The URL can be used to link to this page

Home My WebLink About34-2110-035-0040n I a ~ ~j FtUtKAL tMtKUhM;T MANAUhMtN 1 AUhNUY 6040 U NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the instructions on pages 1- 7. O.M.B. No. 3067-0077 Expires July 31, 2002 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number Dorouth Moncur BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 1801 N.W. 171" Street CITY STATE ZIP CODE MIAMI, MIAMI-DADE COUNTY FL 33056 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 4, Block 12 " Sunny Lakes Estates" PB 95, Pg 6 Miami - Dade County Records BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, eta Use a Comments area, if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - or ##.#a) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 1 $2. COUNTY NAME B3. STATE UNICORPORATE`D 106x5 - - MIAMf-0ADE B4. MAP AND PANEL B5. SUFFIX 87. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B6. FIRM INDEX DATE EFFECTIVEIREVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of W N) 1202500080 1 7-17-95 3-2-94 AE 7.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): _ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when oonshdon 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, AR/A, AR/AE, ARIA1 A30, AR/AH, AR/AO Complete ftems C3.-a4 below according to the building diagram specified in Rem C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert fire 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-29 ConversiolvComments _ Elevation reference mark used DC BM Does the elevation reference mark used appearon the FIRM? ❑ Yes ®No ❑ a) Top of bottom floor (including basement or enclosure) 7. 84 ft.(m) ❑ b) Top of next higher floor N/A. _ft.(m) U) ❑ c) Bottom of b &%l horizontal structural member (V zones only) N/A. _ft.(m) o d) Attached garage (top of slab) - 7. -0a tt(m} 0 C3 e) Lowest elevation of machinery ardor equipment w servicingthebuilding(( A/C Compressor Pad) 7.3ft.(m) E ❑ f) Lowest adjacent (finished) grade (LAG) 6.6 fL(m) Z ❑ g) Highest adjacent (finished) grade (HAG) 6. 8 ft(m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade WA S J ❑ i) Total area of all permanent openings (flood vents) in C3.h NIA 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, 8, 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 1001. CERTIFIERS NAME NESTOR G RODRIGUEZ LICENSE NUMBER 4277 I I I Lt COMPANY NAME REGIStERE URV OR PENINSULA LAND SURVEYOR, INC. ADDRESS CITY STATE ZIP CODE 13113 2 N OPA-LOCKA FL 33054 SIGNATURE DATE TELEPHONE ---7 10-08-01 (305) 687-9191 FEMA Fornt8l-31, JUL 00 AVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Secd n A For Insuranoe Company Use: BUILDING STREET ADDRESS (Including Apt, Unit, Suite, andlor Bldg. No.) OR P.O. ROUTE AND BOX 1801 N.W. 171 Street 0. PoLy Number CRY STATE MIAMI, MIAMI-0ADE FL ZIP CODE 33056 Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARC ITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/comp ny, and (3) building owner. COMMENTS M 0\1_ r%A nC: /'n1 IArTV Dr:klt' J hi A DI! . ❑ 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 informafion 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 his certificate is being completed - see pages 6 and 7. If no diagram aoanately represents the building, vide a sketch or E2. The top of the bottom floor (including basement for enclosure) of the building is _ R(m) _ih.(an) L j 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.(crm) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. For Zone AO only: If no flood depth number is avaiWe, is the top of the bottom door elevated hn accordance with the conymnity's floodplan management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this infamation in Section G. SECTION F - PROPERTY OWNER (OR OWNER'$ REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, 0, C (Items C3.h and C3.i only), andE for Zane A (without a FEMA4ssued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S STATE ZIP TE COMMENTS TELEPHONE ❑ Coleco here if attachments SECTION G - COMMUNMYY INFO TION (OPTIONAL) The kx;d, official who is authorized by law or ordinance to administer the communitys flopdplain m4nagernent ordinance can complete Sections A, B, C (a E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ information to Section C was taken ftm-ottv docurnentatiort &I has been certify won unorrnation. (Ind source and c late ee~ v,and embossed by a fro~rrsad surveyor, erxj, or an~riecf who is authorized by state or local law Comments area blow.) G2. ❑ A own* official completed Section E for a building located in Zone A (without a FEMAAssued or community-issued BFE) or Zone A0. G3. ❑ The following information (items G4-G9) is provided fa community floodplain mairnageme j purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CONPLIANCEIOCCUPANCY 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: - _ft.(m) Datum: G9. BFE or (in Zane AO) depth of flooding at the buiding site is: l _ ft.(m) Datum: LOCAL OFFICIAL'S NAME j TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE Check here if attachments FEMA Form 81-31, JUL 00 REPLACES ALL PREVIOUS EDITIONS