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501 WASHINGTON AVE NU.S. DEPARTMENT OF HOMELAND SECURITY FEDERAI EMERGENCY. MANAGEMENT AGENCY Nationa! F`lood Insu7�ance Program 207885 ELEVATION CERTIFICATE G � Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION A1. Building Owner's Name VICTORIA DEWSNAP AND DON DEWSNAP A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 501 NORTH WASHINGTON AVENUE City CLEARWATER A3. Property State FL ZIP Code 33755 Tax Parcel Number, Legal Description, etc.) t' �� Jv z�-i� r$y►y -G09- ols U OMB No. 1660-0008 Expiration Date: July 31, 2015 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 27°58'15.92"N Long. 82°47'24.95"W 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 � A8. For a building with a crawlspace or enclosure(s): A9. For a buiiding with an attached garage: a) Square footage of crawlspace or enclosure(s) � sq ft a) Square footage of attached garage N�A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade Q within 1.0 foot above adjacent grade 0 c) Total net area of 800d openings in A8.b 0 sq in c) Total net area of flood openings in A9.b Q sq in d) Engineered flood openings? ❑ Yes � No d) Engineered flood openings? ❑ Yes � No SECTION B- FLOOD INSURANCE RATE MAP (FlRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name 125096 PINELLAS COUNTY PINELLAS B4. Map/Panel Number 65. Suffix B6. FIRM Index Date 87. FIRM Panel 0106 H 5/17/2005 Effective/Revised Date 5/17/2005 83. State Florida 68. Flood B9. Base Flood Elevation(s) (Zone ZonX s) AO, use ba 24flood depth) 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile � FIRM ❑ Community Determined ❑ OtheNSource: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: ❑ CBRS ❑ OPA ❑ Yes � No SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Buiiding 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. 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 C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: BM #1233 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 � NAVD 1988 ❑ Other/Source: Datum used for buiiding elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones oniy) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe rype of equipment and location in Comments) � Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, inciuding structural support 26.7 N/A N/A ►_�/3 26.3 25.6 2� N/A Check the measurement used. � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � feet ❑ meters � � feet ❑ meters � feet ❑ meters � feet ❑ meters 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. I certify that the information on this Certificate 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. �� � � F� q\� � Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a %%E � r�� ❑ Check here if attachments. licensed land surveyor? � Yes ❑ No f+lo. 2863 1 Certifier's Name Clyde O. McNeai TiUe Registered Professional Surveyor Address 6250 N Military Trail #102 FEM� Form 086-0-33 (7/12) ��� l�� License Number 2883 Company Name TARGET SURVEYING, LLC City West Palm Beach State FL ZIP Code 33407 _ Telephone (561)E See reverse side for continuation. � I�de �9NW i slOgned �4 DN:CN=CI dq �, S-Ai��'1A�cl�ea� M ���I���� ����6.23 z-oaroa� Replaces all previous editions. ([o7t3ti5) �MPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Ad�ress (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 501 NORTH WASHINGTON AVENUE City CLEARWATER State FL ZIP Code 33755 Company NAIC Number: SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUcompany, and (3) building owner. Comments ELEVATIONS IN SECTION C2-E ARE ELEVATIONS OF A/C SLAB. Signature �--�,,, ,,�---'...'-'� Date 6/19/2014 �r� 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 natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the foliowing and check the appropNate 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, crawispace, or enclosure) is __ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure is ) _._ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams Cr9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is __ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of piatform of machfnery 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, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representa6ve's Name Address Signature Comments City Date State ZIP Code Telephone ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys floodplain management ordinance can complete Sections A, B, C(or E), and G of this Elevafion Certificate. Complete the applipble item(s) and sign below. Chedc the measurement used in Items G8—G10. In Puerto Rico only, enter meters. 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 official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The folfowing information (Items G4—G10) is provided for communiry 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 Datum G9. BFE or (in Zone AO) depth of flooding at the building site: __ ❑ feet ❑ meters Datum G10. Community's design flood elevation: __ ❑ feet ❑ meters Datum Local Official's Name Communiry Name Signature Comments TiUe Telephone Date Check here if attachments FEMA Form 086-0-33 (7/12) Replaces all previous editions.