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1217 WOODLAWN TERU.S. DEPARTMENT OF HOMELAND SECURITY Federal -Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE OMB No. 16604000 ExplratIonDate: November 30, 2010 Important: FolloW theinstructioni ort pages 1-9.. 'Copy all pages of this Elevation Certifib* and all attadhmeritslOr (1) community offload, (2) insurance agent/company, and (3).building owner: .SECTION A — PROPERTY INFORMATION FORINSURANCE COMPANY'USE Al. Building Owner'S Name COSTA:HOMES, INC. Policy Number: A2 Building Street Address cmCludingApt, Unit, -Suite, and/cir•Bidg. NO or P.O. Route and Box- No. 1217 WOODLAWN TERRACE CoMpany NAIC Number 'City State ZIP.Code • CLEARWATER Ronda A3: Property. Description (Lot and Block Withers; Tax Parcel Number, Legal Description, etc.) PARCEL YB'',1311..CteCH, SHADOWLAWN PH* 03405-8038a-0000tv M. BuNding -Uee (e.g., A5. LattudelLongRude: A6. Attach at least A7. Building Diagnsm-Nurnber M. Fra building with a) • Square footage b) Nurnberof permanent c) Total net area.of d) -Engineered A9. Fora budding with .a) Square footage b) Number -of perinarent ay Total net area d) Engineered Residential. Nen;ResIderglai, Addikiri, Lat. N2749.39,6 .LOng. W Accesstn. MC) 'RESIDENTIAL 62-47-13.5 .Horizontal.Datiant obtain flood insurance. 1.0 footaboveadjacent above adjecent:grade 0 NAD 1927 grade JEI NAD 1983 5 2 photographs of the bulldog if the.C.ertificate 1 *being used to 512 sq ft a crawiapace of crawispade ilood flood openings:in flood °POMP? an-atteched of attadied -flood of flood openings flood openings? or endosure(s): or endosure(sy openings in the crawlspace Mb :592 sq.ln orendosure(s) within ft: within 1.0.foot sOlit 0 rives CI No wage: garage a sq Openingti in the attached *garage M A9.b. 0 0 Yee P No SECTION 13..a. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION WI. NW ComMunItY Name & tromPluntIY Wilber CitY .OF CLEARWATER 125096 B2. County Name PINELLAS 83. .State Florida B4. Map/Panel 10060* 85. *AK H 80. FIRM Index Date. 06/17/2005 97, FUN Panel' EffectiVel Revised Date. 05/17/2005 B8..FlOod gone(s) ?‘e 99. Base Flood Elevation(s)Number AO, Use Balm Depth). 21' 1310. Indicate thesource.of 0 F1S.ProOle B11. Indicate elevation .812. lithe building Designation Date: the Base j.FIRM daturh Used locatad:In a -Coastal Flood Elevation (BFE) O. Community Determined. forlIFEin QOM B9: Barrier Resoistes deita 0 NM System 'abase flood depth -entered* Itern139! 0 Other/Source 1929. fg NAVD1988 (C8RSIarea • OthedSotirce: or Otherwise Protected Area (OPA)?. 0 Yes 0 No II CBRS • OPA .FEPAA.FOrtit 0864-33 (7/16) Replaces aM previOus editions. Form Page 1 of 6 ELEVATION. CERTIFICATE OMB No.. 1660-0008 Expiration Date: November 30, 2018. IMPORTANT: In these spites, copy the correspOndingin(ormatIon from Section A. :FOR INSURANCE COMPANY USE Bulking- StreetAddress (inctirding Apt., Uri, Suite, and/or Bldg. No.) or P.O. Route and BoxNo. 1217 WOODLAVVN TERRACE Pdicy NUmber: City State ZIP COde. CLEARWATER 'Florida Company NAIC Number SECTION 6— BUILDING ELEVATION INFORMATION (suRvey REQUIRED) 0. Finished Construction AR/A1—A30, AR/AH, AR/AO. only, enter meters. C1, .BulldIng. elevations are based. on: 0 Construction DrawIngie • . Building.Under donstructiOn! FA new Elevabon Certificate will 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, Complete Items 62.13•74h below acccirding to the bufiding.diegtemepodfied in fiat A7...In PuertbRico BeriChmark•Utilized. HIGHLAND -B Vertical Cotten; NAVD 1988 Inelcateelevatkin datum used forthe elevations in items e) through h) below. II NGVD 1923 gi NAVD 1988 • OthertSourcC Datum used for building elevabontimutt be:the sameas thidosed Mr the BEE a) Top of bottom -no& (Including be:kernel* .crawispacA orendosure floor) 19., 32 Check the meastrement•used. M Met meters .0 b) 'Top of the next higher floor 22 10 0 feet 0 meters 0) Bottore ofthelowest hbrizohtial strucktal member (V Zones only) NIA M feet 0 meters, d) Attached garage.