915 LANTANA AVE v.wi.o. IvV. �vvr^VVI!
NATIONAL FL.dOD WStJRANCE PRUGRAM Expires D�cember 31,200:
� � ELEItATIQN CERTIFICA,TE
fm Read the inst�ans on as 1-7.
3�4"�1QN A•PR�JPERTY QYVI�tER INFQRMATION �Ftxi�sve�ii�.00nparry:tlse; ...
• 8UlLDING OWNER'S N+WIE • .�'��.. . . . .
PETER M�ROLI a5-57489 Not far construc�ion;Not fior design; � ' . � �
Florida St�tute Law 61 17�6.004: two sit�benchmarks uired for construction .': •: :. : . .:.:. ... .:'
BUILOING STR�T,4DDRF�S pndudh�g Apt,Un�,St�,andlor Bldg Na.)OR P,d,ROUfE AND SOX NO. 'CbfnpariyIrIAIC Numhet.
915 LAPlTANA AVE TWO SRE BENCHMARKS Ft�C1UIREQ FOti CONSTRUCTION ' • �
CI7Y ' STATE ZIP C40�
CL.FJ��tWATER FL 33767
PROPERTY RfPTipN(Lot and Blodt Numbars,Tax Parael Number,Legat ' ,atc,}
METES AND BOUNDS,5ES FUU.LFGAL DESCRIF110N
BU1LpING uSE(e,g,,Reskiantlal,MaKesldeMi81.Addltion,AoOe�ry,eEc. 1J9p a Commanta iqea,iF neoe89afy.)
IiESIDENTiAL
LA CFJ�ONGITUD�(OPT10Nl�1.� HOR2d+RAL QATUM: SOIIR�E: GF'S(fYPek
� ##°-i�#-#�#►�' or ##.�#°} � ❑NAD 1927 ❑NAD i683 O t,ISGs 4uad Map ❑aher
SECTIpN 8-FLOOD INSUIiANCE RATE MAP(FIRM�INFORMA710N
61.NFP COA�IIQUNITY WUvE& NlM4B�R B2 CflU�f(Y NAME 63,STATE
PINEI.LA�S 125096 �S �'��
B4. AND PANEL B7.F'�+)PANEL B9.BASE FL,000 B.EVATIDM1KS�
NUM�ER B5.SUFFD( B6.FIRM IPOEX I�A1F EFFECTIIJEJREVISED DATE B8.R.04D ZaVE(5) (1�1e A0�use d�h d Ibodln9)
12fi096�81U2 G 93aQ 53-03 AE 11
��o,lnc�cate fhe�ourGe dfhe Base Flood 9evation(B�j data abese flaod d�th en�ned In�.
. �]FIS Pml;le ❑��wu1 �corrmunily oe�rmr►ed ❑od,er(oasa,'be7,
611,IndceEa ihe�leaatlon dalum used fa the gFE fn B9:�NGVD 1929 ❑NAVD 1998 ❑Ot�er(Des�6e?.._
612 Is the6ullding bc�b�d'm a Coastal8grfer R�esou�s�n(C�RS)are�aa09�v�seProtactedAr�iOPA}? , �Yes �No Designatla��
" �$ECTION C•BUIt.pING ELENATION INFQRMATIOhI(SIJRV�Y KE4UIRED)
c�.eul�ng el�+aUa,s are b�ed on:[�c�r�tructlon ora�ings' ❑ei,�l�rg ur�d�con�n�ont ��'m�neaca,suuciia,
"A new Ele+retion CeRi�cate vu�be recNked when constnx�kxi of fhe buikfng�oompl�e.
• C2.B�1dk�g DEac�rarn Number 1(Seledthebu��ng c�ac�arn mo�tsim�arto�e b�nldin9 fawh�h U�s c�fiC#e is bdnq cample�d-see pages 6 and 7.If nodagram
aocuraldy�nts Bie b�lding�Provide a sket�h apt�ph.)
C3,E�vahm3-�anes A1�130,P�E,AH,A(w�h 6FE},VE,V1•V36,V(wrth�,AR,ARlA,ARlA�,ARlA1 A3(1,ARIAH,ARlAO
Compleh�Items C3,-�I�elow aood�ng ta ihe bui�ng c�agr�m speaYi�d n 16em C2 St�e the datum used if the dah�rn is di�rent tmm the dafum used iorthe BF'�in
Sedion B,aonvert I�e detum to tltiaf used tathe BFE.Slx�u►r field measuranents and dsb,m oarrv�on cak�latlon. Us�the space qo+rlded a 1he Carm�enls area oF
S�tion 0 a Se�lon G,as ap�xupriata ia document the dahrm oonverslon,
D�um NGVD Carnr�siadCommeMsr
Elevation�mak used T�,,I�ihe�evatlon r+ef�'�Ce maric used appeer on fhe FlRM� ❑Yes �r�o
4 a)Top of babnm il�oor[�n9 basert�t or enclas«e) 5.1 ft(m} �
or � ,
Cl b)Tap d nex►hlgr�er flocr �1�Q.�Im1 `°
4 c)�tom aF low�st horiumlal�n�er(V mnes only) PII,A ft(m) �a ,��a (
❑d�AGad�ed 9ara9a(�A oF slab� 4.4 ft{m) �� �y ` � �b�
D e)Lowest ele+�alion of machlnery arxV�or eqci�prt�t �@ �"�.�` `
servfdrg tlie bu�ding(Descr�e in a Comment�a�a) 4.Bik(m) �m ��}� ��\�
p f�t.o�+e�t ad�a�nt(flnisheci�g r a d e(L p,G 7 �,,�t�{m) ��' 1_
❑�H(g h e s t a�a o e n l(fin i s h e d)9 r a d e(HAG) 4.2 f t(m) $
❑h)No.of Aertnanentopenin9s(flood�enls)wi!'�in 1 fi,above�d9►2de_ .�
o ij ra�al area af al�penr��en�oper,ings�ood,rents)n C3.n sq.(n,(sq,cm} °
SECTION D-SURVEY�R,ENGIN�R,OR ARCNITECT C�RTIFlC�4T10N
This certification Is to be signed and sealed by a land surveyor,e�gUeer,or��hitect aulhorized by law to certify elevatlon infiormation,
t cert►�y thet thg informatlon in Sedians A,�,end C an th;s cs+trf'rcats rapr�esenfs my best eflods to lnterpret tlte data aveflable.
I unde�tandlhef eny falsa stateme�t mey he punishable bY Fng��mprrsanment under 48 U.S.Code,Sectfon 100i,
CERTIR�Ft'S NAME GEORGE RRICFiMOND LIC�NSE NUMBER 24Q6
r�f�g COMPANY NAM�F,Lh SURVE`!'S CURP,
• �pp�� CIT'( STA?E aPCOD�
5Q S.9ELCH�#�'19 CLEIIRWATER R. 33765
SIGNA ;�- j , OATE TELEPfiONE
7 21-05 727-047�545
FEMA 81-91,January 2003 See reverse slde for aontinuatlon. Replaces all pteviaus edlt�Ons
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