HomeMy WebLinkAbout34-1136-011-0610( 9401-72 c)-~fo'~`G'1~
O.M.B. NO. 3067-0077
ELEVATION CERTIFICATE Expires Mcy31, 1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to
determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMB).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION ( FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER
KEITH G. SMITH AND JENNIFER GREEN
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
21 N.E. 206th TERRACE MIAMI, FLORIDA 33169
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
LOT 11, BLOCK 33-0-F THIRD ADDITION TO ANDOVER ( 84-88 ) D.C.
CITY 'STATE ZIP CODE
DADE COUNTYFLORIDA 33169
. -~SECTION_,B-FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
s
Provide the following from tT1~ proper-TIR-M.(See Instructions):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE
6. BASE FLOOD ELEVATION
-
(in AO Zones, use depth)
120635
0081
G
1-20-93
AE
6.00
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (B FE): N NGVD '29 ❑ Other (describe on back)
8. For Zones A or V, where' ho BI`=E Is provided on the FIRM, and the community has established a BFE for this building site, indicate
the community's BFE: I I I I I J. L feet NGVD (or other FIRM datum-see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
g ail
1. Usin the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level
2(a). FIRM Zones Al-A30, AE, AH,'and A (with BFE). The top of the reference level floor from the selected diagram is. at an elevation
of I I I I 17 It P1 feet NGVD' (or other FIRM datum-see Section B, Item 7).
(b). FIRM Zones V1-V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is atan elevation of I u feet NGVD (or other FIRM datum-see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I I .U feet above E] or
below ❑ (check one) the highest grade adjacent to the building.
(check
(d). FIRM Zone AO. The floor Used as the reference level from the selected diagram is W . U feet above El or below 1:1
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordancle with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown
' 4stem 3. Indicate the elevation dI; used in determining the above reference level elevations: NGVD '29 ❑ Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
the FIRM (see Section 6, lte`m then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Commen~t~s on Page 2.)
4. Elevation reference ~arkl~use'Illappears on FIRM: Y Yes ❑ No (See Instructions on Page 4)
5. The reference level elevation file based on: actual construction ❑ construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate
will be required once construction is complete.)
lUlde 6. The elevation of the lowestl immediately adjacent to the building is: I I I I 16 I' 14 1 .feet NGVD (or other FIRM datum-see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
Is not the "lowest floor~i as Ace d in the community's floodplain management ordinance, the elevation of the building's "lowest
define
floor as defined by the ordlnal~ce is: I I feet NGVD (or other FIRM datum-see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 93
REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
~i
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al-A30, AE, AH, A (with BFE),V1-V30,VE, and V (with BFE) is required.
Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features-If the certifier is unable to certify to breakaway/non-breakaway wall,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
/ certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Ernesto Beltran 4885
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal)
Reg. Land Surveyor E. BELTRAN & ASSOCIATES,-INC.
TITLE COMPANY NAME
125 S.W. th Street Miami Florida 33175
A S -r r CITY 2-01-94 ° STATE ZIP
552=7450
SIGNATURE / DATE PHONE
Copies shouldAe made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON WITH ON PILES,
_ SLAB BASEMENT PIERS, OR COLUMNS
A V A A V
ZONES ZONES
IT ZONES ZONES ZONES
REFERENCE
REFERENCE BASE LEVEL
E FERENCE
LEVEL
LEVEL FLOOD
ELEVATION
BASE
BASE
REFERENCE
FLOOD ADJACENT
GRADE LEVEL
ELEVATION REFERENCE ADJACENT
FLOOD
ELEVATION
LEVEL GRADE
; •
`r ADJACENT"'
GRADE
The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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