(top.cif slab) . 'WA 0 feet 0 meters e) elevation of madenely or equipment.tervIdng the building 22 .15 ID feat • meters .LoWerit (Describe type of equipment and ton in Comments) f) Lowestaclacent (ffreshed)grade next to Wilding (LAG) 18:2 [3 feet II meters g) Highest adjacent (Meshed) grade nO:d to building (HAG) 19.3 0 feet II Meters ko LoWest radjaCentgrade at lowed elevation' of debit oratalik inchiding 1.8_2 0 feet 0 meters •struCttiral support • • .SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signedendsealed by.aland surveyor,..engineer,•cirerthited(sailhorized by ;ow* that the Intoirriation ari this Certmcaterepresents my best efforts to Interpret•the dateavellable. stptemsnt pay be.punishable.by floe or knprisonment under 18 U.:$. .code, Section 1001.. law to certify elevatiOn friforMafion, tand-,adend that pny false .0 Check here If attachments. Were Mamie end longitude in Section A pro:prided by a licensed land surveyor? nye* is No Certiffer'sNaine License .Number SCOTT OSBORNE 18 6028 • • 47& i k/111 \ Ya 1.‘ ' =, e \',I4 , 1 .1 Title PROFESSIONAL SURVEYOR & MAPPER Company Name ARCPOINT SURVEYING •& MAPPING, LLC. Address 2389 KNOLL DRIVE Cit' State. ZIP Code SPRING HILL/ Florida 34808 Signs "dr pate timpoia Telephone (352) 053-7722 CopyaN — . ofthis Elevation Certificate and alt attachments for (1) carninutfitiofficial, (2) insurance agentkomparly, and (3) Wilding owner. Cements (including type of equiPinentand location, per 02(e), if applicable) ASA =The attached 8 eneloriedgerage is belowthe rallied slab. The Square footage of the hOuie above the slab Is 2059 st C2 -E = Thiefs the elevation arils raised.* conditioner pad • . FEMA Form 08633(7/15) Replaces all previous editions. Form Page 2 of 8 ELEVATION CERTIFICATE QMB. No. 1666.0008. Eicpiratbon Date: November 30, 2018 IMPORTANT: In these spates, copy. the corresponding kiforinatlon from Section A. FOR *INSURANCE COMPANY USE , Building .Street'Address (including Apt, Unit,, Suite, .and/or S(dg.. No.) or P.O. Route and *pc No. 1217 VUO.ODLAWN TERRACE Policy Number, City State ZIP Code.. CLEARWATER. Florida Company NAM Number SECTION E -BUILDING ELEVATION INFORMATION (SURVIY'NOT REQUIRED) FOR ZONE AO AND ZONE A .(WITHOUT BFE) ForZonekAO and A (without BFE), compkteltems, E1—E5. If the:Certificate.is'iMended.to.suppart.a complete Sections A, B,arid C: For'Itemms E1—E4, use manor's) grade, if sivaa1able: Check the measurement enter meters. El. Provide elmiationinforinetion for the following enc chedk the appropriate bokesto ehow'whether the highest adjacent grade (HAG) andthe'laweet. adjacent grade (LAG)., a) Top of bottom floor (including baa ement, crawlspace, or.endosure) is. ]"feet 0 meters LOMA.or LOMR:F request, used In Puerto. Rico only,. the eIeVation It above or below 0 above.or ■ -below the NAG. . . .b). Top of bottom :floor (Including basement, cravAspeoe, or endo sure) is ❑.feed ❑ meters . 0. above Or • .below the LAG, (see pages 1-2 of Instructions), E2. For Building Diagrams 6-9 with perma#nentttood openings provided In Section A kerns a end/or'9 the next high floor (elevation C2.b In the diagrarris) of the building is pleat [] meters ❑ above or ■ below the HAG. 0 above or ['below the:FHAG. E3..Atta shed gatage (top of slab) Is • feet. 0 meters E4. Top.of platfonii'of inachineryand/Or equipment servicing the building is■ feet 0 meters- :0above or INbelow the HAG. with the community's Information in Section G. ES. Zone AQ *only: If no lobd depth number is available. lathe top of the bottom floor elevated in actordence 1loodptain menagementordinance? [J Yes ❑ No (J Unknown. the local official mufiteerttfy'this .SEbTtION.F—PROPERTY ONER(OROWNER'S.REPRESENTATIVE) CERTIFICATION ThC property owner dr oiNrier's authorized iepresentative:who completes Sections A B, and E for ZoneA (Without.aFEMA-issued.or ue community-issd BFE) or Zone AO must sign here. The statements in Sections A. B, and :E are. correct to.the•best.of my (knowledge. Proper*'Owner-or Owne?s Authorized Repiesentative's Narne Address City State ZIP Code Signature. Date Telephone Comments ❑ Check here if attachments. • FEMA Foam 088.033 (7115) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No.1660.0008 Expiration Date: November SO, 2018 IMPORTANT: In thesespaces, copy the.correspotkling Information !tole Section A. FOR INSURANCE COMPANY USE Budding Street Address.