685 SNUG IS;
0
�
F�U�F2At.. �M�tttsttvt,. � t��r,�.,,..�..��... � ....�.. �
NA710NAL FLC}OD INSt1RANCE PROGRAM `�-���.". "�'. "��. �"�' ,
� Expires Decemtter 31, �00� �
E�.�vATtaN c��TiF�c�,T�
Im oc#ant: Read the ins#ructions on a es 1- fi,
`s�c�ioc� R - ��o���rr own��� ��+Fa�Mat�arr �',�� �;�°'�«rc��s��';:��
DEiV{'a {J{IVNER'S NWAME ...
��uttt? �c��ltd�tJpl
3ft�lC. STRE�"i' At}[3FtESS (indt�di ApL, Uc1it, 5uite. 3r�dfOC E33tig. NC.} €3R P.O. ROl7T� A,Mt3 803C t+ld.
��5 5��� i 517�,Ci
C1eat`water F�. SYATE' 33ifi7'
�
�
LA7fTUD�tti}NGiTiIDE {ClPT1i?NAGj tipRl�4htT�l C►ATUM: SOtJRCE: j=1 G�S (±ype}:
( r�r° -�• -��.�r• o� ��.� y � t�at� ��2� L� n�a:� � sa3 l.�1 �s�s �rv.,� n�an 1,�1 cnner �f�.�
NA �A
SE�TION B- FLf3t)i} 1FlSURANC� RAT� MAF (FIRM} #tdFORN1ATIC1t�C
s
F•I•Ix ki�;. NtKt� INUL-X 67. F4Rf�f F'ANEL
[7ATE �FFECi'IVFiREV15EU f}T�3�
{Zarse At�, use d�ptl� at
� ��so�� o�az � � �fo�tzo�� �ta3�zoa� 1 ��A ��� � � � o
pit}. lndicate the : ource of ftic E3as� Ftoe�d �it;v�#ion (�FE) tlata ar base tic;tad depih entered in �9. -
��1 FIS Profite �X j FtRM (__j Community [3et�ermin�d � Othet (f}e`scrib�}:
811. lndicaie thc� eievativn datum usod fur tt�e 8�E in f39: j_j NGVt� t929 ( X j NAVD '198fS �,,,� Other (C�escnbej: ,�, _
812. ts the buildiag locatc�d in a�oastat f�a�r�3er Resources Systern �GBRS� area or 4therwisc Protected Ar�a {t�PA?? I_,_I Yes I�I hta
De�i�natior� [fate:
s�cr�c�t� c= et�it�ntt�� E��var�c�N ir��o�a�ron� {suRV�w ��c�u���n}
Ci � E3ui6ctft�g el�vatiorxs s�re based �n: (_jC.su�strucUvn Drawings' L j8uitdru� !lnder �:o�sttuctior�� j�X Finished (:onstructsc�n
'A new �levation CertiPcate �rill be required when canstruction of the buiCd►`ng is compCete.
C2. 8uiktirig I}iagram t��mber 1 (Setect !h$ buildin� diagram rru�si sitr�iiar to the bulding ttsr w#tich this ceriificate Is beir�g corn�rieted - see
pages 6 arrd 7, !i no diagram accur�t�ly r�presents the buiiding. Pravide a ske#ch csr phc�iograph.y
G3, Etevations = Zor�ss A'{-A30. AE� AFI. A{with E3FEj, VE. Vi-V3t'i. V{wiih BFE.j. AR, ARIA. Af�/A�. A�1�1-A3Q FiWAii, AWAC}
Complet� Itcros C3.a-i b�i�w acxsarding to tft� buiEding dtagram speciiied in itern ��. State the datum uscd. If the daium is di(ter�nt trom
the datutn u�d fi�r �he BF� is� Se�tian 8. a�nvert ihe datum ta t#aat uscc! for the B�E, Show �els! me�surem�r�is anr! datusn convecsibn
calcuRativn. Us� lt��s spar.� prov�deti or ihe Gsmrnients area a# Srec�c�n (� or Sec�n G, as apprapriate, io docurn�nt tf�e� �alum conv�rsican.
Ctatum �AVD i9�$ �onvers�nlCammer�ls W�ter heater ir+a��essiFrie at rime.n =��r,r�
�tevaiion r�feren� marlc ussd�C Iw. ,� 1, , b. 5� tkres the �lEVativn refere�oe ma�ic used ap{�sQar on the FIFtM? �,j Yes �X � No
C.1 a} Top nt be�tt�m ticrc�r eejctosurej � Low 1 i v� $. 9 ft.(m} ;�
C] by Tvp of n�e� higt�er ttoor N, R tt(m� � 2lQ2/20�6
CI cj 6ottvm oi {owcs! tte��zoniat siructurat rnernber (V z�nes ontyj �. A� f�.{rrs� 'N « P. L. S. �!� 1�G ,!'
[� d) Att�che� garage (tc�p oi stab} $ , 1 �,��� � ° ,eS���� +�Y�� °�7'�
0 ej Lc�west ciev<sl�an oI m�chin�ry andlot equipm�nE `� s`' R ,/r t'"
s�rvic�� the #�uilding (�CSCril�c in a Comments arca.j { A%C t!N t T j $ 3�.(m) �' �
.-- �
l� fj Law�st ad�a�er�l {��ished} grade (LAG} 7:� ft.(m) ��
Q gj Ni�hest adjacent (fini5hed} grade {NAG) 7. 7 ft. m r
�� fnrs cea �TC �ns eC�N eR ncn
C7 hj t��> at permanani o�cni»gs (tioc�d vents) wit#t�n 1 tt. above adjas�nt grade td1A � � raa r�+svaar�c� au�ros�s o+r�v aero �s
Cl i Tot�1 a�ea of alt �nt ro �c usFO'ran coasiaucs�oM
) {�ssrm��cnt opeairu�� (Ao+�d ventsj in G3.h F�IA sq. in. (sq. cm)
SECTI�N p- SLlRV�Yt3R. �NGINEER, OR ARC#lITECi' C�R"i1�tCAT10N
'C'his ce�ii�rcaiio� is ta be s+gn4c3 �nd sealed by � larstl surv�yar, engineer, oc archftecf authorized t�y law ig cerU�y cttsvat�n infom�ation.
/ eerlify that the ir�tamaGorr lr� Secliarrs A, 8. ��c� c on rn�s cerr�tcare �p,�sene� my,�esr �t��s co rnre��er rn� asra aYatr�ar�.
1 underst��ta► thaf �ny �else statemerrt maY be ptrnfsf�abJQ by fine or imp�risonrrr�nt �rr�der t8 U S G�de Section fQOt
CERTiEiE�i'S !�[AME UC�NSE t+ttJMB€R
Edward J. Lartqton, Jr. l��154
TIi`t.l� CC}M�'AN1r NAh+t�'
.. � Pretf.sr�� 5�,..-,1 1 .....1 fi�..�.............. . �. r,...r...,.... .,,.s.�..,,......� ..._
Gtetk It�e it i�a�utMe�11S
��C11�/i. C�� 1i�♦� 9r ����____ _ �:ww.w� .. . . . . . .... .. .
tMPC1RTAN�': in therso spaces. capy Ehe co�ressp
E3il:LC3tNG 5T#2EETA�ldR�SS (IndtWtngApt., tJnit, Sui�c
Wi
� �i�,rt SRlF4 ( S � drtd
c�rr Ctearwater �1.
SEC'T'IUN O - SURV�YCiR.
#rom SociTon A Wr Ir�s�urance +
'.O.ROIlTE AND �QX NO, Polic3t,Number
ST�1TE ����� 2iPC�0E
EER, t3R ARGHiTECT CERTiF{CAT10N (CQ
�apy bath sides of this EtevaGon Certi!'ic,ate !or (i ) community a�ciat, {2� insurance agent/company, and (3) buitding owner.
GOtw4tvlEt,i77s
11se:
SECi'tON E- BL11LD1lJG �l.�VAI'ION lFt�ORMATif}N (SUF2V�Y NO�' REQUtREQ) Ft}R 20NE AO At+tb ZC7NE A�1+1fITflOtl7 BFEj
Fo� Zor►e AC7 and Zane A(withou! 8FE). ra�mp[eta ttems Et. throu�h E5. If #h� Eievatian Ge�tifica#e is intended foc use as svpptsrting
intarma#i�n far a l.t3hM ar I.OMFt-F. Section G must k�� camptt�ted.
E 1. Buitding Ctiagrarn Numbe� {Setect the bu�kiing diagram most simi�ar to ttte bu`slding tor wh�ch this c�erti�r,�te is b�ing c�mpleted �
see pages 6 and 7. it rw diagr�m accurately re�rc�ents the buitding. Provide a sketch or photograph.}
E�. 7he top r�i the bntta� tloor {inctuding bas�meni or enclosure) csf fhe t�uifid'sng is I,I_I ft. {m} I.�L_I in. (cmj I� ahove or � belv�v
{ct�eck onej the haghest adjacent grade. (Use natural grade, i( avaiiable.)
�3. Far 6uilding i3iagrarn5 6-$ with a�enings (se�e p�c�e 7), th� next hi��rer f3oor ot etevaled flopr (el�vati4n bj ot the building is
�_J fi• (m) u_Jin. (cm} abovc itse highest adj�ccnt gracie. Comptete Items C3.h and G3.i on tront of form.
E�. "Tt�� !op �i the piaCtorm of mach�r�ery ansitar equipmen# servicing the b+�itding is �,j,,,,, j!t. i�)1,,,,_I._I in. {cm} I.�) at�vs or � befc�v,
(the�k anej ttte hi�hes! �djacent grade. {tJse nalurat grade, it avaitabt�,)
E5. For Zone Ati anly: �f no flood depth n�rmber is �vaala5l�, is ih� 1op of lhe baEt4m float' clevated in accurdance wiih !he community's
t��ipfain rr�anaqernent ordinance? f E Yes � R Nt� I I Unkna,nm. 7he [ocal uiticisi musi certify ihis inforrriation i� SecGan G-
SEGi'ION F- pROF�ERTY OWNER (4Ft OWNER'S RER�tLSEMI`A'fIVEj C�R7iFtCA710N
The presperty awr�er or owner's �ulhorized r�pr�esentative who tampletes Seciio�s A, 8. G{Iterris C3.h and C3.i onlyj, and E far ZQne A
{without a�EMA-issued or cammvnit}r-is5ued BFE} o� Zone AO must s�n hcre. Th$ statemeRts in Seations A, B, G, arrd E ar� cor�ect tts
�he best ot m knowled - e.
RROPERTY O�NNER"S OR t7rWNEft'S AUTM{?RlZ�D REPRESENI'Ai'I51E'S NAME
,4QORESS CiTY STATE ZtP C{�OE
S[GMA'N�2E OATE TELEPHONE
CaM1�iEt+ff'S
(—I Ct�ck heEC it aEtachments
SECTIt7N G - CAMMUAtITY (!�F{7RMA1'!t]N (OPT10NA1»j
The tacal Qtf�cial �ho is authonzed by !aw or ordinance to atlrninister ihe ccmmunity's iloodptain management o�inance c�� c�mpt$te
5ec:#ions A, 8, C�or E), and G ot this �IevaGOn Cartificata, ComptQRe tho applicai�lQ item{s} and sign belaw,
G1. �,_,j The infortnation � Sectian C was taken from c�ther documentaiicn ihat has b�en signed and ernbassed by a liee�sed surveyor,
er�g�n�er, ar arct�itec# wha is aulhorixed by state c�f lacal !aw lo certify elevalion infonnaGon. (Indicate th� sflurce and dale ot thc
efevation data in th� Commersts acea belaw.j
G�. f_..) A cvmrnunity aifictal cotn�It�iQd 5�ction E tar a building lacaled in Zane A(w±thoul a FEMIk-issu�d ar comr»unity�issu�d B�Ey or
Zone A�.
G3. �� 7he !allaw'sng infQrr»ati�an (txems Gd-�9j 1s provide� lor cornmunity fioodptain manac�ement �urpases.
G4. PERMtT
L!�
�
G7. �'his pertnit has b�en issued tor: �f New Cc�flstruCliqn
t38. Eleusiion ot ss-buttt bwest iloor (including basement) a1 the
G9. B�E or (in Zone AtJ} depth oi tk�ad"ing ai �he building site 1s:
G6. DATE CEF27tF1GA1'E t3F C�fvSpLtRtJCF1{}CGUPIINCY
lSSU�O
astaniia! Improvament
is: ft. (mj Daturn:
_ R. (mj Dalum:
ccacn�. c��cw�: s r�,aa�� �rrt,�
CUMtntlMrC1Y t+I11M� T'Et.EP!HOlVE
SIGtaAl'l1RE O1tiTE
C.'{)NI#�Erif;'S
- � t ptedt har8 it at�xnents
FEMA �orm $t-3S, Januacy' 2003 Fte�tf�ces � pr�avious editions
FtUkKA�. EMthct�trv�, i �nru�r��.�..��.. � .....�.. _
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
: Read the Instructions on paqes 1- 7.
SECTION A- PROPERTY OWNER INFORMATION
Bruno Cantalupi
BUItOfNG STREET AD�RE55 (indud'� ApL, Unit, Suite, 3nd/or f3ldg. No.) OR P.O. ROUTE AND 90X NO.
6S5 Snu4 Island
V.fYI.U. 1 �V. JV.. • .
Expires December 31, 2005 �
c��' srA� ZIP CODE
Clearwater F1. 33767
PROPERTY QESCRIPTION (lol and BEOCk N�mbcrs, Tax Parccl N�mber, Legat Oescriptipn, elc.)
Lot 20, UN�7 78 ISLAND ESTATES OF CLEARWATER
BUILDWG USE (e.p., f{esidenGal, Non•residential, Rd�Gon, Accessory, elc. Use a Comments area, N necessary.) � �
Residential
LATITUOFJLOtJGiTUDE (OPTIONI'.l.) H�Rt20F1TAL DATUM: SOURGE: L� GPS (Typej:
(�u° -�� .�x.zu• or az.��tta'� U r�no �sz7 LJ hlAO 1983
��� NA L.,_I VSGS Quad A+iap (,�J Olhcr _�jA
SECTION t3 - FLO00 INSURANCE RAT� MAP (FIRM) IhlFORMATION
ST.
64, h�J�P J1ND PANEL [35. SUFfIX 06. FIF2M INDL-X 87. FIF2M PANEL (30. FLO00 89, f3ASE FLOOD C-LEVATION(S)
NUJ�BEl2 Dl:TE EFFECTlVElREVIS�D DATE ZUNE{S) (Zone AO, usc tiepiti ot Ooodir.g)
� aio2 c 9/0 /2oa3 9/0 /zoo "AE" z�.o
E3t0. Indicale lhe source af tl�e Eiase Fload [levalion (BFE) dala or base Rood depih eNered in 89.
I_1 FIS Profile �X J fIRM (�j Community Determined �_j Other {OcscribeJ:
B11. Indicate the etevation datum used (or lhe BFE in �9: L,J NGVD i929 U NAVp 198n ��J Other (Describe): _
612. Cs the building localed in a Coastal �amer Resources System (CBRSj area or Othervvise Proleded Area (OPA)7 (_J Yes I�LI �a
DesignaGon Oale:
SECTION C- BUILOING ELEVA710N 1NFORMATION (SURVEY REQUIREDj
C1. Building e(evaGons are based on: (JCanstruction Drawings' �,_jBuildng Under Consfruction' UFinished Construcl;an
'A new Elevalion Certificate will be required when construcGon of tho buifding is complete.
�2. 8uilding Oiagram Numbe� 1 (Select ihct bui(ding diagram most similar to the bulding (ar which this cerGficato is being compleled - see
pages 6 and 7. If no diagram accuralely represenls the building, provide a ske[ch or pholograph.)
C3. Elevatio�s — Zones A1-A30, AE, AN, A(with BFE), VE, V1-V30. V(with BFE), AR, AR/A, ARIA�, AR/A1•A30, AR/AH, AR/AO
Camptele Items C3.a-i betow according lo lhe buitding diagram speclfied in Item C2. State the datum used. If the datum is difterent from
the datum used for the BFE in Sedian B, conve�t lhe datum ta thal used for 1he BFE. Show field measurements and dafum canversion
calcutaGon. Use the spacc3 provided or the Gommenis area of Section 0 or Section G, as appropriate, to document tho datum convcrsion.
Datum NAVD 1988 �nversion/Cnmments ua ter hea ter i na c
Efevaiion refCrence marfc used C 1 w. 1/ 1, 6. 5 Does the elevaGon reference mark used appear on lhe FIRM? �_( Yes �X � hia
❑ a) Ta� of bottom ftoar ' enclosurcj ( Low 1 i v) 8, 9 h,�m� q
D b) 7op ot next hiflher Ooor N A is.(m} p 2/02/2006
� c) goUom ot �owest horizornal swctural memher (V zones only) � a ti.(m) � � P. L, S, tI3 � 5 u
❑ d) Attached garac�e (top of slabj $ , 1 {�,�my � p _e??s�� .� �
O e) Lowest clevation of machinory and/or equipment �' ° %
servicing the Uuilding (Dtseribe in a Camments area.) { A/C UN I T j $ 3 ft. m�' �
� � E_
❑ Q Lowesl adjaccnl {finishedj g�ade ([AG} 7. 6 tt.{m) z' �
O g) Highest adjacent (finished) grade (HAG) 7• 7 It.(mj � TInS tER � AT[ IthS BCEN PA Rtp
0 h) No, of �ermanent openings (flood vents) within 1 it. above adjacent grade N/A J • rae IHSURAM(E PURPpSfS OMLY AttO �s
O i) Tatal arca of all nermanenl openings (Qood vents) in C3.h N/A sq. in. (sq. cm) ear i0 BE USED fpq COttStAUtT 16H
SECTION D- SURVEY�R. ENGtAtEER, OR ARCNfT�C'f CERTtFICATION
This cerUfication is to bo signad and sealed by a land surveyor, engineer, ar architect authorized by law to certify elevatian information.
1 ceriify iha! fhe inlorn�a0on !n Set/iorts A, 8, and C on lhis ce�fificale represenfs my besl eNo�ts lo in(erpret (he dala available.
1 understand fhaf any false s(afement may be punlshab/e 6y frne orimprisonmenl under �8 U S Code Sec&on lOOt
CERTIFlER S NAME UCENSE NUMBER
Edward J. Lanqton, J� �3154
TIT�E .. � . . . . _ COMPANY hIAME
EMAORTAN7': !n lhoso spacos, copy the corresponding
BU:LDENG STR�E7 ADDRESS (MCluding ApL, Unil, Suile, and►or
` 685 Snuv lsland
��� Clearwater F1.
iniormat(on lrom Soctlon A
9fdA. No.t l�R P.O. ROUTE AND BOX NO.
S7ATE 33767 z1P COOE
For Insuranoa Company Use:
Number
SECTI�N D- SURVEYOR, ENGINEER, OR ARCliiTECT CERiiFtCAT10N (CONTINUEOj •
Copy both sides ot lhis Elevation Cectificale for (1) community official, (2) insurance agent/company, and (3j building owner.
COMMENTS
� � Chedc here it attachments
SEC710N E- BUILDlNG ELEVATION 1NFORMATION (SURVEY NOT REl'1UIRED) FOR Z�NE AO AND zQNE A(WITHOU7 8FE)
Fa� Zone AO and 2one A(withaul BFEj, compfete Items E3. through E5. li lhe Elevatian Certificatg is intended for use as supporting
infatmation for a LOMA ar LQMR-F, Settion C must be completed.
