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Home My WebLink About34-2109-009-5390PROCESS # C 6q FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 FOLIO # c; Z. { NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 C.O.R. 7.10 ELEVATION CERTIFICATE Im ortant: Read the instructions on pages 1 - 71 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME a Policy Number BUILDING STREET ADDRESS ;Including Apt., Unit, suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 3440 NW 172nd Terrace I CITY STATE ZIP CODE Miami Florida 33056 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot- 5 Block- 44 Pb- 57 Pg-2 BUILDING USE je.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: L_l GPS (Type): ( - - or NAD 1927 LL NAD 1983 l_l USGS Quad Map L_( Other: _ SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NF1P COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3 STATE J Unincorporated Area 120635 Miami-Dade County . FL B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9 . SAS E FLOOD ELEVATION(S) NUMBER 12025C 0080 DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) J July 17,1995 March 4, 1994 X b10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1-1 FIS Profile LXI FIRM 1_1 Community Determined (_J Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: JX J NGVD 1929 J_J NAVD 1988 J_J Other (Describe): B12. Is the building located in a Coastal-Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? J_J Yes LJ No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: J_iConstruction Drawings* L_JBuilding Under Construction* L_~Kinished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number . _l (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 430, V (withB_FE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used IT 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 conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD 1929 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? L_j Yes X 1 No ❑ a) Top of bottom floor (ircluding basement or enclosure) ft. (m) ❑ b) Top of next higher floor N/A ft. m ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A---. ft.(m) 00 ❑ d) Attached garage (top of slab) NZ A ft.(m) ❑ e) Lowest elevation of machinery and/or equipment L' servicing the building (A/C'. Pad elevation) R .24 (m) K - E 5 411 d• ❑ f) Lowest adjacent grade (LAG) 7 ft (m) z 7fl_ I? ❑ g) Highest adjacent grade (HAG) ? 85 ft, m C) h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade none O i) Total area of all permanent openings (flood vents) in C3h ( s cm 506 N / sq. in. q A ) i SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION' III li F ~ ~ III dim w_"k~cL.. r I~~ I u iIR :.k This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to 'certijj 'elevation information s ;.i ~J[' 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 any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section il001 CERTIFIER'S NAME LICENSE NUMBER Jose F. Lopez 3086 TITLnd Surveyor Mapper J. COedPA~JxNAME& ASSOCIATES, INC. A - 555S CITY STATE ZIP CODE E 25th Street, Suite 212 Hialeah SIGNATURE DATE12 / 18/00 TELEPHONE I Ir t ~p (305) 836-482 , 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 Use: BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 3440 NW 172nd Terr. CITY STATE ZIP CODE Company NAIC Number Miami FLORIDA 33056 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 HIGHEST CROWN OF ROAD ELEVATION FRONTING PROPERTY: 7.10 feet, N.G.V.D. 1_1 Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-r, 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_J_J ft.(m) J_J_Jin.(cm) I_J above or (_J 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 I L_J ft.(m) _J_lin.(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 floodplain management ordinance? 1_1 Yes 1 No J_J 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. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS 1-1 Check here if attachments = - SECTION G COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by Iaw' or ordinance t'd 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. G1. J_J 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 elevationf data in the Comments area below.) G2. _ Acommunity official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zcine'AO. - G3. _ The following information (Items G4-G9) is provided for community floodplain management purposes. G4 PERM;T NUMBER - ! G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G . This Oiirm t`has been issued for: J_J New Construction I_J Substantial Improvement G Ehvatiort-of as-built lowest .;floor (including basement) of the building is: ft. (m) Datum: G§~Of- or-(in" 'Zone AO) depth of Gooding at the building site is: ft. (m) Datum: LOCAL OFFT-;IAL'S NAME µ TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here if attachments I~~ #In FEMA"Fo 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS