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Home My WebLink About34-1136-058-0014aon FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM O.M.B. N4.3067-tin L-- Z co c 07 Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read,the Instructions on a es 1-7. Compsrry UaM:: SECTION A - PROPERTY OWNER INFORMATION For BUILDING OWNER'S NAME Pell Nutt Washin on Mutual aank re: BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 110111$14W NAIC Nurrl~bet 175 N.W. 199th Street CITY STATE ZIP CODE Miami Florida PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal.Description, etc.) Portion of Government Lot 2 Section 36-51-41 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) Temporary Construction Trailer Office & Stora e LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: LJ GPS (Type): or •,1W - W.sylt" or so."OSAIG) L....I NAD 1927 LJ NAD 1983 L•J USGS Quad Map L_i Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION mom B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME 83. STATE - Uninco rated Dade Count 120635 d B4. MAP AND PANEL. 85. SUFFIX B6. FIRM INDEX B7. FIRM PANEL 88. FLOOD 89. BASE FLOOD 1:1 VA71ON(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) 944 AO, use depth of Goo_"' 1202500080 J 1/20/93 3/02194 X N A- B10. Indicate the source of the Base Flood Elevation (BF E) data or base flood depth entered in B9. U FIS Profile W FIRM L__I Community Determined LI Other (Describe): B11. Indicate the elevation datum used for the BFE in 1319: U NGVD 1929 L_J NAVD 1988 U Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? U Yes LZJ No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: "Construction Drawings' "Building Under Construction' W Finished jFinished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number -„1(Select the building diagram most similar to the building for which this certificate is being completed -see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/Al-A30. ARlAH, AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum convemio calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversi iA Datum NGVD 1929 Conversion/Comments Elevation reference mark used see c(2mine t Does the elevation reference mark used appear on the FIRM? U Yes LXJ No O a) Top of bottom floor°(including basement or enclosure) 15.9 ft-6K) O b To of next higher floor %(m) 0 c) Bottom of lowest horizontal structural member (V zones only) 0 d) Attached garage (top of slab) ^ . ft.(m) O e) Lowest elevation of machinery and/or equipment 15 9 servicing the building . ft.(+) 0 0 Lowest adjacent grade (LAG) 12.8 ft.W _ 0 g) Highest adjacent grade (HAG) 13 .2-- ft.W. H Florida Registration 0 h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade No. 4798 11/12/2001 0 i) Total area of all permanent openings (flood vents) in C3h - sq. in. (sq. cm) 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 in Sections A, B, and C on this certificate represents my best efforts to Interpret the data available. I understand that an false statement may be punishable b rrne or im risonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME Charles E. Rossi LICENSE NUMBER 4798 TITLE Professional Surveyor & Mapper COMPANY NAME Charles E. Rossi, P.L.S., Inc.* ADDRESS CITY STATE CODE 10301 N.W. 50th Street Suite 102 Sunrise Florida~P 33351 SIGNATURE DATE TELEPHONE 11/12/2001 954 749 4911 FEMA Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company U":_ BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. CITY STATE ZIP CODE Company MC Number Miami Florida SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) buiidft owner. COMMENTS Benchmark Reference: Dade County Engineerinq Department Benchmark as follows: rim of drainage manhole approximately 125 feet East of N.W. 2nd Avenue in concrete median of N.W. 199th Street, elevation = 13.26. Check here If attachcyw is SECTION E - BUILDING ELEVATION INFORMATION NOT REQUIRED) FOR ZONE AO AND ZONE A (1MTHOUT am For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the, Elevation Certificate is intended for use as supportlrq information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is I I i ft.(m) I ~in.(cm) LJ above or LJ below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is L_l-1 ft.(m) I I (in.(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodpiain management ordinance? I_I Yes I I No I-( Unknown. The local official must certify is information in Section G. SECTION 7. 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. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP COD SIGNATURE DATE TELEPHONE COMMENTS Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodpiain management ordinance can complete Sections A, B. C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. lJ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) ' G2. LJ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community4ssued BFE) or Zone AO. G3. (_J The following information (items G4-G9) is provided for community floodpiain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for: !`.I New Construction I I Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building is: . _ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: ft-(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME - TELEPHONE SIGNATURE DATE COMMENTS J' Check here If attach FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS