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1967 EDGEWATER DRU.S.DEPARTMENTOFHOMELAND9ECURITY �LE�ATION CERTIFICA�E FEDERAL EMER�ENCY MANAOEMENT AO�NCY " OMB N0. 1660-0008 � NatlonnlFloodlnserrunaeProgram �mpprtant: Read the instructions on pages 1-8. Expiration Date: July 31; 2015 _._.,, _ . A1. Building Owner's Name Do �G-�q A2. Buildin Street Address (Including Apt `�% F PCs�-1n/� city ��C��ZW/� i �R-. A3. Property Desariptio (Lot and Bloc�� L 0 T 2, � t,n Gk,. ,�1. 8ECTION A � PROPERTY INFORMATION > c. �,� � � E� Ba Unit, Suite, and/or Bldg. No.) or P �(z p�tV�, State ��-r� c,. � oute and Box No.. � ziP code ? > ription, etc.) n 5 AA. Buildinp Use (e.g., Residentlal, Non-Resldentiai Addiflon, Aooeseory, eto.) RE s l D E N�'[�( �� .,......._: ' . �.~� A5. Latitude/Longitude: Lat: Z�% °T � i� 3�, �P �_ Long. _� 2° 4�_'_: �,1 '�' Horfzontal Datum: ❑ NAD 1927 uv NAD 1983 A8, Attach at I e a s t 2 p h o t o g r a p h s o( t he bu i t d ing i f t he Ce r t l f lcate le being used to obtaln flbod ineurance. A7. Building Dlagram Numher � '� - � A8, F'or a building w(th a crawispace or enclosure(s): N A9, For a bullding wtih an attaohed garage: � a) 5quare footage of crawl� ece or enclosure(s) � aq ft a) Square footape oF altaohed perege � N,I� sq {� b) Number vf permanent ����'openinga In the crewlepace 6) Number of permanent dood`openinga in the attaohed �arage or enclo9ure(s) within 1� f�dt'above adJaoenE gPade wfthin 1.O.foot above adJACent grade. • c) Total net area of tlood o'���i��8s In Ae.b eq In c) . Tdtal net aree of 800d openinps In A9.b - eq In , d) Englneered flood openings7 ❑ Yes ❑ No d) �ngineered.tlood opeNnps2 [a Yee ..[], No SEGTION E1- FLOOD IN8URANGE RAT� MAP (FIRM) INFORMATION �B. NFIP Community Name & Community Number 82. County Name �C ' B3. Stete � �.uE,4,�2��tT�..R... / I2r-�- ag � �[�1�1.(, , , , . - Bd. Map/Panel Number 85, Suffix BB. FIRMindex Date 87. FIftM Panel 88. Flood B9: Base Flood Elevatfon(s) {Zone � Effective/�Revfee�d Date Zone a AO, us base flood depth), - 12�o3G �6b(p }� p�-I�,-n O. :. 3 i/ 13'� I �. 810. Indicate the source oF the..._,B�ase Flood Elevation (�FE) data or baee flood depth entered in Item B9, C7 FIS ProFile IJ �IRM , ❑ Commuhity Determined; , ❑ OthedSOUrce: . , 811, Indlcate elevatlon datum used for BFE In Item 89:. p NOVD9929� � NAVD 1986 ❑ Other/Soui'ce: 812. Is the bullding Iocated In a Coestal B�rrler Resources Syatem (CBRS) area or Otherwlae Proteoted Araa (OPA)? � Yes �No DesigneUon Date: ❑ CE�RS . ❑ OPA N G — BUILDINO EL�VA' C9. Building elevations are based on, ❑ Conatruction prawihes" [] Bullding Under Canetructlon' Finished Conatruction "A new Elevation Ce�tificate wtll be required when conattuctlon of the bulldinp Is aomplete. C2. Elevationa —Zonea A1-A30, AE, AH, A(witli BFE), VE, V1—V30, V(with BFE), AR, AR/A, A�i/AE, ARlA1—A30, AR/AH, AR/AO. Compiete Items C2.e—h below according to the building dlagram epeclfled In Item A7. In Puertb Rlao only, enter� ete . Benchmark Utllfzed: � 5'7� - G" � Z� LpT Vertic�l patum• (.� � n Indiaate elevation datum uaed for the elevativne in itema a) through h) below. ❑ NOVD 1929 NAVD:1888 �7 Qth�r/3ource: Datum used for bullding elevatipn� must be the same as that u�ed far'the BFE, , Check the measurement used: a) Top o( bottoln floor (Including basement, crawlepece, or enclosure floor) � �.