106 WINDWARD IS , ���.._� ,��� ,.
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FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
' NATIONAL FLOOD INSURANCE PRO(3RAM Expires December 31, 200
��Q� 03- �3�3 ELEVATION CERTiFICATE ,
• Im �tant Read the instrucdons on a es 1-7. ��i������
—�-� SECTION A•PROPERTY OWNER INFORMATION ;�t�� ��,r :.
BUILDING OWNER'S NAME <�,��ny�AIC N� .
CATHY&ARTHUR NEEDES ,s.
g�����g��q N�RESS(Induding Apt.,Unit,SuRe,andlor Bld�.NoJ OR P.O.ROUT'E AND BOX NO. ZIP CODE �
1p6 WINDWARD ISLA �TA� 33767
CITY Flr
CLEARWATER
PRORERTY DESCRIPTION(Lot and Blodc Numbers,Tax Parce�Number,Legal Desaiption,etc.)
LOT 71,ISLAND ESTATES OF CLEARWA'1ER eta Use a Comme►�ts area,if neceasary•)
BUILDING USE(e.g.,Residential,Non-residemia�,AddKbn,A�o�Y�
RESIDENTIAL �HORIZONTAL DATUM: SOURCE: GPS(Typek
lAT1TUDFJLONGITUDE(OPTIONAI.) ��1927 �NqD 1983 ❑USGS Quad Map ❑��
( ##°-##'-##.##" or #�.##�F##� .
SECTiON B•FLOOD IN3URANCE RATE MAP FIRM)INFORMATION ��A�
B2 cAUNTY NAME �
81.NFIP CON�4IN�TY NAME b COMMUN�NUMBER P��S
��pgg Bg.BASE FL000 ELEVATION(S)
87.FIRM PANEL A0,use depth ot floodhcJl
gq.pAAP AND PANEL �.��IX gg.FIRM INDEX DATE EFFECTIVEIREVISED DATE 88.FLOOD ZONE(S) (7_ane 11
NUMBER p &1981 8-19-91
0008
810.Ind�cate the souroe a�the B FI Flood FJevaUon(Q�Commun�eDetermin�entered in B9a Other(Desaibe);
❑FlS Profile � ❑NAVD 1988 ❑�(�aibe),
B11,Indcate the elevation datum used for ihe BFE in B9:�NGVD 1929
812.Is the buiid located in a Coastal Bartier Resourr�s S u`LDINd ELEVA710N INFORMATIONSUFtVEY REQUIRED No � n��Date
SECTI�N C i Flnished Constn�ction
Bulldfn Under Consmx�lon` �
C1.Buld�ng elevaations are based on;C���5�����s, � 9
�EJevafion Certificate wiil be required when constnx:tlon of the building is complete, 6 and 7, If no cFagram
C�. , �ng Diagram Number 1(Se{ect the build�ng dia9ram most similar to fhe buildin fa which this c�Uficate IS be1�9�P�e�-�P�
accu,ately represenis the buildng,provide a sketch or photogr�h•)
ARIAE ARIA1-A30,ARlAH,AR/AO
C3.Elevati�ons-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BF��AR,AR/A, ,
Complete Items C3:a-i belotiv according to the buildin9Show field measuremer�s and dat�um converslon c�iculation. Use th�e spacet prrnided a the Comments area of
�on g,convert the datum to that used for the BFE.
Section D or Sedlon G,as aPa°G��e�ro�ment the datum converslon.
Datum 19 ConversionlComments
Elevation reference maric used Does the elevation reference mark used appear on the FIRM? ❑Yes �No � ����5
0 a)Top of bottom floor(induding basement or endosure) ¢. �ft.(m) .
�I.A�ft.(m) „
O b)Top of next higher floor �.gft.(m) ��
❑ c}Bottom of lowest horizontal stnx;turai member(V zones only) � �ft.(m) �
❑ d)Attached gardge(toP of slab) W
O e)Lavest elevalion of machinery andlor eQuipme�t �.1 ft.(m)
servidng the building(Desaibe in a Comments area) ,m ��, '
p�Larvest ad�acent(finished)grade(LAG) �.0 ft( ) �
p g)Highest ac�acent(finishe�9rade(HA�) ¢. 6 ft(m) / _ _
❑ h)No.of pemianant openings(flood vents)within 1 ft.above adjacent grade Q
u
❑ i)Tota1 area of alt Pertnanent openfngs(flood vents)in C3.h Qaq.in.(sq,cm)
SECTION D-SURVEYOR,ENOINEER,OR ARCHRECt CERTIFICATION
This certification is to be signed and sealed by a lanon thfs ceitlficate repre ertts tn best�etForts to lnt�ref the data a aifable��ation.
