332 GULF _._... �I'_...,�` r'� �-�1 ! • � .�n --z �_-1,•_ . . .. _ .
I ���_�� :���� rwP �� FEDEFZAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
-l� ; NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200�
� .�_1�L� �pR p ;► �(.�'i __� ; ELEVATION CERTIFICATE
Im ortant: Read the instructions on a es 1-7.
! D E Y E L 0 P M E N T S E R V I C�S D E P T SECTION A-PROPERTY OWNER INFORMATION For Iruurance Canpany Use:
Of Clearwater � Policy Number
BUILDING STREETADDRESS(Including Apt.,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
332 Gutfview Blvd
C�N STATE ZIP CODE
Clearwater FI
PROPER'fY DESCRIPTION(Lot and Block Numbers,Tax Parcel NumtZer,Legal Description,etc.)
Lbyd-Whit�Skinner Sub(So Beach Pavilion Lease)/ 0729/15/52380/000/0181
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
Non-Residential
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
(#IF°-##'-##.##" or ##.#!!�#� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
61.NF�'COMNA1NffY NAME 8 COMNAJNf1Y NUMBER 82.CWNTY NAME B3.STATE
Cily of Clearwaffir/t25096 PineNas FL
84.MAP AND PANEL 87.FIRM PANEL 89.&4SE FLOOD ELEVATION(S)
NUA�ER 65.SUFFIX 66.FIRM INDEX DATE EFFECTIVF�F2EVISED DATE B8.FLOOD ZONE(S) (Zone A0,use depdi o(flood'eg)
12103C 0102 G 913�03 9/3ro3 VE 14.00
B10.Ind'�e tl�e souroe of the Base Flood Elevation(BFE�data or base flood depth entered in B9.
❑FIS Profile �FIRM ❑Community Determined ❑Other(pescribe):_
B11.Ind�cate the elev�ion datum used fa the BFE in B9:�NGVD 1929 �NAVD 1988 ❑Other(Describe):_
812.Is the bui�ing located in a Coastal Barrier Resources System(CBRS)area a Othervvise Protected Area(OPA)? ❑Yes �No Desi nation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Conshuc�ion Drawings' ❑Buikling Under Construction' �Finished Construction �J
'A new Elevation CerGficate will be required when consUucc�on of the building is oomplete. ��
�Buil�ng Diagram Number 1(Seled the building�agram most similar to the building fa which this certificate is being completetl-see pages 6 and 7. If no diagram �
accuratelY repnesents fhe building,provide a sketch or photograph.) �
C3.Elevafions—Zones A1 A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARIAE,AWA1-A30,AR/AN,AWAO �
Canplete Items C3..a-i bel�v acoording to the building diagram speafied in Item C2.State the datum used.If the datum is different from the datum used for the BFE in
Section B,oonvert the datum to that used fa the BFE.Show field measurements and datum conversion calcula6on. Use the space provided a the CommentS'area of p
Sec6on D or Sedion G,as appropriate,to document the datum conversion. ,�0 4��f; ,,�,� ' N{
D�um NAVD 1988 Conversion/Comments PCBM Aur�A ���i� ,1 S G Ci,h�e jd> V
E�e v a ti o n�e f e r�r►c e m a d c u s e d A u r a l A D o e s t h e e�e v a t i o n r e f e r e nce ma r k u s e d appear on t he F I R M? ❑Yes �No � '
a)Top of boUan floor(induding basement a endosure) 6. 69 ft.(m) � �. � �r> .,�
b)Top�nent higher floor N/A._ft.(m) �' .�J.,.•,�✓ �,i _ � .
c)Bottom of lowest haizont�sUuctural member(V zones only) N/A._ft.(m) �� . � � � ,� . «
d)Attached garage(top of slab) 3. 90 ft.(m) E° ��� � � . ° '�r- ' 1 ;
w m . c°�� s:.�_,
e)Lowest elevation of machinery and/or equiprr�t �' r,�
serviang the bui�ing(Desaibe in a Comments area) N/A._ft.(m) �� -ry=�j:� ! '� . � a°�a••� �
�Lcrwest adjacent(finishe�9����) 3.61 ft.(m) z'.� ;.'°�,, • , . �
9)H'�t a�aoent(finished)9����) 3. 91 ft.(m) �m �f;; • � ',.,��,��'�y
h)No.d permanent openings(flood vents)within 1 ft.above adjacent grade 0 J �` � d ,��"'jt�`°
)Tota►area of all pennanent openings(flood vents)in C3.h 0 sq.in.(sq,cm)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authonzed by law to certify elevation information.
1 certify that the information in Sections A,B,and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable 6y frne or imprisonment under 18 U S Code Section 1001
CERTIFIER'S NAME Dennis J.Eyre LICENSE NUMBER 2865
TITLE Professan�Land Surveya COMPANY NAME Geodata Systems Inc.
� CITY STATE ZIP CODE
.2 Drew ' 8 Clearwater FL` 33765
SIGNAT � DATE
TELEPHONE
4I5A�5 7271147-1763
FEMA orm 81-31,Janu 2003 See reverse side for continuation. Replaces all previous editions
_. i ._. ... ._.. . .___. .
. . ...._..___._.........._.r
IMPORTANT: In these spaces,copy the corresponding information from Section A. For insurance Cor❑pany Use:
Bl11LDING STREETADDRESS Qnduding Apt,Uni�Suite,ancUor Bldg.No.)OR P.O.ROUTE AND BOX N0. Po�C,y Number
332 S.Gulfview Bivd ;
�� STATE ZtP CODE Company NAIC Number
�� FI �
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy b�h sides of this Elevation Cerfificate for(1)communiFy offidal,(2)insurance agenUcompany,and(3)building owner. �
COMMENTS
❑Check here if attachments
SECTION E•BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
Fa Zone AO and Zone A(without BFE),oomplete Iterns E1 through E4. if the Elevation Cerfificate is intended fa use as supporting iniormahon for a LOMA or LOMR-F,
Sectian C must be compieted.
E1.Buildng Diagram Number 8(Seled the building diagr�n most similar to the buiiding fa which this certificate is being oompleted—see pages 6 and 7. If no diagram accurately
represents tlie buikling,povide a sketch or photograph,)
E2.The top oi ihe bottom floa(induding basement or enclosure)of the building is 0 ft.(m)_in.(an)❑above or ❑below(check one)the highest atljacent grade. (Use
natural grade,'rf avalabie).
E3.Fa Building Diagr�ns 6-8 with openings(see page 7),the next higher floor or elevated floa(elevation b)of lhe building is _ft.(m)_in.(an)above the highest adjacent
grade. Corr�plete items C3.h and C3.i on front of fam.
E4.The top of the platfam of madiinery ancUa equipment serviang the twilding is 0 ft.(m)_in.(an)�above or ❑below(check one)the highest adjacent grade. (Use
natural�ade,'rf available). �
E5.Fa Zaie AO only: If no flood depth number is available,is the top of the bottom floa elevated in accordance with the community's floodplain management adinance?
❑Yes ❑No ❑Unknam. The local offiaal must ce�tify this infama6on in Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owr�a o�'s authorized representative who oompletes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA�ssued a community-
issued BF�a Zone AO must sign here. The statements in Sections A,B,C,and E are c:o�ct to the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME •
A��RESS ��n' STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑Chedc here if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
11�e bc�l�ticial who is auitiaized by law c�ordin�to administer the oommunity's floodplain management ordinance can oomplete Seciions A,B,C(a E),and G of this Elevation
Certificate. Can�e the applicable item(s}and,ign below.
G1.❑T1�ir�om�ation a�Sectior?C was taken�ran other documentaGon that has been signed and embossed by a licensed surveya,enginee�,a architect who is authaized by state
or Iccal law to certify eleva6on infam��;i�. (Indicate the source and date of the elevaGon data in the Comments area below.)
G2.0 A carrr�u��ity dfidal corr�pleted Sec5on E for a building bcated in Zone A(without a FEMA-issued a community-issued BFE)a Zone A0.
G3.�The follo�ving infa�nat�n(Itans G4-G9)is provided for canmunity floodplain management purposes.
G4.PEWuNT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CONIPLIANCE/OCCUPANCY ISSUED
G7.This permit has been issued fa: ❑New Construc�ion ❑Substantial Improvement
G8.Elevation of asbuilt lowest floa(induding baserrient)of the buikiing is: _._ft.(m) Datum:
G9.BFE or(in Zone AO)depth�flooding at the building site is: _._ft.(m) Datum:_
LOCAL OFFICIAL'S NAME TITLE
CAMMUNITY NAME TELEPHONE
SIGNATURE DATE •
COMMENTS
' ❑Check here if attachments
FEMA Form 81-31,January 2003 Replaces all previous editions
� II I� V IS U t_► t5 rtutru{�tmtK�tNCYMANAGEMENTAGENCY O.M.B. No. 3067-0077
� NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200:
APR 0 7 2005 ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-7.
DEVELOPMENt SERVICES DEPT SECTIONA-PROPERTYOWNERINFORMATION Fartr�suranoe:cariperryUse:
� i; Of Clearwater Pa�cy Number
BUILDING STREEf ADDRESS Qncluding Apt,Unit,Suite,and/or Bidg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
332 Gulfview Blvd
CITY STATE ZIP CODE
Clearvvater FI
PROPERTY DESCRIPTION(Lot and Block Numbers,Tau Parcel Numt�er,Legal Description,etcJ
uoyd-whi�kinnerS�b{se seac�Favilicx►Eeasey U7rzs/15/5z3Eao0flrots'f
BUILDING USE(e.g.,Residential;Non-residential,Addition,Accessory,etc. Use a Comments area,iF necessary.)
IVor�Re.sider�ial
LATITUDEA.ONGffUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(fype):
(#fX'-##'-##.#IE'or ##.� ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other.
SECTION 8-FLOOD INSURANCE RATE MAP(FIRM)iNFORMATION
61.t�COA�JRY NAIuE&COMN0.1NfTY NUMBER B2.COUNTY NAA4E 63.STATE
Cdy of Cle�waled 125096 PineRas FL
84.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATtON(S)
M1M8ER ' 65.SUFFIX 86.FIRM INDEX DA7E EFFECTIV6REVISED DATE B8.FLOOD ZONE(S) (Zaie A0,use deplh of flood'�g)
121Q3C0102 G 9r3ro3 9/3�t13 VE 14.00
B10.Inc�Cate the souroe d the B�e Fbod Elewa�on(BF�d�a or base flood depth entered in 69.
❑FIS Pro�e �FtRM ❑Community Determir�ed ❑Other(Desaibe):_
B11.In�ate the eleva6on datum used fa Uie BFE in 69:O►VGVD 1929 �NAVD 1988 ❑Otlier(Desaibe):_
B12.Is ihe txnldmg bc�ted in a Coastal Barrier Resources System(CBRS)area or OtF�erwise Proteded Area(OPA)? ❑Yes �No Designati�on Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Bu�ng ele�walions are based on:0 Caistrtxtion Drawings' ❑Buiklirx�Urxier Constn�tion' �Finished Constructia� �`
�'A new Elev�on Ce�ific�e will be required when canstnx.fion of the twil�ng is aanpiete. c �
'"'Bud�ng Diagram Nurt�ber 1(Select the buil���ac�am most simil�to the buikJing for which this cerfificate is being completed-see pages 6 and 7. If no dagram �
! �accuratelY represents the bu�ng,provide a ske�ch a photogr�h.) �
3.Elevalar�s—Zones A1-A30,AE,AH,A(with BFE',VE,V1-V30,V(with BFE),AR,AWA,ARIAE,AWA1 A30,AWAH,AWAO �
Complete I�rru C3.-a�i bek�v accordtng to the bu1drg�ag�arn speafied in It�n C2.State the daium used.If the datum is d'ifferent from the datum used fa the BFE in
Sedion B,oonvert the dahim to th�used fa the BFE.Shau fiefd measurements and datum conversion ca�u�ation. Use the space provided a the Canments�ea� p
Sedion D a SecUon G,as appropriate,to document the d�um conversion. �y��:3�;�,,�,e N
Da�um NAVD 1988 ConversiordComir�ents PCBM Aural A �,e 3�, 3�G G',,;=�, � .
Eleva6a�refierence mark used Aural A Does the eleva�on reference mark used�pear on fhe FIRM? ❑Yes �No ��`! �. ��_- -, '�
aG
a)Top of bottom floor(ir�ludng basement or erx�osure) 6. 69 fl.(m) � �`,�`�• . , �=.
b�ro�o��n�floor N/A._ft(m) � ":v,'•' ��� � �w�:��� `�`�.
c)Bottan of IaMest haizontal strudural member(V zones only) WA._ft.(m) °'°/ : ' y�y `- ' • —
y V ± ,4 �.
�Atta�d 9���toP of slab) 3. 90 ft.(m) E� `-,�is1 �y f 3 s:�
e)low�est devakon of m a c h i n e ry andlor e q ui p m e nt W� ..� , *J ' .� s ,;
se�viarg Ihe buildn9(Desaibe in a Comments area) WA._ft.(m) n � '�'. � •� � , �� . '`." � ;;
.�� . { .
f}�owu�t ac�acent EfinisF�9rade(LAG) 3.61 ft(m) z'� r' ''� � - �;� 4
� �� a «>,.' `'".,ti
d r .. , , .:�S�w
9)�����fi��9�(��) 3. 91 ft.(m) � E_ , r �.
h)No.of permar�ent openirgs(flood vents)within 1 ft above ac�acent grade 0 � Jt �' � �:�y��,�*e6
�Total area d a9 permar�ent openings(flood vents)in C3.h 0 sq.in.(sq.cm)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.
!ceRify that fhe iniamation in Sections A,8,and C on this certificate represents my best efforts to interpret fhe data available.
1 understand that any false statement may be punishable by�ne or impnsonment under 18 U.S.Code,Section 1001.
CERTIFIER'S NAME Dennis J.Eyre LICENSE NUMBER 2865
TffLE Prof�sional Land Surveya COMPANY NAME Geodata Systems Inc.
�� CITY STATE ZJP CODE
-�� � $ Clearwater FL� 33765
�� .� DATE TELEPHONE
M5ro5 727-047-1763
FEMA ortn 81-31,Janu 2003 See reverse side for continuation. Replaces all previous editions
IMPORTAfYT: In these spaces,copy the corresponding information ftom Section A �a�„�,,,,�„ce�❑p�,,,y�:
BUILDIN�STREET ADDRESS(Induding Apt,Uni�Suite,arxYor BkJg.No.}OR P.O.ROUTE AND BOX N0. � ' PoGcy Nurt�
332 S.Gulfiriew Bivd :�,� , ,
� STATE ZIP CODE � _. '
�� � C&njiany NAIC Nurtiber ,
� SECTION"D=SURVEYOR,ENGINEER,OR ARCHRECT CERTIFICATION(CONTINUED) _ ` ' '� � -
. , : . �
Copy both sides d ihis Elevabon Certifiqte for(1)communi�o4fiaal,(2)insurance agenUcompany,and(3)building awner. :` _ ____.. (
COMMENTS
❑Chedc here if attachments
SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Za�e AO and Zone A(wiUiout BFE',oomp�ete ftems E1 through E4. IF tlie Elevation Certificate is intended for use as suppor6ng fifamation for a LOMA or LOMR-F,
Section C must be carr�eted.
E1.Bu�d'u�g Diagram�kxnber8(Seled the buil�ng dagram most similar to Uie building fa which this cerfificate is being canpleted—see pages 6 and 7. If no dagram aa;urately
r�r�ts�e buii�n9,provide a ske�h a photcx�raph.)
E2.rne roPame�floorC�,a�r,y�seF„�r,t aer,�,r��ame�,����s Oft(m)_in•(cm)�above or ❑�ow�r.r,�a,e�tr�n�st�d��r,t�. �u�
na�xal grade,A avaaable).
E3•Fo�B�g Diac�r'ams Cr8 with openings(see page 7�,the next higher floor or elevated floa(devation b)of the building is _ft.(m)_in.(an)above the highest adjacent
9rade.Corr�ete i�C3.h ar►d C3.i on front of fam.
E4.The�op d the pfa�rtri of machinery andla equiprr�ent serviang the buikJing is 0 ft.(m)_in.(an)❑above or ❑below(chedc one)the highest adjacent grade. (Use
n�ural gade,'rf available). �
E5.Fa Zaie AO onty: �no flood depth number is av�{able,is the top of the bottan floor elevated in accordance with the canmunitys floodplain management ordin�ce?
❑Yes ❑No ❑Unknown.The la�l offiCial rnust c:atify this infamation in Sediai G. ...
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATNE)CERTIFICATION
The property a�ur�er a ouur�s a��Uiorized representaUve who car�pletes Sections A,B,C Qtems C3.h and C3.i only),and E for Zone A(without a FEMA�ssued or oarununity-
is�BFE)a Zaie AO must sign here. The sfatem�ents in Sections A,8,C,and E are conec�t to the besf o(my kn�mdedge.
PROPERTY ONMF�'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS ��y �
STATE ZIP CODE •
S�`N� DATE TELEPHONE
COMMENTS
❑Chedc here ii attachmenls
SECTION G-COMMUNITY INFORMATlON(OPTIONAL)
(he local c�da��ho is atl�orized by laav�adin�ce to a�tiinister the canmurrit�s floodplain managernent ordinance can complete Sedions A,B,C(a E),and G of this Eleva6on
:eitificate.rar�piete U�e appGcat�item(s)and�gn�bebw.
�1•�Tt���forr��fiai��Sectia�C was faker►from oU�r documentatiai th�has been signed�d embossed by a licensed surveya,engirreer,a archited who is auUiorized by sta�e
a laxl laYv to ce�tify elewation infonn�k7n. (Indicate fhe source and date of the elevation data in the Comments area below.)
32.�A carrnu�ity oA'icial eorr�pleted Sec�'on E fa a buikfing located in Zone A(without a FEMAassued a community-issued BFE)or Zone A0.
33.0 The�IMa��(ftar�s G4-G9)is provided for corrununity floodplain managerr�ent Wrposes•
G4•PERMf IJl11vEER G5.DATE PERMff ISSUED G6.DATE CERTIFICATE OF CONPLIANCEIOCCUPANCY ISSUED
37.This pem�t has been issued fa: ❑tJew Caistnx�ion ❑Su6stantial Improvement
�.Eleva6on of as�built bwest floor(nduding basernent)of tlie bui�ing is: __ft.(m} Datum:
�.BFE a(�n Za�e AO)depth of floodrg�the bui�ng site is: ' ft.m
_ _ ____ _ -_ _ ---_—_ ___ ——_�_)-------—--—Datum:
LOCAL OFFlCIAI'S NAME TITLE --
COMMU�IITY NAME TELEPHONE
S���� DATE
CQMMENTS �
. •
` ❑Chedc here'rf attachments
:MA Form 81-31,January 2003 Replaces all previous editions
. ��,���
�f °�' t � .
�����ti��� A`� ������ C I T Y O F C L E A R W A T E R
�p 34?
�A#" � �.,�� ��i;X
� ���a �
��x ; �� �`r , DEVELOPMENT & NEIGHBORHOGD SERVICES DEPARTMENT
<
�,�� � e �P
��,� . ' ``' ' POST�FFICE BOX 4748� CLEARWATER� FLO�DA 33758-4748
�����; � , MUNICIPAL SERVICES BUILDING, IOO SOUTH MYRTLE AVENUE,CLEARWATER,FLO�unn 33756
" TELEPHONE�72� 562-4567 Fnx(72� 562-4576
MEMO OF REVIEW FOR CORRECTNESS & COMPLETION
In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and completion prior to
acceptance by the community. This complete form shall be attached to all elevation certificates maintained on file and provide with requested copies of
elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to acceptance by the community
X The attached elevation certificate is complete and correct
Minor corrections have been made in the below marked sections by Community Official
SECTION A-PROPERTY INFORMATION For Insurance Company Use:
A1. BUILDING OWNER'S NAME Policy Number
A2.BUILDING STREET ADDRESS(including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
CITY STATE ZIP CODE
A3. PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. BUILDING USE(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. LATITUDE/LONGITUDE(OPTIONAL): HORIZONTAL DATUM: SOURCE:�GPS(Type):
(##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map❑Other
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
B4.MAP AND PANEL g5.SUFFIX 66.FIRM INDEX DATE B��FIRM PANEL gg.FLOOD ZONE(S) B9 BASE FLOOD ELEVATION(S)
NUMBER EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding)
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89.
❑ FIS Profile ❑ FIRM ❑ Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑Other(Describe)
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Protected Area(OPA)? ❑Yes ❑No Designation Date
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction" ❑ Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number (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 C3.-a-i below according to the building diagram specified in Item C2.State the datum used.If the datum is different from the datum used for the
BFE in Section B,conveR the datum to that used 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 Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ❑No
e) Lowest elevation of machinery or equipment servicing the building(Describe in Comments area) ft.(m)
h) No.of permanent openings(flood vents)1 ft.above adjencent grade
i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm)
Comments:
Date of Review: Community O�cial:
�evation ce�tificates shall be maintained by the community and copies with the attached memo made available by request
FRANK HIBAARD,MAYOR
GEORGE N.CRE'I'EKOS,COUNCILMEMRGR JOIIN DORAN,COUNCILMEMBER
PAUL F.GIRSON,COUNCILMEMAER � CARLGN A.PE1'ERSEN,COUNCILMEMBER
��EQUAL EMPLOYMEN'C AND AFFIItMA1'IVE AC1'ION EMPLOYER