� feet ❑ metera b) Top of the next higher tloor �V/A ❑(e�t 0 metera. c) Bottom of t11e lowest horizontal atrUctural member (V Zones only) —�N � feet 0 meters � d) Aftached garape (top of siab) �,l,l�t, ❑ f t C] meters e) Lowest elevation of machinery or equipment se�rvicing tha buildin8 ��,_� feet ❑ metero (Desctibe type o( equlpmAnt and Iocation In Comments) � Lowest adJacent (flnished) grade next to bullding (LAa) �. 3 C� f et ❑ metere g) Nighest adJecent (flnlahed) grade next to buildin� (HAQ) ,� feet [� meters . • h) Lowest adJecent grade at lowest elevaUon of deck or stalre, Including structutal support �..�[.�,_ ❑ feet ❑ meters SECTION D- Sl1RVEYOR, �NOIN�eR, OR ARGHIT�CT C�R7IFICATION � Thfa cer�iflcation is to be signed and sealed by a land surveyor, englneer, or architect authorized by law to certify elevation informatlon. I cert/ fhaf the lnfomtstlon on fhls Cerilf/cate re resents m best efforfs to lnte ret the deta avaUable. '` �� '"" " ! un eisfand that any felse stafemenf may be punlsheble Gy fl�e orlmp� onmenf under 18 U S. Code, SecNan 1001. �°+�'� , � 3"°�� Check here if commenta are rovided on back of form. Were latitude end lon Itude In 3e tlon A rovided b a r ���` `� p 9 � P Y ' �,���..,�+� �".�" . w [� Check here if attachmenta. Iicensed land surveyor? Yee ❑ Na � ` M: , Cedifier`a Naine LARRY L. �VANS Licenae Number PLS # 2937 7itie LAND SURVEYOR bompany Neme EVAN9 LAND SURVEYINO, INC. Address 1460 BELTREES 5� STE: 9 City DUNEDIN, 3tate FL ZIP Code 34898 � .._ i_ S(gnature ��� ��� � '� �jn�� Date � z" � o " � �,, 7elephone (7�7) � .:. . - � °�-��. 'I : � ' � `�4' 1�� '�'t � � � _ � �' r, . ,+;�2` � `� ` . �� �k% A I IUN 4�K 1 IPILA 1 t� �ag� � )RTANt: In tttese spac�s, copy the �g St�eet Addresa (Iftcludinn Aot._ I �n�t c��� 1 rrresponding inforrhatiori from Sectlon A. and/o BIdB. No.) or P.O: R�ute and Box No. LV � . , c��y C � �->4 I� VJi��"�. (2. � ` sta�e ,�, , ziP c�de ��7 �,� ; ' , S . � . � s 8EG710N D— 8URVEYOR, ENOINE�Ft, OR AREHITECT CERTIFICATIdN (CONTINUED) Gopy both sldea of thls �leda0on Certlficate for (1) Community olBcial, (2) Inauranoe eQent/company, end (3) building owner. Comments \ � � �„l �. /��G GOM�(�ESSo�, b�7 C��OUN� l��/�-L ��D. C,� 2, � e, l5 N��'�. c� ��. � d� � i�1� �. �=- � � s� ��� r��l� �4 Lo N�..,, �-� K.� ��.. W � r H�� o o� E. �: �.�'�� f' ► a r..i- 9f 7: , Signature Date : ; (2—Io.- I� ; 8EGTIO.N — LDINO ELEVATION INFORMATION (3URVEY NOT REqUIR�D) FOR ZONE AO ANQ ZON� A(WI'THOU BFE) . , ; For Zones AO and A(without BFE); complete Itefna E1—E5. If the Certi(laate la Intended to auppott a LOMA or LOMR-F request, complete Sectlons:A, B, and C. For Items E1—�4, use natu�al grade, If aveilable: Check the measurement used. In Puerto Rico only, enter meters: ' E1. Provida elevatlon informatlon for khe iollowing and cheek the appropriate boxee to ahow whether the elevatlon Is above o� below the higheat adJacent grede (HAO) and the lowest ad)acent grade (tA0): a) Top of bottom tloor (includlnp basement, orawlapace, or enolosure) is [] feot ❑ metera [] above nr C7 below.the HAG. b) Top of bottom floor (Includir►g basement, crawlapace, or enolosure) Is . Q feet ❑ meters C] abave or Q below the LAG. C2. For 8uliding Diagrama 6-8 witfi •permanent flood.openinea provided in Section A Reme a and/or 9(aee ages 8-9 of Instructfons), the next higher floo� (etevatlon C2.b in the dlegrame) of the building is ❑ Feat ❑ metere Cj above or �below the HAO. E3. Attached garage (top of siab) Is p feet ❑ meters C] above or ❑ below the NAO. E4. Top of platform of machinery end/or equipment aervfcing the bu(Idf�g Is ❑ teet ❑ meters ❑ abave or � below the HAa. E&. Zone AO only: If no Oood depth number is avallable, Is the top of the bottom (loor elevated ln accordanve with the cammunity'e tioodpiain management '� ordinance? C] Yes ❑ No ❑ Unknown. The local oftiolal must ce�tify this fnformation in SecQon Q. � SECTION F- p�iOp�RTY OWNER (OR OWNER'8 REPRESENTA7IVE) CERTIFICATION ..,. The property owner ar owner's autlioriaed represent�tive who completes 5ections A, B, end E for Zone A(without.a FEMA-issued or.communtty-Iseued BFE) or Zone AO muat sign here. The statements In Sectlons A, B, and E are correct to the beet of my knowledge. Property Owner's or Owner's Authorized Representative's Name Addreae City State ZIP Code � Signature � bate 7elsphone - {- _ -- Comments [� (�j�eck here It attachments. SE�TION � — COMMt1N�tY INFQRMATION (QP710NAL) 1;he local offialal who is authorized by law or ordinance to adminiater the community's floodplaln management ordinance can complete Sect ons A, B� C(or E), �nd a o.f this ElevaQon Certificate. Complet� the applicable item(s) and elpn below. Check the measurement uaed in Iteme G4a10..tn Puerto Rico oniy, enter metera. �1. ❑ The (nformaUon in Seotton G wea taken f�orri other documentatlon that has been sipned and asaled by a iicensed aurveyor, engineer; or architect who is authorized by Iaw to oerUty elevaQon informatian. (Indicate the eource and date ol lh� elevation data in the Commente erea below.) C32. ❑ A community offlcial completed 3ectlon E for a buildlnp Ivoated in Zone A(without a FEMA-lesued or community-Isaued BFE) or Zone AO. G3. [1 Tlie follow)ng information Qtems 04—a10) Is provlded for community floodplain management purposes: G4. F'ermit Number G5. Date Permit Iseued O6. Date CertiBcate Of ComplfanceJOccupancy Issued C�7. Thia permit has been Issued for. ❑ New Cvnstructlon ❑ 5ubetan8al Improvement G8. Elevatlon of as-bullt Iowest fioot (Including basement) vf the buiiding: . C) teet CI metera Datum G9. BFE or (In Zone AO) depth of flooding at the buildin8 elte: C7 feet CI metera palum C10. Community's design flnod elevation; ❑ feet � metere Datum - Local Official's Name Community Name Sfgnature Commenks riti� Telephone Dafe �p Gheck here ij�achmerits. . . ELEVATION CERTIFICATE, page 3 Building Photograph� See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE CoMF'ANY U5� Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Pblicy Numb2r. i i� ����:.��`���.- ��v�. City State ZIP Code Company NAIC Number: Ci���v�,�T� �-� 33 5� If using the Elevation Certificate to obtain NF�P flood insurance, a�x at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. ��� . .. . � / f ��� �' i � � � � � !� �,� , �-- , � � �■ � �: � � ,� ; -y`4 F. � _ : �AK�_ ..�1 � t ki� �� & , , � � ��:,�:,. - �� !MIi7n""o"'�r.nr�«.►v .«�,.+!�r,�+�-�`�v� � . , �.� . u.:,.s'�'"'"''� , ��� ,t. F�3't T / � � �� �� +►�uk ..-p � _�r � �,� � . � �_ � ' '� � ` i, � � 3 � � 0 � N ��. ,� ��, W �, y �m+. S3.'�q�� ���`.�!�h�eflAW. Y � �� ��� � �;�, � h - �,�+ � � � ;� �'�� �� � --- - . � . �'�+�,.'"�� . �.. . . ' . ' � � M.T`�:�- - . , _ . .. � � .. .... ',� „ --`—=--�r- Y . . __— _.— �•f 'Y��•A" �'�.. '.' �. ��` ,'�� ,� �- �, �� �' K„ i z ��° "� ,t t - � �` �tF,�� � ��� n:�;� �,���� .� #.«, !� r .'e, � c xw,� .. �i a�t�in: :. .