I ce rti f y t ha t t h e i n f o r m a t f o n l n S e c t i o n s A,8, a n d C
I understand that an false sfafement ma be unlshable b flne or fm dsonmenf under 1 8 U.S.Co de, �CENS E NUMBER 4495
CERTIFIER'S NAME M.G.MAYER
COMpANY'NAME FLdRIDA BENCHMARK
TITLECEO
. Cm, STATE ZIP CODE
�DRESS CLEARWATER FL 33756
l98 LAKEVIEW RD.. OATE TELEPHONE
SIGNATURE p6-02-03 �2�'298-0286
�
FEMA Form 81-3'1,January 2003 See reverae side for continuation.
Replaces all previous editions
�
- iU� . , Ma'� � . .
r • �I. ;I . ` �����U�e:
TANT: in thes�spaces,cop the corres ndin informatfo�from Sectlon A. :P�,�y,,�,par
;,STF2EET ADDRESS(Indudin9 APt,Unk,Su�,e�B�.No.)OR P.O.ROU'TE AND BOX N0.: v�.�I� 4�ef
NDWARG ISLAND STATE ZIPCADE . '�� �f f ;, , Y ,
� 33767
NA ENGINEER,OR ARCHITECT CERTIFICATION CONTINUED
SECTION D-SURVEYOR� 3 �i����•
oth si�ci�es of mis Eievation Certificate fa(1)communtty dfidal,(2)insuraxe a9er��y��l )
----
9ENTS
i2 ,
Chedc here if attachments
. NG ELEVATION INFORMATION SURVEY NOT REQUIRED FOR ZONE AO ANrD Z��a a��a OMR-F, '
SECTION E BUILDI
�e AO and Za�e A(`Mthout B�,��e Iterns E1 through E4. If the Elev a tlon C e r�fi c a�e I s i n t e n d e d f o r u s e a s s u 9
i C mus t b e c o m p e t e d. leted–see pa9es 6 and 7. If no�iagram accurately
;ky�g p;agram Number_lSe�the buiidfng diagram most similar to the bu fl ding t o r w h i c h t h i s c e�l i fi c a t e i s b e i n g c a n P
presents the buil�ng,Pro��de a sketch a photograph•) in cm above or ❑be�ow(chedc one)the highest adJacent grade, (Use
�e top d the bottan floor(induding basement or endosure)of the bu�ding is _��m)-- •� )❑ in cm above the highest�jacent
atural grade,'rf available). ihe next highe�floor or elevated floor(elevatlon b)of the building is _ft,(m)_,_, •( )
nfn s see
x Buildng Diagr�ns 6-8 with ope 9 ( Pa98��
rade. Compete items C3.h and C3.i on front of fam. In cm above or ❑belav(chedc one)the highest�acent grade• (Use
he top of the platfortn o�mach��'andla equipment serviang the building is _�.(m)— � 1�
iaturaf grade,'rf available).
or Zone AO ony: If no flood depth number is available,is the top of the bottar►noor e��in accordance with the ootnmunil�s floodplain mana9ement ordinance?
❑Yes ❑No ❑Unknoa+m. The local offidal must thls V�fom�tion in SecUon G.
SECTION F-PROPERTY OWNER OR OWNER'S�Rq R����y, �d EE«�ne A�Wo1�t a FEMA-+ssued a oommur�ty-
e prc�perty cMmer a awners authorized representative who completes Sectia� , knowledge•
�ued BF� or Zone AO must sign he S AUTHORIZED REPRESEN A7�IVE'S NAME ��to the best of my
20P1 WNER'S OR�WNER STATE ZIP CODE
CIN
DDRESS TELEPHONE
DATE
IGNATURE
:OMMENTS
Chedc here if attachments
SECTION(3•COMMUN(TY INFORMAtION OP''fIONAL �
�e bcal official who is authaized by law or ordnance to administer the canmunily's floodplain management ordin�oe can camaele Sectlons A�B�C(af),and G of-this FJevation
ertificate. Compleba the�cable�tem(s)a�d s�gn below, and embossed bY a Noensed sunreya�engineer�cx arc,hitect who fs authaized by state
1.[]The inftxrr►a8on in.Sedion C was taken fi'om other documentatlon that has been signed
or local law to certifY elevatlon ir�amati�on. (Indcate the sou�ce and date d the elevatlon data in ihe Cortrnents area bekyw.)
�2.�A oommunity offidal canpleted Section E for ��for comm niry�floodplaln managecrient�purposes�muniryassued BFE)or Zone A0.
;3.(]The folloNVing information(Items G4-G9)Is pro
G4.PERMtT NUN�ER
G5. pATE PERM(T ISSUED � G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED
37.This permit has been issued for.[J�Constnx�ion ❑Substantlal Improrvement _:_.ft.(m) DatUm;
;,8.EJevation d as-twilt lomvest floa(induding basemenQ of the building is, _ft�m� Datum:
G9.BFE or(in Zone AO)depth of flood��9 a[the b�llding site is: . T� .
LOCAL OFFICIAL'S NAME
TELEPHONE
COMMUNITY NAME
DATE
SIGN URE
CC„ S
Chedc here if attad►ments
Replaces all prevfous editions
FEMA Form 81-31,January 2003