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530 GULFVIEW BLVD ., ' . �k�� � � • FEDERq1,E��aENCY MANAf3EMENT.AGENCY ' � NATIONAL FLO00.lN8Ui2AyCE PR0C3RAIy O.M.B. No. 3067-0077 � ELEVATION CERTlFICATE Exp���s�aecember s�, 200= . �m rtani: Raad Eh� Instructlons on a es 1 -7. . BU�UDING OWNER'3 P1�!„tE �`CTION A•PROPERTY OWt�tLR 1tZFORM/►TION L N • �. J9�'i.W�4TE�t For Insur�e C��y��: BW�DING S7REET L�' �- . PoJlcp'�4umber ClTY ��(��G^W..Unit,Sul1a.and/or 81dfl.No.)OR P.O.ROU7E ANQ BOX NO: • • � . K ' Company NAIC Number �nt,�1RT. n" � S7ATE PROP�ftTy p����l�(���k 21P CODE A� ���Tax Parc.l Nurr�bar,L.fla1 D.sutDUon.•1�.� o �O.s autLD�t�USF{•.p,, �� a � n. T E +s► ���'►Joc►-rtsJdo�(� ��'�otc. Us�a.Comrr�nts arw,p v�c �,c/ � LATITU ' ' ' n�cessary,). ( �r'.�r-�r.�r or .�ra�,t�tr� nl.o�n�a: (_.,J�IA,D 1Q27 (_J N�1D 1983 gOURCE: U GPS{TYAe): • . �._J USGS�uad Map LI O���er sE�N 6-�LOOD W3URANCE RATE MAP(FIRILS)IHFQRMATlON 61.NFiP Cp�,1UNJTY NM1E b C�#4A;U►aITY NUA98ER B2.COUMY NAME B4.�1dAP ANDPANFL '� fo �Ne1 J�„S 83.STATE NUM8ER 83.SUFFlX 86.Fl�2AI INDE�( . LlJiL i OA . MTE ' . B7.FIRM P EL B8.FL D O I O� EFFECTIV�/F2Ey{SFp pA'I'� ZpNE(S) B9'BASE FLOOD ELEVAT��g� ato. �nd�cate the soiu,ce a the G. ' �� (Zone AO.use de q' -Q ' � P�or gase Fbod Eievat,�oc�(8FE)data or base A , Lj FIS Pr� �F l� ' ' • ood de p t h e n t a r e i i ln 8 9. B 11. lndkate tM eleJatlon datu�used for u��ty Detarmined (�Oihec 812. la the �:B�E 1n�89:(_j'NC3 V D 1 929 {D���): �9�ted In a 8arrlef RosOt�r U Other t }) �°�9�uon Date; �� �s SYs�em{CBRS)are�a opt�e�ae Protected Area OPA ? ,, I___j Yes ,�Cj No BECTION C-Sil1LplNp EL�V/�7iON lNFORAIATION(3URVEY REQUIREp) Buildln�elevatlons are based on: � 'A new Ebva���b���s��D��nfls' (_,_jBulldln�Under ConatruciJon• C2.BuiJdin9 pi�m�� ����n cor�struction of the bulldin9�s complete. 1.2�JFinished ConstrucGon Pa9es 8 and 7. If no diagr�����������.moat ������� slm!!ar to the bu!ldln�for which this certificate is being compieted-see C3.Elevatloras-�i A�� �nq,Provtde a sketch or �AE,AN,.A(wlth BFEj�VE,Vt-V30,V{with BFE qR, P�O4�eph.} Compbte Icams C3a-t below a )ti AR/A.AR/AE, �' the daturn usad for the BFE ln�gb��nfl dla ram s AR/A1-A30,ARlAH,AR/AO =�. fl Pe�ftled In Item C2.Stata the datum used. I(the datum is difiarent Irom ���a�lot�• '����'O�wm to that,uaed for the BFE.Show flel d m easurements and datum `` �°��pr°vid°d or tt" � Da t u m �n°n t s araa of Sectlon p�S conversion � Eleva --�— �VO�y�►ts ,��G,aa approprlate, to document the datum conversion. Uor�refernnca m����.� �e�....: O a)Top ot bo���, �oes the elevatlbn reEeronce ma�iC��d a O b)Top o(nuq������nt��dosure) � ppear on ihe FIRM? U Yes �j No "� . .J�n(m) 0 d)Ati� ���zontal stn���mber(V zones onlY) Dq '�n.�m) �y � '`'� �`1y3i '� O e)Lowesi ���tOP ot slab) • _ft.(in) v �� =°^�icinp tts��of n��y,andJor equlPment o JT c,ers --�-'.1�ft•(m) �a . ,,._� ��(Dssalbe In a Corrurknts area.)o�rtttr E�rJ'. �� � 5 W� �`�' o �L°'"r�st�lacent(Mished)Wada(Uc3) $efew��'a� �,.s,► .� 0 9)�est adj�cent ------_.:L�•,j�ft•(rr1? � . O h)tJo.ot�A�ent`���,���FiAG} ' •,�.ft.(m) �� � o q Toca��ot su ��{Aood ver�ta)wit� � ft.above adjacent gra����n.�m� � Pennsnent open(�fls(Aood venta)in C3.h Nt sq;ln.�� .: . ����D"�R�YOR.EN(3tNEER OR ` �� �s������� ' �CHITECT CERTIFICATION �cenily that ths• �ned ar�d seai�d bY s Iand wrysYo+'..en ksrormatbn!n 5�,�8����� �lnear,ot ar��ct author{z9d•by�aw to certity eleva�on info �wxlersfand an ta�se statement ma ;� �tlllcsto.�presents� CER'i7FIFR'g y best eflorts 10/nlerpret the data ava;lable.�t�on. N+WF 8 b f1�°r Jm sonmenc unde�!8 U.S. Cods, S��;pn 18p1. T��E . �� UCENSE NUMBER � ` . . co�P�►,uMe ''� 3/ sicu.�TU y vaF i L STA E ZIP CODE FEl�4A F o•�re �7 - Ort1�81-31'Ja�1u�2� . -Q�-• QS' �LEPHONE . .. �rsvrsa aids for contlnuatlon. - - � Repiaces e��p�e���s ed�ions �m t: R�ad fh�Instructions o� a os 1 -7. e ►u LDiNp OWNER'8 NA6AE uCT10N A-PRQPlRTY OWNR.ii INfO �`�` � . RMI►TION Fa Inauraru�C«npanY Us�: -•-« A�'I�wNT k (; PoUc;-,Number B�;IIDtNG:: gg(�p� �����«e� ��OR P.O.ROUTE ANQ BOX NO: Q� � �ITY rs ' CompanY NAIC Number � p ' w S7ATE - �OP6RTY pE��pp� C � (�and Blodc Nunb�r�� ax P�rr�l Nurtib�r�Lpal D�scrlPlbn��Ic.) • � w BUIIpINp USE �. � ♦ • , t a�RM�dM11W,NOni�ld�ru{N,A��,���NC. lIq�.COmrtw�fs ar��q��� IAfiT . ( Ifr M�' M�.M�' Or ri�,�� ` �� U t'�D t�QT 30URCE: , u w�o,� u c�s Rm•): . � L.,.)uSGS�wd Map LI ov>er SECTION 8-FLOOD INSURANCE RATE Mqp(FIRM)tNFORMA710N Bt.NF�P Cp6WUN(TY P1MAE� R 82.CO NTY NAME O b . B3.STATE a�.�a�rw p�� es.suF PN U � a . � NUAIBER � � 87.fIRM P' El 88.FL D C �� � � t, �������T� 20NE S 89.BASE FLOOp ELEVA ION(S) � G' • _d q: _o c ) (zo�.no.us.avu�or ncodlnp) Bt 0. Indlcst�tM sourr,s of the Bss�F�ood vallon(BFE)dsfa o r b a s�A o o d d ep t h entarod 1n 68. I (.J F 1 3 P r u f l l e (�FIRM LJ.Cp�y��Def�r►nlned et t. Indtcst�u»�Ievatton cfahun w�d tor th�BFE in�B�: �"�� a°�' 612. 1:the bulldlr►a i��.�a U NOVO 1�29 �j VD 1988 the�(Describe): De� �0�+��kt R�sources 3ystem(CBRS)are or Otherwise P ected Area(OPA}? �J YeS No W�atbn Oate: .IX1 z 8EC7'10N C-BUILDtNp ELEVATION ItrFpR�IqTiO,N(8URVHY RE(3U1RED) C t.Bulldlnp sbvatio�a an " �A►�sw Ekvatlon CertlAc�y��������nfls' �,_JBuAdfn�Under Co�strucUon' C2.Buildinp pisp�m��� ������s�uon oi tho bulldiny Is comp(ete. I.K�Finished ConstrucGon Paaas 8 and?'. It no dta�t�����p���t��to the buUdinfl fot whlch this certificate is betng cornpleted-see C3.Elevatlons- �Y nW'��'tta th�buUdtnp,provide a�Icelch or p��Wog�aph.) Zonst At,A30,/1E�AH..A(w�1y BFE).VE,V1-V30,V(witt�BFE),AR, C�++'�Pwte Ic�ms C3.a-1 bolow�ppp��b���fl� � AR/A�AR/AE�AR/A1-A30,AR/AH,AR/AO � �O���u�d(a�hs BFE In$e�yp�������� � �G�ed in Itsm C2.Stats Ihe dalum used. It the datum is dinerent from ~ • calcula , ao��«� �n�o tha(used for the BFE.Show peld measurernents a�d datum oomersion ,� Datum ���nts�+sa of Section p or S�ctlon a�as approp�iata,to document the datum conversion. � ElevaUon re v«� • u�ed S�'1 �!s....��_- � O b�T p���������������a�e�va���etsronce mark�se�appear on the FIRM? j cp ��Nt Iloor � -�. .�n�R►1 L_J Yes (I�j No �- 0 d)Aitac,��d ��horizontol strt�tur�1 t�r(V zonea only) '�-n•("') �s . Il +�S�y3i �j O s ����OP ot it�b� � (t,(m) a � )l.o�wsf N�vatlon d nyd�r�y andlo��Q�nt o dT uts'� .�.�-R•(m) W�i --�.;�' �"�p���G(�wib�h s Cqmrtw�ta area. ov►�.er " " � 5 . �-'�- /O ,�n,�m� `�--� O h�LN�ast sdlac�ut`(f4Ut1►sd)�fl�ad�t H��C,)��l+�o�. �w�n �• ���my � C� � �. )No.ot:perrr�ar��y�ipQOd vanb � O i)Totai sns d al! �� �ft above adJacent flrade„����m� � P�rrnan�nt op�i(pood vents)In C3.h�w.In.(sq,cm) - ����'�R��R E N t i 1 N E E R,pR AF�CH�CT CERTIFICATION � o T h ls ceNliccatlon Is b b�sf�Md and s�al�d �«���•'�R�+'h S�►wa�,e a����Y«•�Of,����authorized'by law to certi(y elevaGon infom�a►ion. � � /als������� a ��nPnssnts my bast oy�to lnlerpre!the dara aveilsble. TIFIER'g 6 tJns or lm sonment unde�18,U.S. Code, Seclion 1801. TITLE ' UCENSE NUMBER � � t � COMP � � / SIGNA r � � STA Z�P COOE - FEMI�•Fortn 81�t�Jar��Y 2003 � � d,s L PH NE �7 � .. � S�i r�wn�sid�ior ccndnwU o n. �-?7-��8-S/��^ . Replaces e��p�avious ediyons . - —� T __ _ _ �_� _ __ _ _ __ ._ - - ---...,wa:n�..� MANAC3EME f adk �� *"ys�'�°PI �i� �r� '� � � � aE���� �� �P7� s�Y NAr'IONAL FLOOD:'lNBURANCE PR ���p„�" �s " •�'"��°�L,'����'��' > � '; ,� Y ES�M Z T �4w���Y�`1'J'#wr1����„9•C r��,�°,{�l�v t 3�{��'�h��i'�,�1� 1°'���;:� . ' ��� Et_EVATION CERTlF�CATE R�,��1��� ��������,�`��`�W_ .� � ��� . � 1m rtant: Raad fh� Instructlons on a es 1 -7. .t � �EC7'1�N A•PROP�fZ1'y.01lyNg.R ItiRORMATION •'EUILDIfJG O'1NNER'3 NJ1l�AE . For Insurance Cornpanv U�: l N . (. 1�1K.W�etTE�t L L:C. . � Polic-;''Nwnbar BUILDING STREE('AppRESg(�y���.UNt,Su1l�.sr�d/pr 8 , p" �.•. 1d9•No.)OR P.O.ROUTE/WQBOX NO: Company t•Ip,IC Numbor CITY 'f K ' 1�1►'►IaJRT n. � STATE ZIP CODE PROPfiRTY DESCR1P710tJ(Lot srid Sixk Ntmbars.Tax Aarc.1 Numb.r.L a�D.scri a ��� A� � G�.•tc.� auu.D�NC3 uSE{..a,ft«ld.rtiw,Nor,.its3d,ntlsl�/1�y�}p�°~` c � n, T E u�c .,�I �, ' ;,a . . �SSOry,o�c. Us�a.Garuss�nts arw,u"n�ceuary,j. uz�ru � ( +►� �w �w.akr or .�� rr�nr�n��. � U ww�QZr souRC�: (J�N�1D 1483 L.�GPS(TYPe)� . . (�J USGS Quad Map LI O�!�er 3ECi'�Oti B.�L�OD�g��CE Rq�MAp(FIRl�S)INFORMATlON 61.NFtP C,pMi„1UNtTy t�AA�F b�p�UA11Tf NUA�BER B2.GOUN�7Y NAME .�� � 83.STATE B�.�.uw at�DPANtL 85.3UFF1X ga.FlR�11NDE� �NeI1»,� Lu.c,vA NUA48ER ' B�•F��f' E� 88.FL D B9.BASE FLOOD EI..EVATlON(S) O I O�( . �� ' ��CTlVElREV{SEO OATE ZONE(S) (2one AO.use depth ol G� - �� q= -a � � �� 8�0. IndJcate the sour�ce of the Base Fbod Elavation(BFE)data or base ttood_depth entered!n 69. , LJ FIS Pr�!!ie (��t� ' U•���Detem�lned B 11. lndkate th�ebvatbn datum used!or tt�BFE 1+��69: U Othec(Deacrlbe): 812, la the • l_}`NGVD i929 �J��jqVD 1888 Lj Other(Describe): �����a���a�1er RosoutCes Sysiem{CBRS)araa or Otherwlae Protected Area(OPA)? �J Yes No Des1�lSort Date: . .�1 , - $E��H C'�UiLDiAJa EL£VATION INFORAtATIO,N{3URVEY REQUlRED) .Bu11d1np elevaUons aro ba�p�: U�sw�D���9s• BuUd{n Undef ConstrucUon• 'A new Ebvatiorl Cettt}j�b y�� �--�. � �,�Finished ConslrucGon C2.Buildlr�p�m��r ���°n��cu°n of the bulld�n9 Is complete. '�""������D�fi�.�?oat-s1mllar to the bulldlnfl for which this certificate is being comp�e�ed.see Pa9es 8 and 1'. it no d��„�,r,�,�w.,,�er►c,ir�e buud C3.Elev�tioru_ ►rW�provlda a sketch or Ptw�ograph.) Zor3es A1,A.30,AE,Ati,.A(wlttl 8FE)�VE,Vt-V30�V(wlth BFE),AR.AR/A,AR/AE.AR/A1-A30,ARlAH.AR/AO - Compiete Icems C3a-I beJony sc�rd��to tho btsildln dla � �he d�tum used for the BFE In Seciion 8,oonvsrt�����t uaed forithe FE Show n�d rneas ements nd`datlum tconversion ' ���. ��sp�ce Droylded or tt�Comr�snis area oi SecUon D or S Da►um �Ve�y�� ecibn G, aa approp�iate, to document the datum conversion. �� ElevaUort refenence maric used�$� �o��..r,s�� O a)Top ot boitom� Does tt►e elevatlori referonce mark used a {indudJnfl bay�nt p����a� � ppear on the FIRM? (_j Yes �� No a b)7op of nud t�f�sr}b,a .. , .;(�fi,(m) O c)Boitom of bwest hortzat�tal,struciu�l �•�.ft.(m} � � � '�""� ��19 3/ O d R�e�(V zaies onlY) 14 ;ft.(m) ° l� �������� . .L'� c �a O e) �tl i�tr,p�andJa equ(�mant O JT LeTi --'�'- ft. m} --: ii . 5 W� `�1 h�Cars�s�nts area.)o�rTttt EN1'. p �Lowesi sdJacant(Mished)�rsda(L,�(3) Refew�ia� �.•c�• �� •�..ft.(m) �� ` r�� 93 F�hnst ad}�carst(�c�lshed)flrad�(HAG) . . � rZ ft��n.,� z,� o )Tota��Pennanent°p8�tuood veniaj wlihln 1 �,above ad acent�9rade , '��.�m� _ . . oo� � P�nani openings(lfood vents}in C3.h ��XE:: � In. a $E�7�fUN D'S11RVE1fOR,ENQlNEER,OR AftCH17ECT CERTtFICATION _o Thls cerURcatl�on is to be tlQned an�snakd by s tand w e or en , ��erii�that th�•��� �Y Y .: Qineer,or archlt���au��sd�by taw to certify elevation inlormation. !understand an f���e�� ��C°����ta.rep�sents my best eflorts to Interpret the aara e�a;rab�e. G����gµ�E a b tlne orlm sonment under i8.0 S. Code. Section lep1. T�nE ' LICENSE NUMBER �. ,o�ss . � � co►��Mn ru�F '� 3/ SlGi�L�TIJ y V� � STA E L � 2�P CODE �- OJ17E ELEPHONE 7� FEl�1A Form 81�Y�`tanusrY 2003 . _O�_ aS 7 2 7- '3 . �• 3ai rswrsa slda tor contlnuatlon. �e'y 6 0 Replaces all previous ediyons � . � FEDERAL E�AERpENCY MANAC3EMENT,A<3ENGY � AII►TIONAL.FLOOQ INBURANCE PROORAM O.M.e.No.3U67-007t ' ."�� ELEVATtON CERTIFICATE Explres�Decembsr 31, Zoo,= ' ;,• � Im t: R�sd th�i�structtons on a os 1 -7. F �CT10N A-PROPERTy OWNER INfOR�IAfiON F�ir„�� BUtIDtNC3 OWNER'3 PL�1,1E . ComDanY Use: l � . /��'4WMTEk. j; Pd{c;-;iJumber BUIIDiNG S7REE1'Appf2ESg(k�M�d4p/�,.�g��,�ya � , ; p. 81d9•No.)OR P.O.ROU7E MIQ BOX NO: Company hiqlC Ncmber cmr � K � . A � K, S7ATE � ZIP CODE RROPfiRTY OESCRlPT�pN(Lot and Biock NunbMS.7att P�cpl Nurr►b�r.L ai D�scri s � w �4u �fl W►on.�Ic.? o���,�::a'v'x � Co,✓ea ,r. ,..�„ TiSIE ' l �.KNIC�r►fW,Na►riiklwuial,A�dltipt�, Bdl�L��/G �i�..e...� �A . Aoc�sorY�dC. UN a ComrnMlfs ar�a�y n�C�ssary,) • uT►T � . ( MIP-iM'-M�.� ot .�� TUM: _ U��� U�D 1�83 30URCE: (J GPS(Type); ' (.J USGS Quad Map LI O!her SEG71�N�-fLOOD IN8URANCE RATE IW,qp{FtRM)INFORMATtON et.NFIP COM�AUNf(Y W1ME d N R B2.COUNTY NAME O 6. 83.STATE 84.nt�PMIDPMIEI 8b.3UFFU( �+NeU � tu .o� NUAABER �`F�� � B7.FIRM P EL 68.FL D 89.BASE FLOOD ELEVA ION(S) O I O"I • DJ►TE : EFFECTIVE/REV18E0 OATE 20NE S G' -d c ) (zone Ao.use aepth or t�oociirip) B 10.Indicat�the wur+ce o(!hs ga�,�F{����iBFE)dsta or bass tlood depth sntawtl in B9. • LJ FIS Pr+ctUs �J F1RM � �.Community petermfned 811.Indicate ttw elevatlon datum us�d for ttN BFE In�89: L__I Other{De�c�ibe): B12. ts the bul{dlr�p Ip���a�� l_1 NOVO 192a �j NqVD 1988 U Other(Describe): ���Resotuces SYstom(CBRS)area orOtherw�ae Protecied Area(OPA)? �J Yas No �eslynaUon Date: . .1�1 , SECTION C-BUILDWp E�,gyAT�ON INFOR1u1AT10N(BURVEY REQUIRED} .t.BuildinQ elsvatioru aro bassd on: LjConstrucUon Drawin s' 'A new Ekvatlon Certl��y�� D UBuUdin�Under Conscructlon` �,�jFinished ConstrucGon `2.g • r'eQulnd whsn cAr►strucUon ot the bul{dfnQ It complete. u��m��r'�-�����W d�apram most=Imilar to the bufidlnfl tor which this certificate is being completed-see DaGes 8 arx!T. 11 no dtapram�ccu�y�Y nW'�ssnts tM buUd C3.Elevatlor►�- liW,Provlde s aketCh pr phplp�raph.5 Zonss At,l�n;nF eu •�..�..e�.,. - .••-•...-.p.���o�c)�vc,V1-V30�V(vVlth BFE).AR.AR/A.AR/AE,AR/A1-A30,Af2lAH,AR/AO Complste Items C3.a-i b�{p,v �_ the datum u���gFE h��b��G�fl�spsGAed In Item C2.State ihe da►um used. I(tha datum is di{terent from Se�O^�'O0^��t ihs datum to that used for the BFE.Show fla{d measurements and dalum conversion calcul�tlon. Uss fM y>ac�Provklsd or th�Corm�n4 area of Sectlon D or --_ Da►um ���y� SeCtbn G,as appropriate,lo document the datum conversion. ~°� Etevation referonce mark used � � D a)Top o{�n� ''4'��"�''�� ���ele�atlon roferoncs rtwric used appear on the FIRM? O b)TcP o(nuct t�ph�r �b�an�nt Oc�r�dosur�) (_J Yes � No _.,_, . ------�,.,�n.(m) � O c)Botbm ot lo�wist hotizonta!� •�n.(m} � �. ,� '�Sry 3/ �`j +�tur'ai a�r�er(V xonas only) s _.