HomeMy WebLinkAbout34-2113-0034-0020FEDERAL EMERGENCY MANAGEMENT AGENCY
O.M B _ No 3067 007
PROC~sS C2004080385' NATIONAL FLED NHS NC PROS ,M a er 3 7
' Expires D cerhb 1, 2005
FOLIO # 30-3021 1 3034`0020
CROWN OF R'OAD' 6..- 81 F# NGVD_. _ CERTIFICATE
ELEVATION Im rt it. Read the instrucHo' on 1-7
SEC110N A`-'N~ROPEI TY OrMVER 1NFdR]I~ATIOt~ -For Insurance Canp Use;
BUILDING OWNER'S NAME r . Policy Number r
HOWARD MINTZ.
BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
11 NE 151 STREET
CITY STATE ZIP CODE
MIAMI ..m FL 33162
PROPERTY DESCRIPTION (Lotand Block Numbers, Tax Parcel Number, Legal Descr#on, etc.)
LOT'2 BL 1}"$LSSIN'G".P6.169; PG: 5 MIANCI DADCt?i~N
t
BUILDING USE (e.g, Residential; Non-residential, Addibon, Accessory, etc. Use a Comments area, ff necessary)
RESIDENTIAL `4 . .
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): a
( #I#° - fl#' - ? : ❑ NAD 1927 ❑ NAD 1983 , : ; D USGS Quad Map r E Other
SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
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131. NFIP COMMUNITY NAME & COMMUNITY NUMBER 132. COUNTY NAME B3. STATE
UNINCORPORATED 120635? ,I n MIAMI DADE FLCPJDA
B4. MAP AND PANEL
67. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
I UMBEL t ;
B5.'SUFpIX`"
66. FIF M„INDb([?ATI
I#ECTIVFJfiEVISFD b#t
B$. FLOW ONE(S) "
(Zone A4; use d4 of flaocing)
12025C 00.91
J
7117195
32194
AE
7
B1 V.
Indicate thesoaf the Base FloodElevation (BFE)data or Baseflood depth in B9.. y ,
RS Profile M FIRM ❑ community De#errrlined otr',et (fie} t
B11. Indicate tie se n datum used fart BFE in 69: [ NGVD 1829 , . ❑ NAVD 1988 ❑ Other (Describe):
612. Is the bucking Loa d In a q*013arrierReso'Systern CBRS **OOtttetwise ProectedArea ((3P Yes No
SECTION C_- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* Build Under Corstrtction* ® Finished Construction
'.i a
*A new Elevation Certificate WR be need %tw conshr ion of the building is complete.
C2. Building Dial Number 1(Select the lung diagram most similar to the building for which this certificate is bang completed - see pages 6 and 7. If no dagrarn
acmntely represents the building, p wide a slob or photograph.)
C3. Elevations- Zones A1A30, AE, AM,'A`(witli BFE),1IE, V1 N30, V (with BFE), AR, AwA AR/AE, AR/A1 A30, ARIAH, ARIAO ~.w,
Complete Items C3,-a4 belowaocordmg to tie bung diagram speft 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 wed for the BFE.,Showfield measurements and datum conversion calculation.. Use the space pwided ortie, Carmenis-area
Section D or Section G, as appropriate, to doarnent the datum conversion.
Datrrn %ND
Caw ff§onlComments
'77= - , ~ i.,, ~ - -v*~r ' ; r i
r
EWv&n r06e6ce mw tiled BM Does the elevation reference mak used appear on the FIRM? ❑ Yes S No
r
f
o a) Top of bottom floor (inducing t asement dr encbsure) $4 ft(m}
J
o b) Top of O 9
-wo
o c) Bottom of IU11 est i azortal structural member (V zones only) WA, _It.(m)
d}'Attached gage (t#bfslab) .8. 21 ft(m) t= n .wra .
o e) Lowsst elevation of machinery and/or edNet
servicing the building (De xibe in a Corr>n eels area) = 8.21 R(m)
s`
o f) Low agent (finished} grade (LAG) 7.5 t(m) 56
a a
9) Hirst t (finished) grade ~tiAG) _ . 718t
(m)
o h No. of permanent openings Pod vents) Wthin 1 ft. above a*cent grade NIA
o r ToW area of all pwranien'topenings verbs in 2.sq. in. (sq an - i ~
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SECTION D SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ' , ,
This certifficabon is to be signed and sealed' by a land surveyor, engineer, or architect authorized by law to certify elevation irrformafiot _
I certify that the information in Sections A, B, and C on this cerb>cate represents my best eflbrts 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.
CER11FIER'S NAME ALBERTO LORENZO-LUACES LICENSE NUMBER 3087 r{s
TITLE LAND SURVEYOR COMPANY NAME SELF EMPLOYED
ADDRESS- CITY STATE ZIP C0 . .
923 S.W.122 AVE E MIAMI FL 33184
SIGNATURE DATE _ TELEPHONE _
2102105 305-220-6397
FEMA'Form 81-31,, an ry 2. See reverse side for continuation. Repiaces ail previous editions
IMPORTANT: In these spaces, copy the contesponding inforr orlon from Section A. - For Insurance company use:
BUILDING STREET ADDRESS (Ir dudng Apt., Unit, Sate, andor BIt. No.) OR P.O. ROUTE AND BOX No. Policy Number
3
CITY STATE ZIP CODE Company NAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
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Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agentlcompany, and (3) building miner.
COMMENTS
❑ Check here Iattaclvnents
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SECTION E - BUILDING ELEVATION INFORMATION (SURVEY LOT REQUIRED) FOR ZONE AO AND ZONE A "THOUT SFE)
II rll rrlbl~1111rr1~IrllrrIrll Irrrlrrr1~I11rrrrlrr111rllrrr - I 1lrr~ll~r-Irrrrrr-Irrrr~
For Zone AO and ZoneA {cWW13FE7, canplete Items E1 through E4. If the Elevation Certificate is intended fbr use as supporting information fora LOMAor LOMR-F,
Section C must becompleted
E1. BWdng Diagram Nurnka_(Select 0* buildrx3 diagram most similar to the building farvhch this certificate is being completed-seepages 6 and 7. If no diagram accurately
repwentsthe building, provide a sketch or photograph)
E2. The top of the botbm floor (ding bas numt or encImm) of the buikiing is ft(m) _in.(cm) n above or p below(dnedc one) the Wxxg ac ttgrade. (Use
natural grade, if available)
E3. For Building Drams G-8 with openings (seepage 7), the next ttigher ilmordevated floor (lion b) of the buidng is _ t(m) -In.(orn) above tie hVxda*rent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of tie platform of machinery ancVa ecpment servicing the burg is _ 1(m) _in.(c m) ❑ above or ❑ below (dwxk one) the hest a*mt grade. Pee
nah rd grade, if available).
E5. For Zone AO any: If no flood depth nurrt w is available, is tie tap of the botlom floor elevated in accad ice with the community's tkrockbin management ordnance?
❑ Yes ❑ No ❑ UNcrvwn. The local official must cer* this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE} CERTIFICATION
I`r~l~ll rrrl ~~rl 1
The properly mw oramWs authorized representative wfho corrpletes Sections A, B, C (Inns CU and C3.i any), and E for Zone A (vr+thout a FEMA-issued orcommunityy-
issued BFQ or Zane AO must sign here. Theststww* in SecuonsA, B, C, anal Eare cwed to the bedofmyknowledge
PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATM NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
r
❑ dxclc here if attacNnernts
R SECTION G - CON~IIUNITY INFORMATION (0TIONAL)
The local o vAq isautlnoriaed by law or ordrs= to adninister the ca rmuniVsflo#Wn managerrtentordnance can complete Sections A. B, C (or E), and G of this Elevation
Certificate. Complete to apps item(s) and sign below.
G1. ❑ The inb r~ in Section C was taken from otter documentation that has been signed and embossed by a licensed surveyor, engineer, or archiled who is authorized by state
or Io wto~ccstify gyration infamation. (Indicate the sake and dab d the elevation data in the Comments as below)
G2. ❑ Acommunity official corned Section E for a building located in Zane A (withouta FEMA4ssued orcommundy issued BFE) or Zone AO.
G3. ❑ Tt eUiq i V irdamabn (Items Goa) is provided for commurdy floor n managem u tpurposes.
I G4. PERMIT NUMBER Chi. DATE PERMIT ISSUED I G6. DATE CERTIFICATE OF COMR.IANCE=UPANCY ISSUED I
G7. This perrnit has been issued for ❑ New Construction p Substantial Improvement
G8. Elevation of as-built West floor (including base ral) of the building s: ft.(m) Datum:
G9. BFE or (in Zone AO) depth of flooding att to b i dng site s: w L(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE