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Home My WebLink About34-2115-007-0320PROCES # r FEDERAL EMERGENCY MANAGEMENT AGENCY \ i O. M. B.. No. 3067-0077 } FOLIO NATIONAL FLOOD INSURANCE PROGRAM ' Expires December 31, 200. 7 11 CPO ROAD - 5 Ft. NGVO ELEVATION CERTIFICATE O Im rtant: Read the instructions on Pes 1- 7. ~ SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg: No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number I 2541 " 150 Street CITY STATE ZIP CODE Miami Fl 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 12, Block 2, BISCAYNE RIVER GARDENS, PB. 49 - PG. 53 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Residential LATITUDFJLONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): - or ❑ NAD 1927 E] NAD 1983 El USGS Quad Map El Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER - 'R2-.-COUNTY NAME B3. STATE Unincorporated' 120635 [ MIIAMI-DADE COUNTY FL B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of flooding) 1202500090 J 7-17-95 3-2-94 X . NIA i31 U. Indicate the source of the base Flood Elevation. (BFE) data or base flood depth entered in B9. El FIS Profile N FIRM ❑ Community Determined ❑ Other (Describe): - 1311. Indicate the elevation datum used for the BFE in 139: ® 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 N 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, AR/A, 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 f th 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 ments rea of -Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD Conversion/Comments Elevation reference mark useZI H-393 Does the elevation reference mark used appear on the FIRM? ❑ Yes N No #a) Top of bottom floor (including basement or enclosure) 4. 40 ft.(m) Cl) o b) Top of next higher floor N/A. -ft.(m) o c) Bottom of lowest horizontal structural member (V zones only):.. . N/A. _t(m) r tl 00 o d) Attached garage (top of. slab) NIA. ft.(m) _ ~.tom t //f°°`~~ o e Lowest elevation of machinery and/or equipment of machinery and/or equipment servicing the building (Describe in a Comments area) NIA _ .(m) 4 Lowest adjacent (finished) grady (LAG) +7.34 ft.(m) 4 z ri ` Highest adjacent (finished) grade (HAG) +7. 95 ft.(m) ~Il = l Oi)'To~t;il of permanent openings (flood vents) within 1 ft. above adjacent grade 0 area of all permanent openings flood vents in C3.h 0 sq. in. cm SECTION D - SURVEYOR, ENGINEER, IOR 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, B, 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 WALDO F. PAEZ LICENSE NUMBER ' LS3284 TITLE. PROFESSIONAL LAND-SURVEYORS & MAP COMPANY NAME DELTA.SURVEYORS INC.• ADDRES CITY STATE ZIP CODE 13052 U MIAMI FL 33186 IGNATURE DATE TELEPHONE 2-09 05 305-253-0909 IMPORTANT: In these spaces, copy the corresponding information from Sec#ion A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 2541 NW 154#1 Street CITY STATE ZlP CODE Company NAIC Number Mimi FL &W SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVcompany, and (3) building owner. COMMENTS ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (Wi'THOUT 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 pr enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). - 7, 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 adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing 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 AO must sign here. The statements in Sections A, a C, and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments = ` r ! ° 'SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who i-s autfroriE d by Iaw z or ordinance to administer the communiit/s floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation pl pplabie items) and sign below. Certificate. Cor ete ie a G1. ❑ The information in Sec Ln 6'vas 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 cefify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER [ i G5. DATE PERMIT ISSUED G6. DATE CER7dFICATE OF COWLIANCE/OCCUPANCY ISSUED Iiil4ixil- - 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: (i ~ ing at the building site is: _ ft.(m) Datum: G9. BFE or n Zone AO) depth of flood LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS