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1828 VENETIAN POINT DR (3) � , , � OMB No. 1660-0008� U;S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Ex�ires Februarv 28. 2009 Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Policy Number PLM CONTRACTORS and ROWLAND 8�KATHY MILAM A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 1828 VENETIAN POINT DRIVE C� State ZIP Code CLEARWATER FLORIDA 33758 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 3 BLOCK A,VENETIAN POINT SUBQNISION, RECORDED IN PLAT BOOK 27,PAGES 26 AND 27, PINELLAS COUNTY,FLORIDA A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude:Lat.N27°59'14" Long.W82°47'S5° Horizontal Datum: NAD 1927 ❑NAD 1983 � A6. Attach at least 2 photographs of the building if the Cert�cate is being used to obtain flood insurance. A7. Building Diagram Number ONE A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s NA sq ft a) Square footage of attached garage 400+/- Sq ft b) No.of permanent flood openings in the crawl space or b) No.of pertnanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade NA_ walls within 1.0 foot above adjacent grade NA c) Total net area of flood openings in AB.b NA sq in c) Total net area of flood openings in A9.b NA sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Communiry Name 8 Community Number B2.Counry Name B3.State PINELLAS 12103C CLEARWATER PINELLAS COUNTY FLORIDA B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use 12103C 106 � H 9-3-03 5-17-05 VE 15.00 610. Indicate the source of the Base Flaod Elevation(BF�)data or base flood depth entered in Item 69. ❑FIS Profile �FIRM ❑Communiry Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item 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 �CBRS �OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction' � Finisheci�r�hictio . �' 'A new Elevation Cert�cate will be required when construction of the building is complete. �* '�- ��� C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,ARlA1-A30,AR/AH,AR/AO. �n�e It�s C . �=. below according to the building diagram specified in Item A7. �� �; p ��`� Benchmark Utilized CITY OF CLEARWATER BM I-06 -Vertical Datum NAVD 1988 PUBUSHED ELEVATION OF 11.5778 �, �,; p.,� ,�, a) Top of bottom floor(including basement,crawl space,or enclosure floor MAIN ENTRANCE FLOOR 5.54 feelf r �`�: b) Top of the next higher floor SOUTH FLOOR OF HOUSE 6.50 fee� $�, � �z '. ��, c) Bottom of the lowest horizontal structural member(V Zones only) SLAB ON GRADE ; .��, �� - � � d) Attached garage(top of slab) 4.66 feet � �� �m A � &� e) Lowest elevation of machinery or equipment servicing the building 4.90 feet �� �� �r (Describe type of equipment in Comments)(OUTSIDE AC UNI'1� ��°a �; + �".y::°:-W�``J fl Lowest adjacent(finished)grade(LAG) 4.3 feet �""�? ��^ ���� g) Highest adjacent(finished)grade(HAG) 4•9 feet �� v� SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This cert�cation is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation " • information. 1 ceRify that the information on this Cert�cate represents my best efforts to interpret the data available. ��` --���.����' � I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. B�t Lj,:'� �'Y'�f= � . ❑Check here if comments are provided on back of form. P,L� ���4�� �� Cert�er's Name License Number BILL HYATT FLORIDA UCENSE#4636 9 .�1�r� ' " �M Title Company Name ' �� ��,�� t��`'�. PRESIDENT KNOW IT NOW INC. � • r� ;� ; �"< ' ." Address City State ZIP Code °"� ��x MAIL=1497 MAIN STREET#321 DUNEDIN FLORIDA 34698 " .M-°�?�� ' �r.� Signature � ��� DATE: 9-18-OS TELEPHONE: 727-415-8305 "- � ' B�,P.'�O�•///S3 FEMA Form 81-31,January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 1828 VENEl'IAN POINT DRIVE City State ZIP Code Company NAIC Number CLEAt4WATEJ� FLORIDA 33758 �,•t `i;��'�,;,,' ;`:�,� SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) � �. . t �����opy� h siQes•qfttl's'zElevation Certificate for(1)community official,(2)insurance agenUcompany,and(3)building owner. �.�r°� C�m n�� y"; -�� � N, ,�. �� ., -; � e, �. ,�, s �, �,'w � c�� .n'. ❑ ,� `x��.►�h�� .. � "�°AF,�" ••.�.. w . "`�,�$j�rta���t_ Date 9-18-08 Check here N attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use naturat grade,if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation inforrnation for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑ meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is _�feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectiq�.�Items 8 and/or 9(see a e 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _Q feet u meters ❑above or �below the HAG. E3. Attached garage(top of slab)is �feet�meters �above or � below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _�feet �meters �above or �below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The locat official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,8,and E ane correct to the best of my knowledge. Property Owners or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Cert�cate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. � The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community o�cial completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Cert�cate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces al�previous editions Buiiding Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Poiicy tvumber 1828 VENETIAN POINT DRIVE ��ty State ZIP Code �Y�N"� CLEARWATER FORIDA 33758 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least iwo building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View"and"Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,following. ,�+� S/ y �; i � f. . ` 'i'_ , � , , . ,_ �1 � ��� - �, � ars � : � ^ . �. ,�.�s < ,.^'�Y ������ ? ,.._ .,._ _. _: . .. .. .. . � ..�r �q� � J t��� �M�4 I ' �� �i �� 1��' � ..f�, �.: Y ly I t� . .' � :�.��, e k �/� ��' ,. � %�i�a�}: Y �KrTq::�9i ' . . + � ' '��'_.`� ' .+1 �---�"�----- .:�.I - �� a, �,�a � � � � »�� ,�� � ,� � �. �. , ,� . �., .,...- . ^+im�, . . � � � � } ... , z�� ., M". �����; � '/ 't.� l� {�� � �: t. v:, `�a. .`�.ng � .. 1 qyy� �My / y. '<. �� ��+i � , .��".<{ � �I 1 � F �a � � ' � ,� �,� s I � `: a �: i - �,i,�,� , -�-~... - . 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"�XG 'x'.�-?�C'r«��.+�' � .•�C e 41 �r '� �f . // F��j }� � . ..,y, „y �x t f�i'� ..._5*•.' p L . . - r � �� �t �'"a, . ,.. ... ' ^' ' . _..�: .. ..:. V': . ( 1 . . _ -rt . :sR* . ... .. • ,�;�:+.r-'.; .".. � ...� ��... . . J, � .:,.. _� .y�..�.. _ f � � U.S.DE fMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 � ,w Exnires Februarv 28.2009 Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: A1. Building Owner's Name Policy Number PLM CONTRACTORS and ROWLAND& KATHY MILAM A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 1828 VENETIAN POINT DRIVE C�ty State ZIP Code CLEARWATER FLORIDA 33758 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 3 BLOCK A,VENETIAN P INT SUB IVISION, RECORDED IN PLAT BOOK 27,PAGES 26 AND 27, PINELLAS COUNTY,FLORIDA � �� O6 A4. Building Use(e.g.,Residential,Non-Resi entia,Adli'ion,A sory,etc.) RESIDENTIAL A5. Latitude/Longitude:Lat.N27°59'14" Long.W82°47'S5" Horizontal Datum: NAD 1927 ❑NAD 1983 � A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number ONE A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s NA sq ft a) Square footage of attached garage 400+/- Sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade NA_ walls within 1.0 foot above adjacent grade NA c) Total net area of flood openings in AB.b NA sq in c) Total net area of flood openings in A9.b NA sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61.NFIP Community Name&Community Number B2.County Name B3.State PINELLAS 12103C CLEARWATER PINELLAS COUNTY FLORIDA B4.Map/Panel Number 65.Suffix 66.FIRM Index B7.FIRM Panel B8.Flood 69.Base Flood Elevatio�(s)(Zone Date Effective/Revised Date Zone(s) AO,use 12103C 106 H 9-3-03 5-17-05 VE 15.00 810. 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 Item 69: ❑ 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 �CBRS �OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. Building elevations are based on: ❑Construction Drawings* ❑ Building Under Construction• � Finis�Construction 'A new Elevation Certificate will be required when construction of the building is complete. � � C2. 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/A@� �nplet below according to the building diagram specified in Item A7. "� � Benchmark Utilized CITY OF CLEARWATER BM I-06 -Vertical Datum NAVD 1988 PUBLISHED ELEVATION OF 11.!�8�s �`" z � a) Top of bottom floor(including basement,crawl space,or enclosure floor MAIN ENTRANCE FLOOR 5.54 ��e��� o < b) Top of the next higher floor SOUTH FLOOR OF HOUSE 6.50 ;"�ee�` N ,.�� c) Bottom of the lowest horizontal structural member(V Zones only) SLAB ON GRADE � ^`W'"° r u,� 4.66 feet � � � d) Attached garage(top of slab) ��� �v � , e) Lowest elevation of machinery or equipmeM servicing the building 4.90 feet ,:; � . (Describe type of equipment in Comments)(OUTSIDE AC UNIT) ` � ti- �� fl lowest adjacent(finished)grade(LAG) 4.3 feet � r-' "6 _; ,,,.> _. . g) Highest adjacent(finished)grade(HAG) 4.9 feet `.. , �.'......�_ 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. 1 certify that the information on this Cert�cate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment urrder 18 U.S.Code, Section 1001. B I LL HYATT ❑Check here if comments are provided on back of form. PLS # 4636 Certifier's Name License Number ��; BILL HYATT FLORIDA LICENSE#4636 9-�-8,'-�,,� <�, Title Company Name - i��' ' PRESIbENT KNOW IT NOW INC �� �� �(�� := o Address City State Z�P Code �•" { . MAIL=1497 MAIN STREET�i321 DUNEDIN FLORIDA 34698 � �.: � � � � `�• Signature : ��'��n �!�„ � � ` ///j . :� ;�,,9�. /� •1�;; � � /�C 1„/,/ /� Il .Y .•y � flR• `� / \ 7/�O 1 ;`�r �rn r DATE: 9-18-08 TELEPHONE: 727-015-8305 4''"° i , �"' � �=s ' �,A'�.� � Y .,s� , M,�� . ac p aod�- ���s3¢ .,.-F a. FEMA Form 81-31,January 2003 See reverse side for continuation. Replaees ai)previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bidg.No.)or P.O.Route and Box No. Policy Number 1828 VENETIAN POINT DRIVE City State ZIP Code Company NAIC Number CLEARWATER FLORIDA 33758 ;�a „., , ;.°, SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) C,�opyboth 55d; ��i§�t�vation Cert�cate for(1)community official,(2)insurance agenUcompany,and(3)building owner. (bC►hmL�ts. 1'��,.. i� -. EJd�EGs�"� �� � �, ��� ,r�; w �,' ❑ ��1 J:,� � � ,t' ` ,y,,, • r 9i�qak}�re';, , r� -'.` Date 9-18-OS .�, , Check here ff attachments 'SEC I`t�1N `=9t�ILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑ meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is _�feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in SectiqII.�Items 8 and/or 9(see a e 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _Q feet I_I meters ❑above or �below the HAG. E3. Attached garage(top of slab)is �feet Q meters �above or � below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _�feet �meters �above or []below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,8,and E are corroct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here'rf attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Cert�cate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. � The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certiy elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Seetion E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Local O�cial's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions . _ Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Poiicy Number � 1828 VENETIAN POINT DRIVE �ity State ZIP Code �«�v►�cNu� CLEARWATER FORIDA 33758 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View"and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,following. -----._ _. _ ;a: , i r � � � � ���,� r> .�, � :-� � � r3 .�� "ro. a . � ���O�il�� ���,$��` 4 � � f a � � . � ����� �������' ��� � . � i L.I �. t1 3� � �'b„ i �" 4' ,5N-.��' � I V���II�I�C'I� `M1"�r-.s.. � ��I16'1 � �- - �°T�„ ` _ �� ,�� u� � t. ;�tt�yE � �N , ,, ..�� ��� � "� � ..��::,, r,,..�--......_ �. . — ,'� � ��„�,�../'�,f�� ,.. ` a �°t�., ,` �t« .i�y.,� �.P�+� +"�Y/`.� , °'b � ��,� � i ��� ,�y • � i � S �` I {�: � Y % I �r 1 � .. ..�~�.�.� . 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No. 3067-0077 � , � FEDERAL EMERGENCY MANAGEMENT AGENCY ExPires July 31, 1999 NATIONAL FLOOD INSURANCE PROCRAM ATTENTION: Use of this certificate does not provide a waivar of the flood insurance purchase requirement.This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to determine the proper insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).You are not uired to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pagee. SECTION A PROPERTY INFORMATION FOH,I„� "" e BUILDING OWNER'S NAME ' r;"'-- ` m I R�,__ � JAME M R AM S. HILL �`� � � � � �� STREET ADDRESS(Including Apt.,Unit.Suite and/or Bldy.Number)OFi P.O.ROUTE ANO BOX NUMBER � ' COMPANY MBE r � ;',� � ��� ;.�V.1 ;� �$�2JL � �� c .� OTHER DESCRIPTION(Lot and Block Numbers,etc.) '.� f��� T�,�,,�� LOT 5 BL CK A VENETIAN POINT DRIVE ��-��: � �= �'� �`��'•r,��``�.��'.`�`t�`� ��LEARWATER '�:::t��<�aE:�;���. SEC;10�B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Provide the following irom the proper FIRM(See Instructions): 1.COMMUNITV NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION (in AO Zones,uae depth) 125096 0008 D 8-19-91 VE 14 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE): ❑NGVD'29 ❑Other(describe on back) � 8. For Zones A or V,where no BFE is provided on the F�RM,and the community has established a BFE for this building site,indicate the community's BFE:�J.0 feet NGVD(or other FIRM datum–see Section B, Item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate lnstructions,indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's�eference level_1— . �i). FIRM Zones A1-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation ot I I I I�L I�f feet NGVD(or other FIRM datum–see Section B, Item 7). (b). FIRM Zones Vt-V30,VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reference Ievel from the selected diagram,is at an elevation of��,LJ feet NGVD(or other FIRM datum–see Section B,Item 7). SEE BACK (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is W.0 feet above❑ or below❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is W.U feet above❑ or below 0(check one)the highest grade adjacent to the building. If no ilood depth number is available,is the building's lowest floor(reference level)elevated in accordance with the community's floodplain 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: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section 8, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes �No (See Instructions on Page 4) 5.The reference level elevation is based on: � actual construction ❑ construction drawings (NOTE: Use ol construction drawings is only valid i/the building does not yet have the relerence level floor in place,in which case this certi/icate will only be valid for the bui/ding during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) 6.The elevation of the lowest grade immediately adjacent to the building is:��.0 feet NGVD(or other FIRM datum-see Section B,Item 7). SECTION D COMMUNITY INFORMATION 1. Ii the community official responsible for verifying building elevations specifies that the reference level indicated in Section C,Item 1 �s not the"lowest iloor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: ���.0 feet NGVD(or other FIRM datum–see Section B, Item 7). 2. Date of the start of construction or substantial improvement . FEMA Form 81-31, AUG 96 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION � , � This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation info�mation when the elevation information for Zones A1—A30,AE,AH,A(with BFE),V1—V30,VE,and V(with BFE)is required. Community officials who are authorized by local law or ordinance to provide floodplain management information,may also sign thp certification. In the case of Zones AO and A(without a FEMA or community issued BFE),a building official,a property owner,or ai� owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8- Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment;area use,wall openings,or unfinished area Feature(s),then list the Feature(s)not included in the certification under Comments below. The diagram number,Section C, Item 1, must still be entered. l cerlify that the inlormation in Sections B and C on this certificate represents my best elforts to interpret the dafa availabl;e. .. I understand that any lalse statement may be pun:shable by line or imprisonment under 18 U.S. Cod�, S�ction 1001. ��� � 2J(�„�, � � .,� , .. `c.t�;, CERTIFIER'S NAME UCENSE NUMBER(or AMix S'aal�• •`- , ' ' GEORGE A. SHIMP II 2512 _, : c;' � �: ��,'�. :T TITLE COMPANY NAME -•, �., c�� � :. • PRESIDENT GEORGE A. SHIMP II & ASSOC:"'r�•, �-, �<y ;`�,� � � ADDRESS CITY � '.���� .. STAIE.,� : ' ZIP 3301 D TO BLVD. PALM HARBOR � '� 'A a p d.k ".;r�� `�"��.683 SIGNA � DATE " p OB #980674 11-11-98 7 : —,54 6 "::. Copfes should be o this Ceniflcate for:1)community official,2)Insurance agent/company,and 3)buflding owner. COMMENTS: THE HOUSE MAY HAVE BEEN BUILT PRE—FIRM, THE LOWEST F OOR ELEVATrnN — � �� � ON WRH ON PILES, SLAB BASEMENT PIERS,OR COLUMNS A V . A A y ZONES ZONES ZONES ZONES ZONES REfERENCE � REFERENCE LEvEI BASE LEVEI REFERENCE FIOOD IEVEI ELEVATION ;��,�. ��i' ���-:'�'n�f.:'''�:::5`�:.... ifYj�':��ii::n�:`:.: �.,'V:'..n,.:�i�'.: �.V�.::y��':��i:�j.:.'. �L�Ft... ��1�). ����,��`��''.' BASE BASE �.:. ... :::�:::�.:�::i;�.�'.: ;:'��v,�. FLOOD ""' �"" ADJACENT 'r�'�`'FZ' REFEHENCE .;�%{;:,, i1000 ELEVAtpN REFERENCE ADJACENT GRADE ' :1�.� IEVEI ELEVATION LEVEL GRADE )��'�s� rtL'.¢v.::!,,.... y,�',....:•�:;:;,; ,�t,�.:a, �.:. ;�t!:. ., . ;:.i,;.ti •�:•.�;•::;.'�•":,::i:i:: , ;�, �'��'i:7:•:';`i�:';�::i.;;'!•. � . ..:.,;�,..:,;:i:: ..•.•• :.:i•::�i.: �i:!..: •.•i:�•:�:. '�:�i�i �:'���iit.:::�... ,.. .�: '.^I•',{. ..,.�..•.�. .. "1C}:1;:'::'ii�,, •.:�, .,..�.i:�;::;:::`•• ••.e � . i•:>:.i.;:.�,:., :��.A0.IACENT�;; ^'� r � �.,��.A ' fiRADE .....:��:��:�.:�.'.:.'::'�'::�>:'•:'.�::;,"�11f 11"�?•: . The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. • Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2