�.� ° d��c'ad'°d w�(�d�j . ._rt.�m� . ; �;. � O e)L.ows�t Nsvatlon d G •.,�.ft.(m) .�a ' � _ ? rtwd�r►ery andlor s q u l p m ent o.�r cets �; . 5 �,� . ; �-�,. 0 i°����kW(D�scdb�In s Cqautwnts ares.)ovr�et �. �� � :_ � ..� p fl'Lowea!�����)�t�G3R��h+�io✓ �iww � .�ft.(m) �� - ��� �pt�ast sd O h)No.ot�parmsrtient opsnirWs(Aoo�1 venb)wlthir�1 R.above ad�acent flrade���ft.(m) � 0 �)Tota►area a a!i perma�,.nt ° ... � �Gs Iaood vents)In C3.h�w.ln.(sq,cm) � � sE�ON C'3l1RVEYOR�ENt3iNEER,OR ARCHfTECT CERTIFICA710N o Thts certiticaYon ls b be s{pned snd s�sNd I c�rtify th�t yN.�y�y� ���w�YaY«,ec�ineer,or arc,h{te��authorl�ed'by law to certi(y elevaGon inlormation. �^'e'�C��«����A+gss�ts my best ello�is to lnterpret the data aveilabfe. ���� �statemsnt rns bi a 6 �ne a/m sonmen�under 18.U.S. Code, Section 1a4i. TITLE ' �ICENSE NllMBER �ODRESS j COMP ►,V,A,� � / SIGNA r i � L • 3TA E ZIP COOE _ � E EIEPHONE 77 FEMAFormBt-3t.;,�„�,,� -°`�' as �.��- �Ye-v-��o . . . 3�i��wra�sld�tor contlnuadon. . Replaces all previous ediyons , . IMPORTANT: 1�th�s�spac�a,ao f � BUiIOiNG STRE ,�pp�� Py��CO^'�sP°^dinq,:InformaUon!rom 3�ctlo�A. - t�����"V^��'�����ndJor 8�dfl.No.)OR P.O.ROUTE AND BOX NO. For Insurance Company Use: C17Y � w Policy N�mber «Irt„ h„ • STAi'E ZIP COOE Compa��NAIC Number SECTi�N D• �v�'�� SURVEYOR�ENS3INEER,OR ARCHITECT�ERTIFICA710N(CON7WUED) Co.py bo�h sides of this ElevaUor�CeNttca(e for.(1)community oHiclal, (3)Insurence aganUcompany, and{3)buildin owner. COMMENTS" . � i..r '��AS 9 ..'Lr►WP a11 4 . v� – F.f s �rt.ol` ''p_ N o � 3 _ SECTION E-6UI�DiNG ELEVA710N INFORMA710N�(SURVEY NpT REqUtRED)FpR Zp for Zone AO and Zone q(�„��out/FE),comp�ete items 9.fhrough E5. Jf the Elevatlon Certiflcate is intendecy� Check here iI attacr�menis information for a LOMA or LOMR-F,Section C must be comp�eted. NE AO qND 20NE A(WlTHOUT BFE) E 1• Building Diagram Numbe� or use as supporting. see pages g and 7. It no diagram a�cc�tai��y rsPte=ents the buiiding provide a sketch or photo ra h S81eCt the bWiding dla9ram most similar to the building tor which this certi(icate is being compleied - E2. Tha top of the bottom floor(inctudins�sg���o�endoaure)oftha buildin Is 9 p '� (check one)the hi9hest adj�cent 9rade. (Use natural prade,it avellabie.) 9 �`�—'��t' �m��--LI in, crn E3. For Buildin�Dia�rams 8-8 with opeMn�s(see � )I_I.above or i_�beiow E_J��tt.(m}i I tin,(cmj aboye the ��e 7).'the next hiflt�er ftoor or elevated floor(elevaUon b)o!the building is E4. The top ot the plattorm o/���e ���jecent prade. Corrip�ete ltems C3.h and C3.1 on(ront of torm. ry andlor equiprr►ent seryiG��ths buUd(n la (check onej the.highest adjacent flrade. (Use na►ural grade;it availabie.) 9 �—�—���� m � O1�I_I in. (cm)I_l abovs or�_�beiow E5. For Zone AO oNy: If no ftocad dapth nurribe�is avallable,ls tha top of ihe botlom iloor elevated in accordance with the commun � f�ood lai�mana ement o�dinance? Yes Np SEC710N F-PRppERTy pyyN�R(OF�OWNER'S RE RESENTATIVE)CERTIFICATIONt'on in Seclion�G s The property owner or owne�'s a�thorizsd representativ�w h o c o m p l e t e s S e c t lons A,B,C(Items C3.h and C3.i onlyj, and E t (with o u t a F E M A-I s s u e d o�communfty-Issued BFE)or Zone AO musl sign hare. The sta�ements rn Sections A, e, C, and E are co� the�est ol m knowlad e. or Zone A FROPERTY OWNER'S OR OWNER'S AUTHURIZE�REPRESENTATIVE'3 NAME �ect to A�ORESS • C�� STATE SIGNATURE ZIP CODE DATE TEIEPHONE COMMENTS The local officiai who is authorized by law or oCd'►n4N e t adrfuM s er theNFORMATION(OP710NAL) Check here if attachmerns Sections A,8,C(or Ej,and G o���E�eY�����f��� �P�ete the ppm�b�e,item(sj and s(gn bel went ordinance can complete G�� I_.I 7ha infocmatip��ggq�p�C y,,ps�8n(rom other documentation that has baen aigned and embossed b a li engineer,or architect who(�autho�ized by sta�8 or local faw lo Certity elevation informaUon. (Indicate the source and date of the � .elevation daia in the Comme��s aroa below.) Y censed surveyor, GZ� I_)A community otficial compiet8d SeClion E tor a buildln9 located in Zone A(without a FEMA-issued or communit -issu Zone AO. G3. (_�The foilowing information(items G4-G9y is provided for community tloodplain managemenl purposes, y Y ed 8FE)or Ga.PERMIT NUMBER GS. DATE PERMIT tSSUED ' G6. DATE CERTIFICATE OF COMPLtANCF10CCUPANCY G7. This permit has bee�lssued for. tSSUEO G8. Elevation of as-built lowest floor(inG ding basement)o(�e b tl ngbs�ndal Improvement G9. BFE or(in Zone AO)depth�o(flooding at the buildinp sita is: ---_______.,_ft. (m} Datum; IOCAL OFF�CU4l'S NAME '--------_•_.__ft.(; j Oalum: COMMUNITY NqME TI7LE. TE�EPHONE SIGNATURE � DATE � COMMENTS . . • FEMA Fom�81-31,�itlUiry 2QQ3 C�eck�era il allachm�nis Replaces all previous edi��ons �EOLRAI.�IEROENCY MANAGEMENT.A�3ENCY _ . PI/►TIONAL RLOOD INBURANC�PROORAM O.M.e.No. 3067-0077 ' ��� ELEVATION CERTIFICATE EXp�res�oecemb�r 3i, 200� � t: R�sd th�instructlons on a os 1 -T. + eu�lDUrC�OVYNER'8 NM„IE �CTWN A-PROPERTY OWN�R INfORMl1T10N For Insuratsc�CompanY Usr N Mt �t. (; PdIC;'�?Jumbsr BUILOING STREET ADpFt�gg�k�yp�.��,�� O� �9•�•)DR P.O.ROUTE ANp BOX NO: Company NqIC Number CITY vs ' K. StATE � ZIP CODE RROPfiRIY OESCRIpTIpN(Lot aM Blodc Nurnb�n� ax P�eoN � w v Nurnt�r�lpal O�scrlWlon��IC.� 8U0.D1trp 11S�I�,Q,.�Wal.Non ~ � E a ,�/ • �ntW�rYW'A�.�o�aoiY�Nc. UN�.CpmtNnfs ans. n�sw�y) u � ' � "� �" �'� °f '�'� U w�o t� souRCe: u w,o,� u c�s Rrv): ' L.)US(3S awd Map LI Orher �CT10N 6'FLOOD IN8URANCE RATE Mqp(FtRM)INFORMA7tON et.MFiP COAWUNITY pyy„�E a R 82.CO N1Y N�1ME O b. 93.STATE s,.►�u►P�r,w��� es.suF P"' �r , .� NUt�ABER • 87.FIRAA P EL 68.Fl p � � I O . �� ' ��C?����SEOOATE ZONE S 89.BASE FLOOD ELEVA ION S � '(f ' -a � c l �zo�.no.ua.wPU,o�noodf,w� 810.Indlcst�fM ww+ce ot 1hs 8aq Fbod El�vstlon(BFEj dsts or bas�Aood depfh�ntarod In B9. t L__)FIS ProNs (,�FIRM ' Lj CpnrrwN�y pey�rMnsd et 1. Indkat�th��lsvatbn datum uNd for tfw BFE In�B9: I._10th�r(Describe): 812. Is ths bultdlnp Io���a���� L1 NOVD 192� �NqVO 1988 Oe���D�y+ �s�cos 3ystem(CBRS)a�ea or 0therwrse rote ed Area(OPA}� ��Yes No .I,�J ��N C'�tJU.DIf'1Q ELLVATION INFORIAATION{8URVEY REQUlRED) C t.8u1{dlno alevaUons ah b���: L..I�structlo�Dawlnpa• 'A new E{eyatlon�y�a L,JBuUd{np UndefCor�strucUon" ��jFinished ConstrucGon �'�V�!d wha�constructlon of tha bulidinfl Is complete. 2.Bufidlnp plapra���r�_��������t�ar to the buUdlnfl for which this certificat ' pepes 8 and T' �f�°c�a�n�sWy npt+�Wnv t1�bu1� � e is being comp�eted•see C3.Elsvstions-Zonss Ai�A3p�AE.AH�A(wflh BFE).VE,Vt-V30,V�th 8FE),AR,AR/�A�E,AR/A1-A30.AR1AH,AR/AO ,�"" C�P�te It�ms C3.a-1 bdpy � —a. �►°daturt►used tor tM BFE In 3�� �����G�ed In Itsm C2.Stats tha datum used. If the datum is ditterent trom cakulatlon, li�� �rt►to thac.ussd(or the BFE.Show ileld measurements a�d datum co�vers;on � Dalum �����°�����of�cUon p or g�ct�p�as approp�late,to document the datum conversion. Conve�sloMCor�nts U ElavaUon referonce nwk used SE/ �dw.--��-� 0 a)Top oi bottom poor(k�W p��t»nt oc�� •the elevaUon�etaronca rtwric used appear on the FIRM�� , O b)ToP ol tlud hlpl�r Appr •. , � I:_.,I Yes �J Na, -r 6 ,j�n,(m� O c)Bottom ot iowwt ' ' •.j p d)AttadNd para��P a�b�rtarnber(V=onas only) �'i'�.(m) �_� ��� ?� O e)Lowr�t�vsfbn af nyd�In�rY a�ld�or�qt�ipment o ds urs •1.�n•(m) �� �°" ��; �� °�.� � � �10�+�+41 ant��(D�aaib�In s CqrmMn4 vea.)ovl�,a�r f�r� � • 5 -n�m� W� � �- �;f� �� � ,�� p�+�d�(1.11�3) I��i't+�'+' � �d •1� � fl���st adlaaru(14�Ishsd)yra�`(MAG) . °`r Aw�" � • '„�t-h•(m) �� ti�� : ��` �- .`` ,fp.r�.��' �� O h) ot.pemtar�snt��aood vertti)wllflkt 1 R.above edjacent��--^---� •�ft.(m) �rr�-`�',� -•�.J 0 i)Total sros a au�n,an.nc ,.,Nt�.y� � .... `� �`°� °PW►�nps(Qood vents)in C3.h c{����"f " -Ho��sq.In.(sq,cm) ����'���R EN3iNEER�OR ARCHITECT CERTIFICATION , Thia ceNffcatlon y b p����� 1 wrtily diat�• �Y�land wryeyor�enpineer,or archltect au ' l �+�on�n S�c�/oru�,��C�����n thaized'by!aw to certify elevation infom�ation, �d arJ /���� a Pnsenls my bost ol/p�to lnfsrp�et the data eveileble. CER1'I��ER'S b t/ns orlm sanment under 18.U.S.Code. Section 184l. TI?LE ' LICENSE NUMBER � t � C MP � � / , SIGNA r � � 3TA ZIP COOE - � • dS L FH NE 77 FEMA•Fortn 81�3t�`larw!ry 2003 7�7- ?9 f9-v��� � . '' � ��w�'+�tW�tor oondnwUon. . Replacea all pravious ediyons � . IMPORTANT: In th�s�aPac�a.coPY tl»ao�spo�dinq I�formadon trom 8�ctio�/►. . eUI�01NG STRE T/�ppl�Sg . � W ����"V^u'����� � �dp•No. OR P.O.ROUTE ANp gOX NO. For Insunnce Company V�: CITY Policy Number q h, • STATE "� `��`� 21P COOE Compa'�NAIC Number SECTION D•3URVEYOR,ENt31NEER,OR ARCHITECT�ERTIFICATION(CON7INUED) , Copy bp�h stdes of this Elevay�Ce�y��a fw y COMMENTS' . � )�muNty pf(�clal, (?�Insurance ag@nt/com an ' P Y, and(3)bufiding owner. ��� � ' � �� � — 1N 1 ---�-= �. . FrT T N't1�� � i1 W � _ SECTIQN E•BUILDING EI.EVATION INFORIWqT10N�(SURVEY NOT RE For 2o�e AO and Zona q(wiWout BFE C��hera i►auacnmems )�complete Items 1.through E5. )f the E eva.on'Certlfica�te s ntoe ded oON e as`suTHo 11T BFE) intormation for a�OhAA or LOMR-F,Section C muai be comp�eted. E 1. Building Diagram Number Pp rt�ng — (Selsct the buA d(n g d i agram most similar lo the buUding(or which this certiticate is being compteied- se e p a ges 6 and 7. It no diaflram accu�at��y reptesents tha building;prp��de e 8ketch or photograph.) E2. The top ot the bottorn floor(i��d�fl���,���doaure)cf the bulldin Is (c��ane)the hipheat adJacent prade. (Use natural prade,il availabte.) 9 I_I_.)It. (m)�,_,L)in. crn E3.For 8uildinfl Oiaflrams 6.8 with � �I�I.�bove or(_I below (J J(�•(mj °Pe�q=(see pase T),4he nexi hipher flpw or elevated floo�(e18�ation b)of the building is E9. Ths top of ths pIWM.p�)�OYe�or�qWpment servicin the hiphest sdjacent prade, Cprrp�ets items C3.h s�d C3.1 on tront of torm. {cneCk ona)the.higt�st adjacent flrade. �Uae natural yrade;if available.�fng Ia I_l._)ft.(m)I_I.._I in. cm • E5. For Zo�e AO oN : �1� ( )I_.I above or�_� below y fbod dePth number Is ayaUaWe,is the top of 1he bottom(loor elevatad in�ccordance with the community's fl°°d �ain mana ement ord' ���? Yea No Unknown. 7he local cfflc{8�muat certif this intormation in Saction G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATII/E)CERTIFICATION Tha property ownar or ownar's aulhprized rearesenta4ve who completes Sectfons A,B,C(Items C3.h and C ' (wilhout a FEMq-�SSUed w community-lssued BFE)or Zone AO must sign here. The stalemen�s in S the best oPm know/ed e. 3•i only), and E (or Zone A PROPERTY pWNER'S OR OWNER'S AUTHpRIZEp R�p�SENTATIVE'8 N�ME eclions A, B, C, and E a�e co��ec�fo AO�RESS SIGNATURE C�� STATE ZIP CO�E COMMEN7S �AT� TELEPHONE The Iocal o(fiGal who is autho�ized by law or ordinOance t adm��n s er theNFORMATION(OPTIONAL) Check here if attachmenis Sections q,8,C(w E),�G o����va���f��. �plete 1he ppl�cable item(sj an�d s gn b e went o�dinence can complete G�• I_)The information ir�$e�p�C N,as����a�e�dxumentatton that haa been slgned and em engineer,or a�ch���Who���u�horiZed by syts or bcal[aw to certify elavation inlormaUon. (Indicate the sour elevation data i��C bossed by a licensed suroeyor, °'nments area below.) ce anC date ot the � G2' �—)A�����ity official cpmp�eted SeCUo�E for a bu(Idl�g loeated in 2one A(without a FEMA-issued or Zone AO. G3. �_�The followinfl information(Iter�Cq.GBj Is provided ior community floodplain managemenl pur ose communiry-issued BFE)or G4.PERMIT NUMBER GS. QqTE PERMtT I�SUEO p S� G6. DATE CERTIFICATE OF COMPUANCElOCCUPANCY G7.This permit has bean Issued(or. tSSUEo G8. ElevaGon of as-built lowast 800r(inG dlnq basement)o(the building is: G9. BF��yr(in Zone AO de th•o1 i �--)Substantlal Improvemant � P boding at tt►e buildinp slte is: -------_•._,_tt.(m) Datum: IOCAI OFFIC1Al'S NMAE -------------.�--,ft. ��` � �a1um: COMMUNITY NAME YITI.E. S►GNATURE TELEPIiONE COMMENTS DATE ' -..._ . • FEMA Form 81•31,January Z003 CR��k here if altachme�is ReplaCes alt previous edilions FEDERAL EyERpENCY MANAt3EN�ENT A�3ENCY •, - ' ' HIITIONAL.RLOOD IN8URANCE PROORAM O.M.e. No. 3067-0077 "�� ELEVATI4N CERTIFICATE E"p�`es o�`mbe`3,, 2oos � � t: R�sd Eh�Inatcuctlons on os 1 -7. BU�IDINCi OWNER'8 PU1t�AE uCTiON A•PROPERTY ONiNER INRORWIATION ALTOw� ' For Insuranc�CornPanY Usr A (, � Palc�r:3Jumber BUILDING STREET AppREgg(y�k�dy�p�,��g��,�� p. „ `v� Mo.)OR P.O.ROU?E 11ND BOX NO. Company NA�C Numbor CITY , ' .��in�.u��.tF�.. STATE ocnn�e�., F���, l� ZIP CODE •••a••�• �x.nu�noN(Lot�nd BbGt Ntmpws. ax Paral Nw��L M1�I �GsctiPUon �IC� BUB.pIfJO USE(�.p.. N M 1�J� � �{ q, • ' �dd�10�1.I►aM�Ofy.�iC. Uq+.COftIrt1M11f af�a u . , . c +w'•+ar-,�r.rr or'�rr� U t,���2r U w�a i� souRCe: u�as��� r �, . M� u o�,:e� �CTION 8•F1000 INgURANCE RqTE MAP(FIRM){NFORMATtON 81.NFIP CORWUNITY t�tA►IE i 82.CO WTY NAME T hv�. K. (� B3.STATE B4.�AMANOPMIEL +Ne�Iw� 8S'.SUFFIX N.i w NUAABER ' B��F�P � B8. L D 89.BASE FLO00 EIEVA ION(S) G . _�� � EFFECTIYEfREy�gEO pATE; 20NE(8) • • (IoM AO,us�dep�Ot�y�) e 10. Indlcat�tM wunce ot�s Bata Flood El�vatlon(BFE)d�t�or baa fbod depth enterod in 89. ' (,_J FlS Pt+otfJe �FIRM �...��uUty Detenn{ned Bt t.Indkats tM�IsvaUon datum us�d for tlw:BFE(n�89: I_l Other(Deseribe): B12. Is the puiW4p 1���o L..1 NOVO 192� (�J NqVO 1988 LJ Other(Describe): ���Re+ou�oss 8ysfam(CBRS)area or Otherwise Protected Area(OPA)? �_J Yes oe�,.�«,o•�e: . �,�,J No 8ECT'ION C•BUILDtNQ ELEVATION INFORUAATIOFI($URVEY REQUIRED) C 1.Bu(klinp el�vatlons an based on: . 'A new El�vstbn C�rW�y wll)b� ��ction Orawinys LJBulidlnp Under Constructlon• C2.B ����w��of the bulldlny Is complete, IX 1Finished ConstrucUon C3 �� ��'��_�`$�������t�at to the buUdlnp for whlch lhls cerUficate is being completed-see d�n aoaxaWY nW'�MnV tM bulldirq,ProvWe a�lcstch or photopraph.) .El�vatlOni-ZOnss A1�A30�I1E.Ni�.A(M�fh 8FE)�VE,V1-V30,V(wlth BFE),AR,AR/�►.AR/AE,AR/A1-A30,AR/AH,AR/AO Compl�te it�ms C3.a-I bNow tt�s datum����E h�b��0�O�m speciAsd In Item C2.S t a t s the datum used. If the datum is different from ��oonw�t the datum b thal used for ttts 9FE.Show fleld measuremants and datum oonver�ion ����. �� ��Convsr�loN���y���D�S��G,ei pPP�R�ate,to document the datum conversion. Elevanon rotsronoe rtwrk used S�/ �Q ..� --� O a)Top ot bottom Aoor '—'-"�- Does ths alevation rotero�ce ma�ic used a (k�dudinQ p���pr�n� b ppear on the FIRM? L)Yas U No O b)ToP of�t�d Nptwr ppp� •. , . ��'n.�m� �{ � O d)eotbm of lowpt hor���msmber(V zonea only) ~� '-""'���m� ,j ` ,� / ,�'�•� )�uad�d pa�ap�t�a�Iab� � ._h.{m� �� ��,�,, O sy Lorwst M�vatbn of t�y�y�y -�-� �.(m) • ':,. . ��r ���W�aiqlbi b i GOf1i11N�b ifli. Ei�'L��E�•Zq W� �`��r��p ��� �r, �- -,� 0 n l.°a'kt+�{�t(ANstwd � 10 ,,�n,�m� `�, � ` � 0 Q�Filqnsst adlaan�(a�ned�`�G�. � s �,h�m� �� c.� �� -- O h)No.oGpsm�u°����Aood wnb)wlft�ln 1 ft. � •YSt n.(m) � =y ��, x� �' . O q Total ana d au abovs adJacent fl�ade �'.- a�>_ , P�wt�nt openirWs�Aood ven4)In C3.h J�f�_w.In�- " 'f>. -`�' - (s9.�) ,," ,".�_- ����'�R��R EN(3WEER,OR ARCH17ECl'CERTIFICATIOH ` * ^ ( 7Ns ceNlkati�on b b b�sla��q� , n • !aiWy th�t tM•y�liorrr��h ����'sy��e�e�,or arct�ltect au�ed'by law to certity alevaUon infonnation. �tu�d�rstand ��^'8'�C:���+�nP�a�nts my best�florts to 1nlerp�et fhe date a veileble. CERTIFIERg /ds�sfat�n�nt nu b� 6 Nr�s ar sor�ment under iB.U.S.Code, Section tept. TtT�E '' LICENSE NUMBER � � MP � � / S� r � � STA E ZIP COOE ' QS l PH NE 7 FEMA�Fam 81-9t.Jarw!ry Z003 � - ?B-S/�c n . .. � 8�i nwra�sid�for oontlnwUon. . Raplaces all previous ediyons IMPORTANT: In tt►�i�spa��s�Co ` BUIlO1NG STRE �ppRE�( Y th�oornspondin informstlon trom S�ction A. . . ���"V^u'���• or �dq.No.)OR P.O.ROUTE ANp gOX NO. For Insurance Company use: CITY , � Policy Number , h h, • S7AtE ZIP COOE Compa��NA{C Number SECTION D.SURVEYOR,ENt31NEER,OR ARCHITE T�ERTlFICATION(CONTINUED Copy both sides of thls Elevatlon C�ry�te foc(t)community ofllcial,(3)Insurance a onUcom an y COMMENTS' . 9 p y, and(3)building owner. � i/v '�� -r!�p� G v ` ~ j f.o/ '' '' , -- SECTION E-BUI�DING EIEVATION INFORMATION'(SURVEY NOT REQUiRED)FoR ZONE ao for Zone AO and Zone q(W�t�out�FE),comp�et��tema 1.fhrough E5. If the Elevation Cettiflcate is intend Chack here it atlachmems info�maiion for a LOMA or LOMR-F,SeCtlon C muEt be completed. AND 20NE A(WITHOUT BFE) E 1. Building Diagram Number ed for use as supporting. (Select the bullding dlagram most similar to the buiiding for which lhis ceni(ica�e is being compie�ea- see pagea 6 and 7. If no diaflram aCCU���Y�s�eisnts the bWldinp,p�ovide a akatch or photcspraph.) E2. The top o(the bottom ftow(indudinp bassrt�en�ot e�qpsure)of the bulldin la (�eck one)tha hiflheat adjac.ent prsde. (Use natural prade,ii available.) � I--I__..I ft. (m)LI._I in.(cm)�I.above or�_�be�ow E3.For 8uildinfl piaprams 6-8 wlth IJJ�t•(m) °��9s��°�fle 7)���he next hiflher Aoor or elevated floor(elevatlon bj of the building is I I lin'(cmj a�°���=t adjacent�rade. Complete ltems C3.h and C3.1 on tront of form. E4. The top of ths platipnn of m��nery andlor�qulpr�nt servic►np tt��buAd(n Is (check ons)the.highsst adjacent 9rade. (Use natural flrade,iI avaflable.} 9 (—��«��rt'�(—I_,1�n. cm E5. For 2one AO oNy: U�o Aood depW number Is avaUsWe,ls Iho � )I_I above or�_�below tlood lain mana ement oMinar��� Yes No ��������m��o°r elevated in�ccordance wilh the community's SECTION F-PROPER7Y OWNER(OF�pWNER'3 RE RESENTqTIVE)CERTIFICATIpN�on in Section G. The property owner or owner's autho�ized represony-�tive who completes Sectlona A,B,C(Items C3.h and C3.i only), and E for (withaul a FEMA.�ssued or commun�ty.�ssued BFE)or Zone AO must sign here. The statements in Sections A, e, C, an fhe bes�ol m knowled e. Zone A PROPERTY pWNER'S OR OWNER'S AUTHpR d E aie correct fo �E�REPRESENTATIVE'S NAME AOORESS CITY STA7E SIGNATURE Z�P CODE DATE 7ELEPHONE COMMENTS SECTION O•C0IAMUNI7Y INFORMATION(OPTIONAL) Checac here�I attacnmerns The local official who is authorized by law o�ordinance to administer lhe community'a floodplain•managemsnt ordi�ance can com let Sections q 8,C(�E�,�G���E�v�������. �pl�te the appllcabla Item(a)and slgn below. `' G 1� �T����A�1n Sedlon C was take�(�a�ar docurnentation that haa been slgned and embossad b a licen ' P e enginee�,or archit��Who 1�puthorited by stals or Ipca�Iaw to certify elevation informatlon. (Indicate the source ane date ol the f elevation data in the C Y sed surveyor, �'^�n�s area bolow.) GZ• I._I A community official cpmp�eted SecUp�E(�a butldl�g located in 2one A(withaut a FEMA-issued or community-issued BFE r Zons AO. G3• I_I The(dlowinfl information(Itema G4-G9)Is provided for community floodplain managerr�ent purposes, )� G4.PERMIT NUMBER G5. DqTE pERM�T ISSUEO '" G6. OATE CERTIFICATE OF COMP�IANCElOCCUPANCY G7. This permit has beon Issued for. �SSUEo G8. Elevation of as-built lowast floor(inGudl fleb sement)of the b I1u d ng s��u��mprovemenl G9. BFE or(in Zone AOj depth•of tloodinfl at the buildlnfl aite 15: -------._.__•`(t,(m) Oatum; L�W.OFFICIAL'S NMAE --_ft.(; ) Datum: � �"`� TITLE. COMMUNITY NAME TELEPHONE SIGNqTURE ° � DEC 0 5 20 " �oATE � COMMENTS _ ` • FEWIA FOrtT1$1.3�,,Ji�tui�y 2pp3 Chstk here i1 a��achmerns Replaces ail p�evious ediGons . . ��� �/�� '��v C'-�/F v giX�a���� ���'�'�rNEc''�� C I T Y O F C L E A R W A T E R � �����I i, sz� ��'r =�� �"' DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT :�,,�� =_� �� �����+>�_��' ��1� POST OFFICE BOX 4748� CLEARWATER� FLOa�Dn 33758-4748 ��i�'qT�R���1y� MUNICIPAL SERVICES BUILDING, ZOO SOUTH MYRTLE AVENUE,CI.FARWATER,FLORIDA 33756 �X�"��9 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 ceRificates 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 The attached elevation certificate is complete and correct X 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 530 GULFVIEW BOULEVARD CITY STATE ZIP CODE 33767 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 62.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 5/17/2005 EFFECTIVE/REVISED DATE (Zone AO,use depth of flooding) 12103C-0104 610. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in 69:❑ NGVD 1929 ❑ NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑No Desi nation 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 compiete. 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 NAVD 1988 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)1ft.above adjencent grade i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm) Comments: � Date of Review: Community Official: c' �evation certificates sha//be maintained by he community and copies with the attached memo made availab/e by request FRANK HBRARD,MAYOR GEORGE N.CRE'fEKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBLR PnuL F.Gi[�SON,COUNCILMEMAER � CARLEN A.PE'I'ERSEN,COUNCILMEMBER ��EQUAL EMYLOYMEN'f AND AFFIitMATIVE AC1'ION EMNLOYER�� � _ -- ,__.._ ____ -.___ ._.__ . __._.. . ___,_ ___.._. , ��(f _ $„�,- � G� - v , __ ..._ _._ . . _ _ ___ -- _ __ � --.. . __ ___ �. c �r _ _ �.��.�.� '� �_.____. . _���.���_ ____ : �_ _._�._ _ _ _ _�..__ _.__ ____ _ �� �' � �_ . _ _ ____ _ ,_ , ____. _ _.__ ____ _���_ �` _ _ _ ______ __ _ __ _ __ _ � _�_._ . __.__ _ . _. . ._ • • � , ��i� =R' '' �� `: '�;,�/������� �, ,�; '"_' f r s�C. �.,t i ��; �=. : ,r`� ..� � �� � �- .��.,� � ! ! 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'_ � - � ,r • �ax� �$�o�rH���� !��_ �`�� �b CITY OF CLEARWATER � V 4�\ / x � �r-�—�� ��yy DEVELOPMENT & NEIGHBORHOOD SERVICES DEPARTMENT ����� ��`a� POST OFFICE BOX 474H� CLEARWATER� FLO�DA 33758-4748 �.��tt.YY�� L[' 'qT�p�,�;���' MUNICIPAL SERVICES BUILDING, lOO SOUTH MYRTLE AVENUE,CLEA[tWATER,FLO�uDn 33756 TELEPHONE�7Z� S6Z-4S67 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 The attached elevation certificate is complete and correct X Minor corrections have been made in the below marked sections by Community O�cial 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 530 GULFVIEW BOULEVARD CITY STATE ZIP CODE 33767 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:0 GPS(Type): (##°-##'-##.##" or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map�Other SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 62.COUNTY NAME B3.STATE 64.MAP AND PANEL 67.FIRM PANEL 69.BASE FLOOD ELEVATION(S) NUMBER g5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8�FLOOD ZONE(S) �Zone AO,use depth of flooding) 12103C-0104 5/17/2005 610. 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) 811. 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 Otherwise 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 compiete. 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,convert 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 NAVD 1988 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)1ft.above adjencent grade i) Total area of all permanent openings(flood vents)in C3.h sq.in.(sq.cm) Comments: Date of Review: Community Official: �(1 elevation certificates shall be maintained by the communiry and copies with fhe attached memo made available by request • FRANK HIBBARD,MAYOR GEORGE N.CRE'IEKOS,COUNCILMEMBER JOIIN DORAN,COUNCILMEMBER PAUL F.GIRSON,COUNCILMEMRER � CARI.EN A.PE7'ERSEN,COUNCILMEMBER ��EQUAL EMPLOYMENT AND AFFI1tMATIVE ACTION EMPLOYER��