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1835 WINWOOD DR� 11.S.DEPARTMENTOFHOMELAND3ECURITY ����q�'�ON CERTIFICAtE FED�RAL EM@ROENCY MANAGEMENT AGENCY NatlnnalFloodlnsurnncePrograin Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A1_ Building Owner's Name � A� p� g�� �) �� rt A2. Building �r �t Add� �(i�ncluding Apt� n D�e�, and/orGBldg. No.) or P.O. Route and Box No. 1� � N W f7 O � L/ City �,,,r � � ' - State � ZIP Code 3 � � G�C-/�t� W �". , � Property Descr�ptlon (L t and Btock umbers, Tax Parcel Number, Legal Description, etc.) �q—r iA_ ._Q-� dlv I 1'.� Y�I �U �? � OMB No. 1660-0008 Expiration Date: July 31, 2015 A4. Building Use (e.g., Residentlal, Non-Residentiai, Addltion, Accessory eto.) ��'? � �!� I*�f'TI !� la A5. Latitude/Longitude: Lat. _�� °��� �5,�" Long. ��-� ' �, " Horizontal Datum: ❑ NAD 1927 NAD 1983 A6. Attach at least 2 photograph�of the building iF th� Certiflcate Is be(hg used to obtain flood insurance. A7. Building Diagram Number _� Ae. For a buiiding with a crawlspace or enc�osure(s): � A9, For a building with an attaohed garage: � a) Square footage of crawispace or enclosure(s) �� sq R a) Square footage of attached gerage � sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings In the tached garage or enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adJacent grade c) Total net area oF flood openinps in AB.b sq in c) Total net area of flood openings In A9.b sq in d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 82. County Name B3. State �� �� s�, ,N ,� �� � �„ � � 25 �� r,� � � r,� �° ��./� 5 ��.� �. � 1�A B4. Map/Panel Number 85. Suffix B6. FIRM Index Date B7. FIRM Panel 88. Flood B9. Base Flood Elevation(s) (Zone �� � p 7� �, (� � 2, � � S M ��-�c) EfFe�ve/CRe�viseUd D3ate Z ne s) AO, use�b� �e Flood depth) 610. Indic�a.t�e the source of the Base Flood Elevation (BFE) data or base Iiood depth entered in Item B9. LrI r-IS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: . 811. indicate elevation datum used for BFE Ht item B9; [❑ NGVD 1929 �AVD 1988 ❑ 9ther/Source: / B12. Is the building �ocated in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area {OPA)? ❑ Yes [�'No Designation Date: ❑ GBRS � OPA SECTION G— 6UILDIN� ELEVATION INFORMATION (SURVEY REQUIRED) , C1 C2. Buiiding elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction" Finished Construction "A new Elevation Certificate will be required when construction of the buiiding is complete. Elevations —Zones A1-A30, AE, AH, A(with BFE), VE, V1—V30, V(with 8FE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO. Complete Items C2.a—h below according to the buiidin dlagram specified In Item A7. In Puertb Rico only, enter meters. � 1 Benchmark Utilized: P�, �. �/� G 7 p 2�} Vertical Datum: 5g }�� � N� v� �� ✓ Indicate elevation datum used for the elevations ln items e) through h) belpw. � NGVD 1929 NAVD 1988 �7 OthedSource: Datum used Tor building elevat(ons must be the same as that used for the BFE. a) Top of bottom floor (Including basement, crawlspace, or enclosure floor) J� ,_� �et ❑ meters b) Top of th� next higher floor N/A. ❑ feet 0 meter� c) Bottom of the lowest horizontal structural member (V Zones only) N�A ❑ feet ❑ meters d) Attached garage (top of slab) �(�, 2 [g feet (] meters e) Lowest elevation of machinery or equipment servicing the buildfng �.,__�__ []�'�eet ❑ meters (Deacrlbe type of equipment and location ln Comments) � Lowest adjacent (finished) grade next to buiiding (LAG) "r�J'`' , L [!3 f�e t ❑ meters g) Highest adjacent (flnished) grade next to buflding (HAG) �, O Q"feet ❑ meters h) Lawest adjacent grade at lowest elevation of deck o� stairs, Including structural support _��i .�__ f�-f�t ❑ meters SECTION D— SURVEYOR, �N(31NEER, OR ARCHITECT GERTIFICATION � ;; This certificatfon is to be signed and sealed by a land surveyor, englneer, or architect authorized by law to certify elevation - �� f�' , Informatfon. 1 ce�fify thaf the informetlon on this Certlflcafe represents my besf e/forfs to interpref fhe data avallab/e. ,,., ��.- ��,;°; �', ! un rstand fhat any fa/se stafement rnay be punishable by nne or impnsonment under 18 U.S. Code, Secfion 1001 � �•'` " .,' �-'��"» V+ 1 . � Check here if comments are provided on back of form. Were latitude and longitude in Seckion A provided by Q,' �,� F� f •• �+ � � � � �'.'r, ' C�Check here iF attachments. Iicensed land surveyor? [�es ❑ No ` ." � � �; , �� ��".� • �� � Certifier's Name LARRY L. EVANS Tit�e LAND SURVEYOR Address 1460 BELTREES ST 5ignature Company Name 9 City DUNEDIN , ,t, Date License Number PLS # 2937 EVANS LAND SURVEYING, INC. � - � 5 -1�o i 3 State FL ZIP Code 34698 Telephone (727) 7343821 t � i ; 4�9 '-1� x�.. � +��i �fl �5 ,�7 a .. 14 3 { 4�yJ 6' 4 .- ; e+� ��J+abi. ye``. � g i R`p�S���; - .. ,'` 1�,.. �.W �7r � . .,. , —r ; �q,�1lM, I IUN 4�K 1 IFi(;A 1 t, page � IMWORTANT: In these spaces, copy the correspondtng informatlon from Section A, Buildin Street Address (including Apt., Unit, Suite and/or Bldg. No.) or P.O. Raute and Box No. _ ����i w � IV IN Cl � �.� �(�, I�✓ �- ��ty �. L� State ZIP C�de �bl�i�l�iiy NAt�' �11�f`�f�si�,= „ �� '; f, � ' �: , � �� � � � � �f' �� � � r,uN- , � .u1 Sk f,r,t,4���tx� ,�+,. �,s;`4�s s,x�P ' . 3��ilON D- SURVEYOR, ENC3INEER, OR ARCHITECT CERTIFICA7IUN (CONTINUED) Copy both sides of this Elevation Certiflcate far (1) communfty afficial, (2) Insuranca agenUcompany, and (3) building owner. Comments G � � i � �.5 �r,l E��T'r��l��, ��G GoM.�►�E.�,Sca�, bl� C�-f��'ulr�� LEV�� �',��, .�' � � � Signature SECTION E°- DINC3 �LEVATION INFORMATIO aate g_�5_i3 URVEY NOT REQUIREp) FOR ZONE AO AND ZONE A(1NITHOUT BFE) For Zones AO and A(without BFE), complete Items' E1—E5. I( the CertiFicate la Intended to support a LOMA or LOMR-F request, compiete Sectfons A, B, and G. For Items E1—E4, use natural grede, i( avallable: Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation informatlon for the followfng and check the appropriate boxes to show whether the slev�tlon is above or betow the hfgheat adjacent grede (HAG) and the lowest adjacent grade (LAG). a) Top of boftom floor pncluding basement, crawlspace, or enclosure) is ❑ feet � meters ❑ above nr [] below the HAG. b) Top of bottom floor (including besement, crawlspace, or enclosure) is [] feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Dlagrams 6-9 with permanent Plood apenings provided in 3ectlon A items 8 and/or 9(se�e�pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ metera ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below ihe HAG. E4. i'op of platform of machinery and/or equipment aervicing the building is ❑ feet ❑ meters ❑ above or � below the HAG, E5. Zone AO oniy: If no flood depth number Is availabie, is the top of the bottom floor elevated in accordance with the cammunity's floodplafn management ordinance? ❑ Yes ❑ No ❑ Unknown. The locai officiai must certify this information in Sectinn a. SECTION �— PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION 7he property owner or owner's authorized representalive who completes Sectlons A, B, and E for Zone A(without a FEMA-Issued or community-issued BFE) �r Zone AO must sign here: The statements fn Sections A, B, and E are oorrect to the best of my knowledge. ' Property Owner's or Owner's Authorized Representative's Name '� Address City State ZIP Code ' Signature Date Telephone i Comments ❑ Check here if attachments 3ECTION � - COMMUIV�TY INFORMATION (QPTIONAL) ' 1`he local ofFicial who fs authorized by law or ord(nance to administer the community's floodplain management ordinance can complete Sections A, B, C(or E), and G ' of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used In Items GS—G10. In Puerto Rico only, enter meters. C�1. ❑ The information in Section C was taken from other documentatlon that has been signed and sealed by a licensed surveyor, engineer, or architect who fs authorized by law to certify slevation Information. (Indicate the aource and date of the elevatlon data in the Comments area below.) Ca2. ❑ A community offfciai completetl Section E for a building located in Zone A(w(thout a FEMA-issued or commuMty-Issued BFE) or Zone AO. C,3. ❑ The foliowing information Qtema GR—G10) is provided /or commuNty iloodplain management purpoaes. � G4. Permit Number G5. Date Permit Issued G6. Date Certiflcate Of Compliance/Occupancy issued C�7. This permit has been issued for. ❑ New Construction ❑ Substantiai improvement G8. Elevation of as-built lowest (loor (including basement) of the building: C❑ feet ❑ meters Datum f•;9. BFE ar (in Zone AO) depth of flooding at fhe buiid(ng site: ❑ feet ❑ metera Datum C�,10. Community's design flood elevetion: ❑ feet ❑ meter� Datum Local Official's Name Community Name Signature Comments Tikls Telephone Date Cheak here If attachments EL,,,�VATIJN CERTIFICATE, page 3 g�ilding Photographs See Instructions for Item A6. �C�f� INSU�tbNCE CdMf�ANY, US�. �: IMF'QRTANT: In these spaces, copy the correspanding information from Section A. , ,�, euildin 5treet Address (including Apt., Unit, Sufte, and/or Bldg. No.) or P.O. Route and Box No. F?blicy NuMb�t" 1� �� ��,�' d N'�' ��: 'i7 �` :1 �1�. . city �� state ZIP Code Coinpah� NAIC Number �,� � �� ____ -�� � If using the Elevation Certificate to obtain NFIP flood insurance, a�x at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. E� ;, � ��;:w - �. ��. f � .�F: � �,, �„�� ��' > � � , �. �, ; � � ���� '3�� � 'P Y — �: . � � � � � �� : � _ � � �, �. . �,:a�,� ��� ���' '�, �� ' "a �'� � s:;,:. }'.o `> � � . � .. � ' ,�b �. ; � . �" � ��.� � ������ � ' � ...-. � .�'.��-_ . e.,� c�.� r�... � � _- � ' '�'�,:. .. ..... ... .... ' . . <.. � " ��. � . ....... .. .. �". ._,:.. ,,`.. . � `�' � ' ,: � � � ' �„ ;: r �:�;. � I� � � �k ���_____�,»�: r,_L..�-='�._-�.__ . __._�,.. � � � r� . ��� .t ��� r 1- �;� s �c�rr�' r � * �� �': � �' �� �y, . ._.� . . ���� � ■ �,. � ��� � � � � � �., �` �F. ,� �, } . ; .��.. � _,��'�I���TM � ._„t. .-�, � „_ :�(tai , . . .�„�r` `Ik —' . .