-tinduding Apt., Unit, 'Suite, and/or Bldg. Nolor P.O. Route and BokNe. 1217WOODLAWN teRF*E Podoy.Number City 'State ZIP Code. CLEARWATER. Flodde Company NAIC Number .SECTIONG - COMMUNITY INFORMATION (OPTIONAL) Thalami official who is authorized by lawornMinance Se4tions A. B, .0 (or E). and G of Mit FleWittlea used in-Iterns GB -G10. In Puerto Rice only, enter 0 The ItWOrmatiOn M.Section.CWastaken engineer,. or architectwho is authorized. data in thetommerits area bel..) G2. 0 A Oo:nl nitinjly ofticial.cOmpleted Seal:4TE zA to edministeetha cOmMunity's floOdplalii mbnagement ordinance can complete Certificate. Complete the applicable iteM(S) and sign below...Check the measurement meters. from other dociimentatiOn thet has been signedend seeledby a licensed surveyor, by. law tocertifi elevationinforrnation. (Indicate die:sour= and date Of the. elevation for a building located In Zone A (uvithoUt a FEMA4sstied or community-Ism:Kid FE) for community kodpialn•manageMel*PurPeses, Da. . The folk*Ing Information (Items 44-G1)1s.provicsd G4. Permit Number oS. Date Permk Issued (3e. Date Dertific.ate of CoMpliarce/Occuparicylsaued G7. This permit has been titled for 0 GB. Eievadon of as-budt lowest floor(induding of the building' G9. i3OE or tin ZonaAO) depth(); flooding et the Gib. Community'edesign flood elevation: 0 feet 0 feet New Construction • Substaralsa Imprcivement base.merit) • Meters Datum building tilte: • • meters Daum 0 meters Datum •„ • feet 'mei Pffiaiars Name Title Community Name Telephone Signature Date Comments (induang type of equipmenterid location, per C2(e), (fappkable) 0 Checkliere If attachMents,. FEMA Form o88 -a -3a (7/15) RePkicee aliprevioirs editions. Form Page 4 Of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit• Suite, and/or Bldg. No.) or P.O. Route and Box No. 1217 WOODLAWN TERRACE Policy Number: City State ZIP Code CLEARWATER Florida Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix 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. ,.. !tet• _ }'• es. 41 5 . . Roto One Photo One Caption FRONT VIEW OF BUILDING 11/01/18 :• 5 i r ' . t r iloto 1 Wo Photo Two Caption REAR VIEW OF BUILDING 11/01/18 FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 5 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name COSTA HOMES, INC. Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1217 WOODLAWN TERRACE Company NAIC Number City State ZIP Code CLEARWATER Florida A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL "B", BLOCK "C", SHADOWLAWN PID# 03-29-15-80388-003-0030 A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat. N 27-59-38.5 Long. W Accessory, etc.) RESIDENTIAL 82-47-13.5 Horizontal Datum: obtain flood insurance. 1.0 foot above adjacent above adjacent grade ❑ NAD 1927 grade x NAD 1983 5 2 photographs of the building if the Number 7 Certificate is being used to 512 sq ft with a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b 592 sq or enclosure(s) within in sq ft within 1.0 foot sq in 0 ❑ Yes x No garage: garage 0 openings in the attached garage in A9.b 0 ❑ Yes x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF CLEARWATER 125098 B2. County Name PINELLAS B3. State Florida B4. Map/Panel Number 12103C0106 B5. Suffix H B6. FIRM Index Date 05/17/2005 B7. FIRM Panel Effective/ Revised DateFlood 05/17/2005 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) Zone AO, use Base Depth) 21' B10. Indicate the source ❑ FIS Profile B11. Indicate elevation B12. Is the building Designation Date: of the Base Flood Elevation (BFE) ❑ Community Determined for BFE in Item B9: Coastal Barrier Resources data ❑ NGVD System or base flood depth entered in Item B9: ❑ Other/Source: x FIRM datum used located in a 1988 ❑ Other/Source: or Otherwise Protected 1929 x NAVD (CBRS) area ❑ OPA Area (OPA)? ❑ Yes x No 1111 CBRS FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1217 WOODLAWN TERRACE Policy Number: City State ZIP Code CLEARWATER Florida Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* *A new Elevation Certificate will 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, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Benchmark Utilized: HIGHLAND -B Vertical Datum: NAVD 1988 x Finished Construction AR/A1—A30, AR/AH, AR/AO. Rico only, enter meters. Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 x NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 19. 32 Check the measurement used. x feet ❑ meters b) Top of the next higher floor 22 10 x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet ❑ meters d) Attached garage (top of slab) N/A x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 22 15 x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 18. 2 x feet • meters g) Highest adjacent (finished) grade next to building (HAG) 19, 3 x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 18. 2 x feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by I certify that the information on this Certificate represents my best efforts to interpret the data available. statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. law to certify elevation information. I understand that any false Were latitude and longitude in Section A provided by a licensed land surveyor? x Yes ❑ No ■ Check here if attachments. Certifier's Name License Number SCOTT OSBORNE LS 6028 Title PROFESSIONAL SURVEYOR & MAPPER i .. ( _ '� - Y1 " '. e-` � e . \ \ '1 Company Name ARCPOINT SURVEYING & MAPPING, LLC. Address 2389 KNOLL DRIVE City State ZIP Code SPRING HILL Florida 34608 Signat e Date Telephone -iA--. 11/01/2018 (352) 683-7722 Copy all pag s of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) A8 -A = The attached & enclosed garage is below the raised slab. The square footage of the house above the slab is 2059 sf. C2 -E = This is the elevation of the raised air conditioner pad FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1217 WOODLAWN TERRACE Policy Number: City State ZIP Code CLEARWATER Florida Company NAIC Number SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑ above or ❑ below the HAG. ❑ above or ❑ below the LAG. 9 (see pages 1-2 of Instructions), ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. ❑ above or ❑ below the HAG. with the community's certify this information in Section G. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters E3. Attached garage (top of slab) is ❑ feet ❑ meters E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1217 WOODLAWN TERRACE Policy Number: City State ZIP Code CLEARWATER Florida Company NAIC Number SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance 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. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone AO) depth of flooding at the G10. Community's design flood elevation: New Construction ❑ Substantial Improvement basement) ❑ feet ❑ feet ❑ feet ❑ meters Datum building site: ❑ meters Datum ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS ELEVATION CERTIFICATE See Instructions for Item A6. OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1217 WOODLAWN TERRACE Policy Number: City CLEARWATER State Florida ZIP Code Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix 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. Photo One Photo One Caption FRONT VIEW OF BUILDING 11/01/18 Photo Two Photo Two Caption REAR VIEW OF BUILDING 11/01/18 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6