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Home My WebLink About34-2116-000-0040PROCESS # FEDERAL EMERGENCY MANAGEMENT AGENCY FOLIO # 3094160000b p NATIONAL FLOOD INSURANCE PROGRAM C.O.R. 10.05' ELEVATION CERTIFICATE rtant: Read the instructions on oaaes 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 BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bidg No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 15600 NW 32nd Avenue Portable No. 1- i CITY STATE ZIP CODE Miami Florida PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Portionof S 1/4 of SEc. 16-52-41 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) Non residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: I-l GPS (Type): ( - - or L_l NAD 1927 L_l NAD 1983 L_l USGS Quad Map L-I Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME R COMMUNITY NUMBER B2. COUNTY NAME B3. STATE Unincorporated Area 120635 Miami-Dade County FL B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 12025C 0090 J July 17,1995 March 2, 1994 X, B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_1 FIS Profile 1J FIRM L_l Community Determined 1J Other (Describe): 1311. Indicate the elevation datum used for the BFE in 139: [X I NGVD 1929 1_1 NAVD 1988 1 1 Other (Describe): B12. Is the building located in a Coastal-Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1J Yes IXANo Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: I_IConstruction Drawings' 1_1Building 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, ARIAO Complete Items C3a-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 Elevation reference mark used Does the elevation reference mark used appear on the FIRM? L_I Yes gI No ❑ a) Top of bottom floor (including basement or enclosure) 11 20 ft. (m) ❑ b) Top of next higher floor _ N/A. _ ft.(m} U) ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A ft.(m) 0 0 ❑ d) Attached garage (top of slab) _ N/A ft.(m) E r ❑ e) Lowest elevation of machinery and/or equipment W m servicing the building _ 11, 20 ft.(m) 8 ❑ f) Lowest adjacent grade (LAG) 8 1 ft.(m) z' ❑ g) Highest adjacent grade (HAG) 8.. 2 ft. (m) r ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent gra de None ❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This cerfification 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 Secfions 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. CERTIFIER'S NAME LICENSE NUMBER Jose F Lopez 3086 TITL&nd Surveyor & Mapper JCO PAMP0 & ASSOCIATES, INC. 555 E. th Stre Suite 212 Hialeah FL 33013 SIGNATURE_ July 16 ,DAT TELEPHONE 2001 (305) 836-1822 FEMA F &n 1-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Section 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 15600 NW 32 Ave., Portable No. CITY STATE ZIP CODE Company NAIC Number Miami FLORIDA SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS HIGHEST CROWN OF ROAD ELEVATION FRONTING PROPERTY: 10.05 feet, N.G.V.D. 1 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 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 or enclosure) of the building is 1-1-1 ft.(m) 1_1_lin.(cm) 1-1 above or 1_1 below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1-1-1 ft.(m) 1_1_Jin.(cm) above the highest adjacent grade. E4. 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? 1_1 Yes 1_1 No 1_1 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, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S 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. 1_1 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. 1_J 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. J_J The following information (items G4-G9) is provided for community floodplain management purposes. G7. This permit has been issued for: 1_1 New Construction 1-I Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building is: _ ft. (m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here if attachments FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS