321 PALM ISLAND NEFEDERAL; EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Important Read the instructions on pages 1- 7.
SECTION A PROPERTY OWNER INFORMATION
BUILDING OWNER'S NAME
Denis A. & Cheryl L. White
BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
321 Palm Island NE
CITY STATE
Clearwater FL
PROPER -1Y ESC UNIT (Lot and
Numbers,
OF CLEEARWATER ems)
BUILDING USE (e.g., Residential,tiNon-residential, Addition, Accessory, etc. Use Comments section if necessary.)
Residential
O.M,S. No. 3067-0077
Expires July 31, 2002
For Insurance Comp
Use:
,Policy Number
Company NAIC Number
•
ZIP CODE
33767-1931
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: LJ GPS (Type):
LJ USGS Quad Map LJ Other.
( toe - ## - ##.##. or ##.# #°) L1 NAD 1927 LJ MAO 1983
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY E & COMMUNITY NUMBER
City of Clearwater 5096
82. COUNTY NAME
Pinellas
83. STATE
FL
B4. MAP AND PANEL
NUMBER
125096 0007
B5, SUFFIX
D
86. FIRM INDEX
DATE
7/2/92
87. FIRM PANEL
EFFECTIVE/REVISED DATE
8/19/91
88. FLOOD
ZONE(S)
AE
89. BASE FLOOD ELEVATION(S)
(Zone AO, use depth of flooding)
11.0'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89.
LJ FIS Profile 12ci FIRM LJ Community Determined L.J. Other (Describe):
B11. Indicate the elevation datum used for the BFE in 89: Ej NGVD-1929 LJ NAVD 1988 1J Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LJ Yes Li No
Designation Date:
SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: LJConstruction Drawings* LJBuilding Under Construction* LYJFinished Construction
•A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. 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/AO
Complete Items C3a-i below according to the building diagram specified in Item 02. State the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to thatused for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum NGVD 1929 Conversion/Comments
Elevation reference mark used City BM 7.275 Does the elevation reference mark used appear on the FIRM? LJ Ye:
❑ a) Top of bottom floor (including basement or enclosure) 11. ,__ ft.(m)
❑ b) Top of next higher floor 22. /1_ft.(m) a
O c) Bottom of lowest horizontal structural member (V zones only)
N/A. _ R(m)
O d) Attached garage (top of slab) 7 . L. ft.(m) a
O e) Lowest elevation of machinery and/or equipment
servicing the building 11 0 Lon)
D 1-
f) Lowest adjacent grade (LAG)
O g) Highest adjacent grade (HAG) 1.0. 9 ft.(m)
O h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 12 8
O i) Total area of all permanent openings (flood vents) in C3h 818 sq. in. (sq. cm)
6.9 ft.01 Z .
L No
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed bya land surveyor, engineer. or architect authorized by Law to certify elevation information.
1 certify that the information in Sections ,4, B, and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by or imprisonment under 18 U.S. Code, .Section 1001.
CERTIFIERS NAME Edward C. Elliott LICENSE NUMBER 3983
TITLE Professional Surveyor & Mappe COMPANYNAME Ovecheck & Elliott. Inc.
ADDRESS CITY STATE ZIP CODE
0 9 Roosevelt Blvd. Clearwater
SIGMA 9,4
DATE 3/20/01
FEMA Form 81-31. AUG 99
SEE REVERSE SIDE FOR CONTINUATION
FL 33760
TELEPHONE
(727) 524-9666
REPLACES ALL PREVIOUS EDITIONS