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Home My WebLink About34-2109-015-0020FEDERAL EMERGENCY MANAGEMENT AGENCY PROCES # C 2 0 0 212 2154 ~ NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 i=o`io #.34-2109-015-0020 Expires December 31, 2005 ELEVATION CERTIFICATE CROWN OF ROAD 7 ' 91 Ft NGVD Important: Read the instructions on pages 1- 7. 71 SECTION A - PROPERTY OWNER INFORMATION For Insucanoe Company use.. BUILDING OWNER'S NAME - Policy Numbet Sydney S. Marshall BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 18210 N.W. 31 Ave. CITY Miami STATE F,1 . ZIP CODE PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 2 Blk. 1 BANKERS SUB. PB 70 PG 62 BUILDING USE (e.g., Residential; Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Res; i den•E i al LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER Unincorporated 120635 B2. COUNTY NAME Dade B3. STATE, Florida B4, MAP AND PANEL NUMBER B5. SUFFIX B6. FIRM INDEX DATE B7. FIRM PANEL EFFECTIVOREVISED DATE B8. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) (Zone A0, use depth of flooding) 1202500080 J 7-17-95 3-2-94 AE 7' B10. Indicate the source of the base Flood Elevation (bt-E) oata or case riooo aepn enterea in ta. ❑ FIS Profile R FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 139: (y-~ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the Wilda located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes El No Designation Date ~~rssa.-.ter r.■ i ~rr.~.~~i SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction DraWngs* ❑ BuildGng Under Constr don* J] Finished 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 BF:), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.-aA below according to the building diagram.specified in Item CZ 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 conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum Conversion/Comments Elevation reference mark usedB - 7 Does the elevation reference mark used appear on the FIRM? ❑ Yes ®No ❑ a) Top of bottom floor (indudng basement or enclosure) 9 • 150 ft.(m) ❑ b) Top of next higher floor N/A -gy(m) 'I S ❑ c) Bottom of lowest horizontal structural member (V zones only) N A Mm) 00 ❑ d) Attached garage (top of slab) N /A -ft-(m) ❑ e) Lowest elevation of machinery and/or equipment - N/A _ servicing the building (Describe in a Comments area) . -ft-(m) _ ' ❑ 1 Lowest adjacent (finished) grade (LAG) 7.9. -ft.(m) Z a ° '°PI:g # 4368 ❑ g) Highest adjacent (finished) grade (HAG) 8.5 _ft.(m) I tl ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N / A 6 - 2 6 - 2 0 0 5 ❑ i) Total area of all permanent openings (flood vents) in C3.h N /X4. 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 elevatoor infor atiion. . I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data avar. bbd 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001 iy1ll ii N . . CERTIFIER'S NAME LICENSE NUMBER PLS # 4368 Joseph L. Martin TITLE COMPANY NAME President County-Wide Land Surveyors, Inc. ADDRESS SoutWiYFlorida :R'TE ZIP CODE P. 0. BOX 8 2 3 27 1 IT 33082-3271 SIGNA, RE DATE 6-26-2005 ELEPHONE (305) 2-0766 FENIA Form 81-31, January 2003 See reverse side for continuation. " Replaces all previous editions f V!, IMPORTANT: In these spaces, copy the coffesponding. nfornndim from Sec'bor't A. For lns~ Company use: BUILDING STREET ADDRESS (induding Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. P* Number' CITY STATE ZIP CODE NAIL 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 ❑ 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 E1 through E4. If the Elevation Certificate is intended for use as supporting 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 , ft.(m) _in,(cm) ❑ above or ❑ below (check one) the highest adjacent grade, (Use natural grade, if available). E3. For Building Diagrams 6.8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is ft.(m) -in.(cm) above the highest adacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery andlor equipment servicik the building is _ ft.(m) -in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. 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? ❑ 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, C (items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community- issued BFE) or Zone A0 must sign here. The statements in Sections A, B, Q and E are correct to the best of my knowiea c e, PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G -COMMUNITY INFORMATION (OPTIONAL) The local official who is auiftt ed by lawn' r 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 items) and sign below. G1. ❑ The information in Section C was takertfrom 'oth er documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to ce* elevation informa-tion. -(Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E fora building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone A0. G3. ❑ The following infommation (items 04-09) 'is provided for community floodplain management purposes. 134. 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 is: _Mm} 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 ❑ Check here if attachments F EIAA Form 81-31, January 2003 Replaces all previous editions