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Home My WebLink About34-2115-005-0420oo FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM `0312-098 ELEVATION CERTIFICATE C.O.R.=11.0V N.G.V.D. Important Read the Instructions on pages 1- 7. SECTION A -PROPERTY OWNER INFORMATION O.M.B. No. 3067-0077 Expires December 31, 2001 BUILDING OWNER'S NAMEy DORETHA NiCHSON 3 ll~ " ~'e c C~ BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND B.OX NO. 1951 NW 154 STREET Forlnsurance Company Use: Policy Number l: Company NAIC Number CITY STATE ZIP CODE OPA LOCKA FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 7&8 BLK 3 FIRST ADDITION TO MAGNOLIA SUBDIVISION PB 44 PAGE 16 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): { - - or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION „131. NI-IP COMMUNITY NAME & COMMUNITY NUMBER I COUNTY NAME I B3. STATE 120635 MIAMI-DADE FL B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTW REVISED DATE BB. FLOOD ZONE (S) (Zone A0, use depth of flooring) 1202500090 J 7-17-95 7-17-5 x B u. indca>e me source or me base I-looc Llevawn (fit-L) cats or ease flood ciepm entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Descnbe): 1311. Indicate the elevation datum used for the BFE in 99: S NGVD 1929 ❑ NAVD 1988 ❑ otter (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 Drawine ❑ Building Under Consruction* ® Finished Construction *A newElevation 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 b the bulding 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 NGVD1929 Conversion/Comments Elevation reference mark used CBM Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (including basement or enclosure) 12.0 ft. (m) o b) Top of next higher floor WA. _t(m) o c) Bottom of lowest horizontal structural member (V zones only) N/A. _t(m) o o dl} Attached garage (top of slab) 11. if L N E o e) Lowrrst elevation of machinery and/or equipment L servicing the building (Describe in a Comments area) WA. ft(m) o f) Lowest adacent (finished) grade (LAG) 11.0 ft(m) z o g) Highest adfacent (finished) grade (HAG) 19. 1 t(m) h N o ) o. of permanent openings (flood vents) within 1 ft. above adjacent grade WA o 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. 1 certify that the information in Sections A, B, and C on this ceitiflcate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U S Code, Section 1001, CERTIFIER'S NAME DAVID L. FUTCH LICENSE NUMBER 4843 TITLE VICE PRESIDENT COMPANY NAME GLOBAL DIMENSIONS, INC. '"uu CITY STATE ZIP CODE 8200 N. 7TH STREET STE-108 MIAMI FL 33122 StGNATU DA'Z'E TELEPHONE /1 10-8-04 _ . 305-5124225 IMPORTANT: In these spaces, co y the corresponding information from Section A For Insurance Company use; BUILDING STREET ADDRESS (Indudng Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number CITY STATE ZIP,CODE Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance ageWcompany, and (3) building owner. COMMENTS CENTERLINE FOR NW 154 STREET. =11.08` N.G.V.D. ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A WTHOUT BFE) For Zone AO and Zone A (withoutBFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMB F, Section C must be completed. E1. 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.) E2. The top of the bottom floor (including basement or enclosure) of the building is 1 ft(m) 0in.(crm) ® 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 flow or elevated floor (elevation b) of the building is _ ft(m) _in.(cn) above the highest adjacent grade. Complete items C3.h and CW on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft(m) _in.(an) ❑ 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 conmuniiy's flood plain management ordinance? ❑ Yes ❑ No 0 Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly 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 orcommunity- issued BFE) or Zone AO must sign here. The stateinents in Sections A, A C, and E are correct to the best ofmy knowledge PROPERTY WMRS OR OMflERS 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 authorized by law or 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 item(s) and sign below. G1. ❑ 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 elevation data in the Comments area below.) G2. ❑ Acommunity official completed Section E for a building located in Zone A (*outa FEMA4ssued or cor munily issued BFE) or Zone A0. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. U4. ft M► I NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued fig: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest fioa (including basement) of the building is. _ft. (m) Datum: G9. BFE or (n Zone AO) depth of flooding at the building site is: _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNASIlRE DA'T'E COMMENTS Check here if atfaichments