Ei. Suilding Diagram Numbe� (Select the building diagram mosl similar to lhe building for which lhis certificale is being Ctmpleled —
see pages 6 and 7. If no diagram accurately repcesents the buiidiag, provide a sketch or photoc�raph.}
E2, The Iop of lhe bottam tloor (inclucfing basement or encfosurej nf !he building ts �_j_j tL {m) �_�� in. (cm) (_) above or j_( below
(check one} the highesl adjacent grade. {Use natural grade, ii available.)
E3. For Building Diagrams 6-8 with openings (see pa�e 7), the next hic�her ftoor or cle�ated flaor (elevation bj of the building is
�,jJ ft. (mj �JJin. (cm} above the highest adjacent grade. Complele ftems C3.h �nd C3.i on front ot torm.
EG. The !op ot ihe p!a(form of rnachinery and/or equipment servicing the building is �J_j ft. (m) ��^J in. (cm) (�f above or U betow
(che�k onej lhe hic�hesl adjacent gradc. (Usc natural gradc, if available.}
�5. For Zone A� onty; If no 11ood deplh number is available, is (he tap of Ihe bottom floo� etevated in actordance vrith Rhe communily's
Roadplain manaqement ordinance? � � Yes �( No ( � Unknown. The local olficial musl certi(y this iniormalio� in Section G.
� S�CTION F- PROPER7Y OWNER (+dR OWNER'S REPRESENTATIVEj CER7IFICA710N
The property owner or awners authorited representative who comptetes SeGions A, 8, C(Items C3.h and C3.i or
�withoul a FEMA-issued or community•issued 8FE) or Zone AO must sifln here. The statements in SecUons A, 6,
the besl of my knowledqe.
PROPERTY OWNER'S OR OWhtER'S AUTHORR2E0 REPRESEN7A7NE'S NAME
, and E for Zone A
and E are correct co
ADDRESS CITY STATE Z(P CODE
StGNATURE OATE TEIEPHONE
COh4MENTS
(�) Check here if attachmenLs
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
Th� tocal o(fiaal who is aulhorized by taw or ordinance to administer !he communily's Ooodplain management ordinance can comp(ete
Sections A, B, C(or E), and G af this EfevaGan Certificate, ComplelQ the applicable ilem(s) and sign below.
G1. (_j The in(ormalion in Section C was taken from ether documonlation lhat has been signed and embossed by a licensed surveyor,
engineer, or architect who is aulharized by stale or local la�v to certify elevation infonnation. (Indicate lhQ source and date o► the
elevation dala in tha Comments area 6efaw.)
G2. j_� A communtly o(fictal completod SecUon [ for � building locateci in Zone A(without a FEMA-issued or community-issued BFE) or
Zone AO.
�3. ��� The tollowing intom�alion (Items GA•G9} is provided for community tfoodptain managemenl purposes.
G4. PERMIT NUMBER G5. DATE PERMIT 1SSUED GG. dATE CERTIFICt�TE O� COMPLfANCFJOCCUPANCY
ISSUEO
G7. This pertnii has been issued for: (� New Construction �_J Subslanliat Improvemenl
GS. ElevaGon of as-built lawesl 8aor (including basementj ot thc building is: ft. (mj Datum:
G9. 8FE or (in Zone AO) depth of fboding at lhe building sile Is: _ ft. (mj Datum:
LO�AL OFFICIAl.'S NAME t17LE
CCIMMUNtTY NAME TELEPHOfYE
5lGNATURE
COMMENTS
I 1 Checic here if attathmenLs
FEMA �ortn 81-3t, January 2003 Reptaces a0 previous editions
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LANGTC}N SURVEYING� I NC. �,.g, ���4} 6285 FARK BQULE1fARD, PINELLAS PARK FL 33761
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