16 KENDALL �C ,,,, O.M.B.NO. 3067-0077
� �— ELEVATION CERTIFICA�'E E�,;�es�3�,1996
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FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION:Use ot this certificate does not provide a waiver ot the ilood Insurance purchase requirement. This iorm is used only to
�de elevation iniormation necessary to ensure compliance with applicable community floodplain management ordinances, to
�mine the proper insurance premium rate,andlor to suppo�t a request for a Lelier o(Map Amendment or Revision(LOMA or LOMR).
Instructions tor completing this torm can be tound on the totlowing pages.
SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANV USE
BUILDINO OWNER'S NAME POLICY NUMBER
���E,.!---k oo I�,E�_ -- ------- -
-�-----
STREET ADOHESS(Includiny Apl.,Unit,SuNe end/or Bldg.Number)OR P.O.ROUTE ANO BOX NUMBER COMPANY NAIC NUMBEH
�1� _KENpg�4_��tR�-�' � -------
OTHER DESCRIPTION(Lot and Block Numbers,elc.)
r.or-!4,--� So• �3.5� o� �.o�-- 5� BLOG�G � , RE� Ma�� c�� . BE��----
CITY STATE ZIP CODE
�aR WATE2 P���GN , �-� .
SECTION B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Provide the (ollowing from the proper FIRM (See Instructions):
1.COMMUNtTV NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION
(In AO Zones,use depth)
�25�9� ��°7 � e-►9-9 t A E 12.o _
7. Indicate the elevation datum system used on the FIRM for Base Fiood Elevations(BFE): QNGVD'29 ❑Other(desc�ibe on back)
8. For Zanes A or V,where no BFE is provided on the FIRM,and the community has estabUshed a BFE for this building site,indicate
the community's BFE:LJ—LJ__L�.0 feet NGVD(or other FIRM datum—see Section B, Item 7). .
SECTION C BUILDING ELEVATION INFORMATION
t. Using the Elevation Certificate Instructions, indicate the diagram number trom the diagrams iound on Pages 5 and 6 that best
describes the subjecl building's c�eference levet�� .
2(a� FIRM Zones A1-A30,AE,AH,and A(with BFE). The top oi the reterence level floor irom the selected diagram is at an elevation
•f Ll_I_1Q_l(�J.�feet NGVD(or other FIRM datum—see Section B, Item 7).
(b). FIRM Zones V1-V30, VE,and V(with BFE). The bottom of the lowest horizontai structural member of the re(erence level irom
the selected diagram,is at an elevation of� I I I I I.0(eet NGVD(or other FIRM datum—see Section B, item 7).
(c). FIRM Zone A(without BFE). The tloor used as the re(erence level from the selected diagram is L�.0 feet above�� or
below L) (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level Irom the selecied diagram is L�.0 feet above❑ or below�_)(check
one)the higl�est grade adjacent;to the building. I(no flood depth number is available,is the bullding's towest floor(reference
level)elevated in accordance with the communily's tloodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations:�_✓�NGVD'29 �.� Other(describe
under Comments on Page 2). (NOTE: ll fhe elevation datum used in measuring the elevations is diflerent tl�an that used on
(he FIRM �see Section B, Item 7), ttien convert the elevations to!he datum syslem used on Il�e FIRM and sl�ow tlie conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: L" Yes ❑No (See Instructions on Page 4)
5. Tiie reterence level elevation is based on: �►!�actual construction ❑ construction drawings
(NOTE: Use o/construc(ion drawings is only valid il U�e building does not yet have Ihe�e%rence level/loor in p/ace, in wliich
case this certilicate will only be valid lor tlie building durirTg tlie course ol construction. A posf-construclion Elevalion Certilicate
will be required once cons(ruction is complete.)
;6.The elevation of the lowest grade immediately adjacent to the building is:�_L��.�.� feet NGVD(or otfier FIRM dalum-see
Section B, Itern 7).
SECTION D COMMUNITY INFORMATION
1. It the community official responsible(or verilying building elevations speci(ies that the reierence level indicated in Section C, �tem 1
is►rot the"lowest floor"as defined in ihe communiiy's floodplain management ordinance,ihe elevation of tt�e building's"lowest
2.�^`' as detined by the ordinance is: LI_�_L��.U Ieet NGVD(or other FIRM datum—see Section B, Item 7).
of the start of consiruction or substantial improvement .
FEMA Form 81-31,MAY 93 REPLACES ALL PREVIOUS EDITlONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
7 his cerlilication is to be signed by a land surveyo�,engineer,or architect who is authorized by state or local law to certily elevation
inlormalion wlien the elevation intormatio�i for Zones A1-A30, AE,AH,A(with BFE),V1-V30,VE,and V(with BFE)is required.
Community otficials who are autl�orized by local law or ordinance to provide tloodplain management iniormation,may also sign the
certiticalion. In tlie case of Zones AO and A(without a FEMA or community issued BFE),a building o(ficial, a property owne�,or an �
owner's representalive may also sign tf�e certification.
Reference level diagrams 6, 7 and S- Distinguisliing Features-It the certitier is unable to certity to breakaway/non-breakaway wall,
enclosure size, IocaUon of servicing equipme��t, area use,wall openings,or unfinished area Feature(s),then list the Feature(s)not
included in tt�e certilication under Comments below. The diagram number,Section C, Item 1, must still be entered.
/certily(hat tlie information in Sections B and C on this certilicate represents my best el(orts to interpret the data available.
!understa�ld t!►at any lalse statement may be punishable by line or imprisonment ur,der 1B U.S. Code, Section 1001.
CERi1FlEf�'S NAME LICENSE NUMBER(or Affix Seal)
Larry_L. Evans 2937
_ _ --- -- - - — - - --- ---------
T�TLE COMPANY NAME '
___ ________Surveyor ________ _Evans Land Surveying, Inc. _
ADDRESS CITY STAfE ZIP
________ 2194 Main Street lJnit H ` Dunedin, F1. . 34698 ' _
SI(3NATURE DATE PHONE
1-L6 6 734-3821
Coples should b ma oi thls Cert(ficate tor: 1)communfty otflclal,2)Insurance agenbcompany,and 3)bullding ow�er.
COMMENTS: -- -- ------- — ------- ------------
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ON WITH ON PIIES,
SLAB ' BASEMENT PIERS,OFiCOLUMNS
n V / A A V
ZpNES ZONES ZONES ZONES ZONES
. REFEFlENGE
nEfE��Et�CE B�SE �E�� ��EAENCE
LEVEI � FIOOD LEVE�
EIEVAiION
�_ 1 A: .
... ���y,a',� � r x' . . ' 1 .
.A ';�� ��.: �[ Sj` BASE
BASF . 1 d: REFERENCE f���
/tOOD ..i:,"t;:;' AQq�pE '�•.•��: LEVEL ELEVATION
EIEVAIION REFERENCE IIDJACENT ;�`.�'?
IEVEL GIiAOE . ;;���.
� � .. � . `f�:'�f:.��`�'�'�:'��;
.':!�i�:' :�i:�.:
' . -j, ?.�_...- :.
� � 4� . ADJACENT}
. . �. • .. ,;� '" GtinDE
....'��:h(�`�i`:'::�.[::?':�.::":�:���.�`:`.�;i�;��-`i:� .
The diagrams above illustrate the points at wt�lch the elevations should be measured in A Zones and V Zones.
Elevations(or all A Zones should be measured at the top of the reterence level iloor.
Elevations ior all V Zones should be measured at the bottom o(the lowest horizontal structural member.
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