HomeMy WebLinkAbout34-2115-002-0400PROCESS#FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077
FOLIO# C.0.R. 34-2115-002-0400 ELEVATION CERTIFICATE lZ Expires December 31, 2005
.O.R 9.6'
Important: Read the instructions on pages 1- 7.
SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
DELROY ST. ELMO COWAN
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
16495 NW 27TH AVENUE
CITY STATE ZIP CODE
MIAMI FL 33054
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 7 less the East 5 feet & Lot 8 less the East 5 feet BLOCK 4 of "NW 27TH AVE HEIGHTS" PB 47 PG 55 OF DADE COUNTY RECORDS
BUILDING USE (e.g., Residential, Nonn--rreesid6nnbal, Addition, Accessory, etc. Use a Comments area, if necessary.)
Got A Il~t 6944~6L
LATITUDE/LONGITUDE (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
B2. COUNTY NAME
B3. STATE
UNINCORPORATED -120635
MIAMI-DADE
FLORIDA
B4. MAP AND PANEL
B5. SUFFIX
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(S)
NUMBER
B6. FIRM INDEX DATE
EFFECTIVEJREVISED DATE
B8. FLOOD ZONE(S)
(Zone AO, use depth of flooding)
12025 C 0080
J
7/17/'95
312194
X
N/A
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 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/A1-A30, AR/AH, AR/AO
Complete Items C3: a-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 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 NONE
Elevation reference mark used N445 Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ~r
o a) Top of bottom floor (including basement or enclosure) 111.21(m) -9
o b) Top of next higher floor N/A. ft.(m) C/)
o C) Bottom of lowest horizontal structural member (V zones only) N/A. ft.(m)
o d) Attached garage (top of slab) N/A._ft.(m) 0 '
o e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area) NIA. ft.(m) E = " y %-15
o f) Lowest adjacent (finished) grade (LAG) 10.4 ft.(m) Z
o g) Highest adjacent (finished) grade (HAG) 10.5 ft.(m)
o h No. of permanent openings flood vents within 1 ft. above adjacent grade N/A
o i) Total area of all permanent openings (fkxxf vents) in C3.h N/A 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 'r,,6ections A, B, and C on this certificate represents my best efforts to interpret the data available.
I umderstand Vhaf2a false Jtet~nt may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001.
LICENSE NUMBER : #5880
T}TLl~ P L SURVIPODRAND MAPPER COMPANY NAME ROYAL POINT LAND SURVEYORS
CITY STATE ZIP CODE
i I u~T 3JITE403•; MIAMI FL 33014
~ W-- - DATE TELEPHONE
V-5e` 12129/03 T: 305-822-6062 F: 305-827-9669
FEMA Form 81-51~'7t.7L 60 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS