HomeMy WebLinkAbout34-1135-006-0110lIV7491162 FEDERAL EMERGENCY MANAGEMENT AGENCY
L»~,pr'.E/f',,,3 NAL FLOOOiNSURANCE PROGRAM O.M.B. No. 30fi7-0077
Expires December 31, 2005
ELEVATION CERTIFICATE
Important.: Read the instructions on pages 1- 7.
SECTION A -PROPERTY OWNER INFORMATION ,
For irwame Company Use,
-ILiN ADING OWNER'S NAME Policy Number
WILLIAMS # 04-1576
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and(or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
20140 N.W. 15TH AVE.
CITY STATE ZIP CODE
MIAMI FLORIDA 33169
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 312 BLOCK 5, PB 682 AT PAGE 21
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATiTUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
{ ##0 - - or ❑ NAD 1927 ❑ NAD 1953 0 USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP COMIALWY NAME & COMMUNITY NL UBER 62. COUNTY NAME B3: STATE
120635 MIAMI-DADE FLORIDA
84. MAP" PAIVEI.
67. FIRM PANEL
B9. WE FLOOD ELEVATION(S)
NJMSER
135. SUFFIX
86. FIRM INDDC DATE
EFFECTNEIREVISED DATE
BS. FLOOD ZONE(S)
(Zone A0, use depth of flooding)
1202500080
J
7/17/95
3/2/94
AE
7.00'
B10. Indicate the sou re dthe Base Flood Elevation (BFE) data orbasefmd depth entered in 69.
❑ FIS Proms ® FIRM Community Debelmitied ❑ Other (De=i e):
1311. Indcate the elevation datum used forte BFE in B9: j0 NGVD 1929 ❑ NAVD 198E ❑ Other (Desarbe):
612 Is the building located in a Coastal Barrier Resotmes System (CBRS) area or 00ovke Protected Area (OP A)? ❑ Yes ®No Designaflan Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations ere based orr p Construction DrawfV ❑ Building UnderCdxtstn,cto El linished Construction
to newE(-r , Cer't;fmte v l be tequrreed vAm cmdn fbn ofthe buldng is complete.
C2, Buikling Diagarn Number 1(Select the building diagram most sinftb the burg for W icch fhis certificate is being completed-see pages 6 and 7. If no .diagram
accurately represents the building, pWde a s orphothgraph.)
C3. Elevatim-ZamAl-", AE, AK A (with BFE), VE, V1430, V (wtfh BFE), AR, AR/A ARIAE, ARIA1 A30, ARIAHI, ARIAO
Complete Items C3 -m below according to the bung dagam specified in item C2 State the datum used If the dahn is different ftm the datum used for the BFE in
Section B, convert the datum to fhat,used fnr the BFE Show fdd meastr~ and datum corwersion calculation. Use the space prwided or the Comriwnts area of
Section Ror Section G, as alpgxiate, to document the datum comersion.
Datum NGVD is
Elevation reference mark used BM Does the elevation retrenoe mark used appear on the RRM? ® Yes ❑ No
a) Top ofboborn floor (including base Worenclosure) 7.6 7. -ft(m) CIS
b) Top of next higher floor 0 ft(m)
+11t(m) - -
c) BdW of towesthotontalstructural member (V "ony) .0
d!) Attached garage (1op of slab) 0 _ ft(m)
E~
IN 7
e) Lmesteh-Aon of machinery ardtoreInt w
servicing the building (D=ft in a Camients area) 7.84 ff:(m)
{
E 'd
t) 1-owesta4acentOnished3 Bade MG) 6.71 R(m) Z.0 9) Highest adfacent (finished) grade (NAG) 7.1 ra t(m) i 81 17'%04
h) No. of permanent openings (flood vents) within 1 ft above adacent grade, _RLA
) Trial area of allp*m anent openings ftod vents) in C3.h NIA SQ - IN . (SQ. CAS) 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 iformaton III li ~C # t'I
I certify that the Information in Sections A, B, and C on this cerfificate represents my best efforts to interpret the data available. -
l understand that any : false statement maybe pun4hable by fine or imprisonment onment under 78 U.S. Code, Section 10I'
Q7.
CERTIFIERS NAME LICENSE NUMBER 4
AD I S N...NUNEZ 5924 COMPANY NAME - r
REGISTERED LAND SURVEYOR BLANCO SURVEYORS, INC.-
ADDRESS CITY STATE ZIP COD
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 Insurafice 6;~ 0,s `
BUILDING STREET ADDRESS Vnckda g Apt., U* Suite, ardor ft. No.) OR P.O. ROUTE AND BOX NO. 'Poky NurnW, a
20140 N.W. 15TH AVE.
CITY STATE ZIP CODE Compary NAIC Number
MIAMI FT.nRTnA 14,1169
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) commur* official, (2) as<xance agenVcQnpary, and P) building a+uner.
COMMENTS
CROWN OF ROAD ELEV. 6.37' ON CENTERLINE ON CENTER OF ROAD
BM # N-369 LOCATOR # 2120 S ELEV. 7.31'
❑ Check here K attaacchments
SEC T ION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (IMTHOUT BFE)
For Zone AO and Zone A (YAW BFE), cornplefe Items E1 through E4. If the Elevation Certificate is intended for use as supporting hbm-at on for a LOMA.or LOMR-F,
Section C must be eompletk
E1. Banking ;W= NuE;itaai _(.ct I-,e b-,xdV dVr. most ckdlm to the buikkV ford rtAich this =ffimfa is bei.^g completed -seepages 6 and 7. If no di r: aoaxat*,
Iepresentsthe building, provide a sketch orphobogaph.)
E2. The by of the botbm floor ( ng basement or encaser+e) of the builcfng is `ft{m) _ h(orn) ❑ above or ❑ below(chedc one) the highestAa' c'antgade. (Use
natural Bade, I anrarlable).
E3. For Burldng Diagrams 6-8 with openings (seepage 7), tiered higher floor or eievaled I= (elevation b) of the building is ` f t(m) `h(orn) above the Highest acfaoent
Bade. Camplete iterrs C3.h and C3.i an front of form.
E4. The by of the platfam ofmacWeryand+ar eq*mtsavickV the twidng is i fL#n) _h(an) ❑ above or ❑ below (check one) the W*_x tadaoentgade. (Use
nab" grade, if available).
E5. For Zone AO onty: If no flood depth nurttw is available, is the top of the bottom fi=elevated in accordancewth the c mnxWs 11=11ain managmw taanance?
❑ Yes ❑ No ❑ UnknouUn. The local official must certify this information in Section G. '
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property angrier or owner's authorized rgxeserrfafivewhocompletes Seckm A, B, C (Items C3.h and C3.i or>Fy), and E for ZoneA (without a FEMA-issuerl ore minty-
issued BFE) or Zone AO must sign h%e~ 7hestafemer& h Sedans A B, C, andEare=red tot4ebest ofmyl v*kdge.
PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVES NAME
ADDRESS . CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
Q Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local atfaciial who is aut omed bylaw or adinarim to adni the comnunit s floodplain management ordnance can complete Sectiors A, B, C (or E), mid G of ft Elevation
C a6e. ~.oinpii be the gVk;abie kn(s) andsigri below.
G1. [ The info ft ion in ;won C vas taken tram odher docunerkation that has been signed and errrbossed by a licensed suveyor, engineer, or who is authorQed by state
or local Iawbo certify &vation irr amation. prxTi * the source and date of the elevation data in the Comnwts area below)
G2.'[] AtY,q-mu iEy offia'at completed Section E fora buidV located in ZoneA (wrthouta FEMA4ssued or eorrv unity4swed BFE) or Zone AO.
G3.I ❑ The b lowrxl iftmatim (Itiarns G4-G9) is p v ided for wmw* floocolain managemw t purposes.
G4. PERMIT NUMBER DATE PERMIT ISSUED I G6. DATE CERTIFICATE OF COMPLIN CEI000LIPANCY ISSLIED
L i=W t G7. This permit has been ibr: ❑ New Corisirld n ❑ SubstarM hpMement
G8. Elevation of as-built bwnt floor (indudrng baserr;emt) of the btriking is: it(m) Datum:
G9. BFE or (n Zone AO) depth of floodng at the building site is. _ ft(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
FEMA' Form E1-31, January 2003 Replaces all previous editions