxovement _ _.
FEMA Form 81$1� MAV 90 �EV! A�55 ALL �REV��VS EDir;prys �EE P�vE'i$E $IDE FOR CONTMUATION
�
SECTION E CEpTIPICATtON
This �ehificatio� fs 10 be signed by a land surveycr. englneer. a arch{tect whc ts aulhorized by staie a Iocal law to ceAifr elevatbr
informalbn when the eleva�i� p���a�b� �a g�es At—A30, AE, AH, A(wiTh BFE),V1—V30,VE, and V(with BFE) is reejuhed.
C�nrtNxdly oHietals who ere authp;iied b�, I�i law or wdinance to provide noodp�ain managemeM lnformation, may ai� ��
�'�nO^• �^ �►�a case o� Zones AO and A(without a FEMA or community Issued BFE), a M�ilding oHkial, a property owner, a an
owner's representalhre may afso sfgn the ceAificalion.
Relerentx level diagremg 6, 7 and 8- DisOngulshing Fealures—If the cerltHer Is unable to cerlNy to breakaway/non-breakaway wall,
eixiosure size, locaticn �I servicing ��p��� area use, waq opemngy, ar unHr.lshed area Fealure(s), fhen list Ihe Feature(s► not
�ded in We cerliffcation under Comments belpw. The cAa�am mJtflber, Seclion C. Rem 1, rrn,+st s191 be ernered.
� certi7y Jhaf fhe in/pn�a�ion �� S�,y�s B ano C on fhis certifrcafe represents my besf eNOrts �a lnterpret fhe data avallable.
I undersfand Nyf any �else s►alement may be punishable by Bne d lmp�sonment urrder �8 U. S. Code, Secfion 100 f.
�
ctriTlF1ER3 NAME � �- Li�'.'NSE NUMBEH (a A�ix Seaq
Philio C G,�c,c;'c R L S# 3035
rrr�
PrPS1C12i1 � C�P�Y NAME
�p�� — �*-�et_iand Survevinq INc
E24 F�St B3�/ DT. .1'11t2 #� Cmj,3tgp STATE 21p
��� --- FI. �1641
6�14i'91 784 EQ573
Ccples ahould be made of thia Grrtliicate for: 1) tommunity ofllclat, 2) insvrence agent/company, and 3) bulidlr� ermer.
C4MMENTS: ��hmark= Bench Mark Disk "AWI. USCE 1941", Map # i45, Elev.= 7.985'.
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The dagrams above iliustrate the points at which (he elevations should be measured in A Zo�es and V Zones.
Elevations lor ail A Zones should be measure� at tha lop ol lhe reference Ievet Iloor.
ElevaTions Ipr all V Zones should be measured at the tattom oi ihe iowesl horizon'aI structural member.