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139 12th Street ELEVATION 02.23.2011 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. r SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name BRIAN J.&ELISABETH P.KELLY Policy Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 139 12TH STREET City ATLANTIC BEACH State FL ZIP Code 32233 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) THE EAST 24'OF LOT 2 AND THE WEST 26'OF LOT 3, BLOCK 50,MANDALAY,PLAT BOOK 10,PAGE 11; RE#171826 0000 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL A5. Latitude/Longitude: Lat.30°20'14" Long.81°23'51" 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 1B A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) NA sq ft a) Square footage of attached garage 768 sq ft b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade NA within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b NA sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? 0 Yes ® No SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1. NFIP Community Name&Community Number B2. County Name B3. State ATLANTIC BEACH 120075 DUVAL COUNTY FLORIDA B4. Map/Panel Number B5.Suffix B6. FIRM Index B7.FIRM Panel B8.Flood B9. Base Flood Elevation(s)(Zone 1200750001 D Date Effective/Revised Date Zone(s) AO,use base flood depth) 4-17-89 4-17-89 X - B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. 0 FIS Profile 0 FIRM 0 Community Determined ® Other(Describe)NONE B11. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 0 NAVD 1988 ® Other(Describe)NONE B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® No Designation Date 0 CBRS 0 OPA SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 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. Use the same datum as the BFE. Benchmark Utilized SEE COMMENTSVertical Datum 1988 Conversion/Comments*VERTCON Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 14.25 ®feet 0 meters(Puerto Rico only) b) Top of the next higher floor 24.70 0 feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N.A 0 feet 0 meters(Puerto Rico only) d) Attached garage(top of slab) 13.52 ®feet 0 meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 13.47 ®feet 0 meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 12.7 El feet 0 meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 13.4 ®feet 0 meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including N.A 0 feet 0 meters(Puerto Rico only) structural support 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 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. ,r0°- 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a .,....-d,_ licensed land surveyor? ® Yes 0 No --, Certifier's Name JAMES D.HARRISON,JR./MICHAEL A.GARRETT License Number #2647/#6643 o r Title REGISTERED LAND SURVEYORS Company Name ALL AMERICAN SURVEYORS OF FLORIDA, INC. Address 6820 SOUTHPOINT PKWY#4 City JACKSONVILLE State FL ZIP Code 32216 Signature Date / Telephone 904-279-0088 OZ/ 3/Z '!s FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions J r 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 139 12'"STREET City ATLANTIC'BEACH State FL ZIP Code 32233 Company NAIC Number SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments BENCHMARK USED: NAIL&DISK IN ASPHALT IN FRONT OF THIS LOT, ELEVATION 11.99'NAVD 1988.CONVERTED TO NGVD 1929 USING VERTCON,ELEVATION 12.32'NGVD 1929.ALL ELEVATIONS INDICATED ON THIS FORM ARE NGVD 1929. ITEM A5:LA ND LO G D PICT FRO °OGLE EARTH f OZ/Z; // Signature Date ® Check here if 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 El-E4,use natural grade, if available. Check the measurement used. In Puerto Rico only,enter meters. El. 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,crawlspace,or enclosure)is ❑feet ❑meters El above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is 0 feet 0 meters ❑ above or❑ below the LAG. E2. For Building Diagrams 6-9 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 0 feet 0 meters ❑above or ❑ below the HAG. E3. Attached garage(top of slab)is ❑feet 0 meters ❑ above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet ❑meters ❑above or 0 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 Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 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 Certificate. 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 official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. 0 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 0 meters(PR)Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR)Datum G10.Community's design flood elevation 0 feet ❑meters(PR)Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments FEMA Form 81-31, Mar 09 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. Policy Number 139 12TSTREET City ATLANTIC BEACH State FL ZIP Code 32233 Company NAIC Number 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 on the reverse. 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