2045 ANCHORAGE WAY (2) FCDEi�l.;�i'Jil�RG�NC'y'iNAf�GflV'�i:iti� r�,�EIvCY O.M.B. No. 3067-0077
�' r' ' NATlONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
--��
� - � � � � ELEVATION CERTIFICATE ��,� �.� , � � �� p, � ._
Im orkant.Read the instructions on a es 1-7. '�� � ✓ '� �'� �' �? ��'._.�:
�� SECTION A•PROPERTY OWNER INFORMATION Fa Insu�anoe Canpary Use:
;iLD�ING OWNER'S NAME Pd�y Number
JASON R. HARRE & LAURA E. FANKUM
, B�IA.DI�G ST�F�jHB�F�EGE��WAY A�''Unft,SuRe,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
U4
C�N STATE ZIP CODE �
CL�AR��TER � � FLORIDA 33755 �
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legat Descriptlon,etc.)
' LOT 8 , BLOCK "A" , BAY TERRACE
BUILOING USE(e.g.,Residentlel,Non-residenllal,Addkion,Accessory,etc.,Use a Comments area,If necessar�r„)
�RESIDENTIAL '� • , � , � . ,
U171TUDE/IONOITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS(Tme): � --
( #N°-#If'-#q.i4�f" or #N.#�Ifli' ❑NAD 1927 ❑NAD 1983 ❑USOS Quad Map ❑Other:
•�.
SECTION B-FLOOD INSURANCE RATE MAP(FlRII�INFORMATION
81.NFIP COMMUNf iY NAME&COMMUMTY NUMBER _ 82.COUMY NAME . B3.STATE
CLEARWATER-125096 PINELLAS FLORIDA
,84.MAPMD PANEL � . B7.FIRM PANEL B9.9ASE FLOOD ELEVATION(S)
NUMBER l35.SUfFIX 86.FIRM IrDEX DATE EF�ECTIVEIREVISEDDATE 88.FLOOD ZONE(S) (Zona A0,use deplh of floocirg)
125096-0106 "G" 8-19-91 9-03-03 "AE" 11 .0 ,
610.Inckate Uie�rrce d the Base Flood Elc�ration(BFE�da�a base Aood de�lh ente�eci in B9.
❑FIS Pro61e �FIRM ❑Cmmunity Determined ❑Ofher(Desaibe):
811.Irxkate the elevation dahm tsed/or Uie BFE in B9:�NGVD 1929 �NAVD 1988 ❑Ofher(Desabe):
Bt2.Is Ihe buWirx�locaf�d in a Coas�l Barrier Resouoes CBRS area a Otherwise Protec6ed Area OPA? []Yes No D ' ation Date �
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUI )
C1.Buikl'ing elevatir,ns are besed on:�Consttxtion Drawirx,�' ❑Buik�ng Unde�Caishuction" Flnished Ca�s6uctiai
.'A new Elevati�on Certificaba wiG be►equired when ca�s6�xtion of the buidng is camplefe.
�ikfing Di�gram Nunber 1 �elect Ihe buicJrg ciag�rn most similar to Ihe buikGng frx wttid�llus ceii��icale is being carpleted-see pages 6 arxJ l. If no dag�arn
��Y�������J.P�a skekh or pho6ogaph.) .
C3.Elevations—Zones A1,A30,AE.AH.A(1n�ilh BFE�,VE,V1 V30,V(wilh BFE�,AR,ARIA,AR/AE,AWA1-A'�0,AR/AH,AR/AO
Corr�ilete Itet�s C3.-a-I below acoordrx�to the buic�ng dagam specified In Item C2.S�te Ihe i�a6um used.I(Ihe dahm is d�erent(rom tl�e datum used tor Ihe BFE in
, Sectlon B,oanre�t ihe dahm to Ihat used fa the BFE.Sh�w field measurernenLs and dahm conversion calculation, lJse ihe space p�v�ided or tlie Carmen�area of
�Sectlon D or Sect(on G,as appropriate,b cioctrnent tl�e dah�n oonverslon.
Dalun :Conversion/Cmxnenls
rt.,eo L;"'w.
Elevation iefererice mark used Does Ihe eleva6on reterence mark used appefv o5 8 FIRM? ❑Yes ❑No ,���*�'ry � � t}� ;��'
o a}Tap of bolbom Aoa(nclucirx�b�sement or enclosure) ' 12. _ft(m) � 0 C T , �•,� ; 2 0 0 4 .
o b)Top of next hk,�her Iloor ft m N r:� ,r
— ( ) a :,,
o c)Bottom oib�west ha¢ontal s6uctual me►riber(Vmnes ony) ._R(m) °1 � � �� ;; '� � , ;�
o �Aqached gmage(bP of slab) 10. 8�(m) �S ;�, � �. '' ' .=�
E c r y
o e)Low�estelevada►ofrn%+��n:�;y�xVic e�ui�r,ient '4 ° ",,
senricting the buW�o;Jesa�be in a Carrnenfs ar�) _.,,_R(m} E� r %'� ,,�,>
o Q Lowest a�acent(Bnist�gade(I.AG) 1.d.�R(m) z,Q, �� ',,,� , a''" ��
o9)Highestacfacent(6nished)gade(I-IAG} 1.1����m) �N '` ,<, �,,�
o h)No.ot pe�mar�ent openings(flood vents)within 1 R abwe ac�acent gade Q1 �� 8
�� )Tdal area dap pem�anent openings(Aood venls)in C3.h sq.in.(sq.an)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFlCATION
This certificaUon is�to be signed and sealed by a land surveyor,enginee�,or architect authorized by law to cerlify elevaGon infama6on.
!cerfly thet the lnl�►metlon!n Sectlons A,8,and C on fhls certlllcale�presents my best e/fons lo Interpret the dela evalleble.
• _/understand fhet any felse sfatement may be punlshable by flne or lmpilsanment under 18 U S Code,Sectlon 1001
CERTIFIER S NAME LICENSE NUMBER
. WILLIAM C. KEATING N0. 1528
� REGISTERED LAND SURVEYOR \' COMPANYNAME
ALLIED SURVEYING
�D�2118 E D EW STREET CLEARWATER FLORID� 3376��
SIGNATURE , DATF TEL.EPHONE
, 1Q_ � 727-446-1263.
. �s— .
��..,.'.�,au::i,l.11'1y u�o l.uul:u�IV��u�u���uunuduu����uu�J1:l.UUnI1. i��u�.,�u.���.c„u,iy.•„��,,,,�:
_f lr�luirx�Apl.,Un�,Sute,andla F31dj.No.)OR P.O.ROl1TE MD DOX N0, Pdicy Number
�4� ANCHORAGE WAY
�� STATE ZIP CODE Compary NAIC Nunber
CLEr'1RWATER FLORIDA 33755 .
R SECTION D-SURVEYOR�ENGINEER,OR ARCHITECT CERTIFlCATION(CONTINUED) �
� levation Cextificate fa�(1)cannunihr olbaal,(2)u�suanon sigenVoanpa►ry,�d(3)building awner.
❑chedc t�ere K auactments
:CT10N E-BUILDING ELEVA�ION INFOf�IMTION(SURVEY NOT REQUIRED)FOR ZOt�Ai0 AND ZONE A(IM11i0UT BFE�
d Za�e A(without BFE�,carip�eb Ite�r�s E1 Cxough E4. If Ihe EIF.vaUon Ce�ti6ca6e is in6ended(or use as supporting iniama6on for a LOMA or LOMR-F.
�e oorrple�ed
�-atp IVuriber_(Select tl�btiking c�c�arr�rrast similar to the buikting for wi�Ch this certificate is being completed-see pa�es 6 and 7. I(no ciagam aocuratety
he buid�ng,praiide a ske4ch a photog-aph.)
�e bdbm floa(nclucing�t a endos�re)of fhe buiking is ,R(m)_in.(an)�above a ❑bebw(chedc one)the trgh�t adacent gade. Nse '
e,�avaihable).
D'�agarns 6-8 with openings(see Page�.the next higher floor a eleva�d floa�(elevation b)of the bu�d�ng's _ft(m)_in.(an)abwe Ihe highest ad}acent
iplele iDerru p.h and C3.i an tror�t of tam.
e pla�am atmachirx�ay arxYa eqiip�nent servicing the buidng is _R(m)�in.(an)�abwe or O t�elow(check one)the higt�est adjacent gade. (Use
�,a���.
)or�ly: If no Aood deplh rnrriber is available,is the bop of the bot6orn tba elevated in acc�dance with tlie carxrxini�'s Ilooc�lain managerrier►t arci�nce?
]No ❑Unknown The bcal ofbaal must certi�r tl�ls infamation in Section G.
SECTION F=PROPERTY OWNER(OR OWNER'S REPRESENTA7IVE�CERT1FtCATION
wna'a oru��aulh�od r�x�tiu�who cmiplo�es��l�,B,C pi€�63,h and G3,1 a�y),nnd�ia Zono A(wiUaul o FENUI�i�ued a canmuniy.
•Za�e AO must sigi he�e. The s(ataner�ts In Sedkr►s/�B,C,s�d E are conect to the bestt ofmy knowledge
l�OR OWNEf7S AUTHORI7FD REARESENTATNE'S NAME
CITY STATE ZIP CODE
pATE TELEPHOPE
❑Check here if atlactxnents
� SECTION G-CON�NUNITY INFORMATION(OPTIONAL)
who is au�iorIDed by law or adnanoe to adnirYSter the cam�unily's Aooc.�lain mar�agernent aYinance can canplete Sectiau A B,C(or�,and G ot this Elevation '
iplele Ihe appGr,able'item(s)and sig�bdow.
m�ation in Section C was talcen fran otl�docunenlaGon that has been signc�d and�xi by a licersed surveyu,engir�,a archiVect who is autlia¢ed by slate
law bo certify eleiration inforrriatiai. (In�ica�e tlie souce arxl date of Ihe eleuation dafa in Ihe CaYxrients area bebw.l
w�ily o�iaal carip{ebed Section E for a bu�6ng locatsd in Zone A(witliout a FEMA-is�ed a carrnuniiy-issued BF�a Zone A0. �
xtii�g ir�orrr�ation Q6e�ru GMG9)is pro�ided for corrmunity floocplain manage�nent p�rposes.
1M8ER (�. DATE PERMIT ISSU[D O6. DATE CERTIFICATE OF COMPLIANCEI�CCUPANCY ISSU[D
_
--
!!rass neen issued tor.p New constuc6on p Subdantial�mprwerr�enl . , - .
as�buitt lowest Aoor(u�ducing beserr�ent)d Uie buiking is: _—R(m) ' • Dadm: .
one AO)deplh d Aoocing at tl�e buiking site's: . _—ft(m) Daiun: �
;IAL'S NAME TITLF
NAME TELFPHONE
DATE •
��` ,
f-1(�ar.kMrK�Haflar.Frtxinf.s . .�_.