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Home My WebLink About34-2116-006-2220 itiAM1.DA0F 0 FEDERAL EMERGENCY MANAGEMENT AGENCY MIAMI-DADE NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 ELEVATION CERTIFICATE Expires July 31, 2002 PROCESS # C/ g0 1-0A~ V 78 FINAL-EC Rev. JAN 01 2000 . Important: Read the instructions on pages 1 - 7. Amended by Miami-Dade County-DERMOet 1999 r SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME CLIVE SPAULDING 61d 60 - '4--0 Policy Number BUILDING STREET ADDRESS (Including Ap t., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 2930 NW 161 TERRACE CITY STATE ZIP CODE MIAMI (30-2116-006-2220) FL 33054 PLE E T LD~ R1' iC ,(L ,~lo Ti a~c uri e ~ sc ~ e9dOK 46 PAGE 75 MIAMI-DADE COUNTY Fl. BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) ( - - or HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): NGVD 1929 ❑ 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 B4. MAP AND PANEL NUMBER 19099coo-ao B5. SUFFIX B6. FIRM INDEX DATE _-1/9/9Z1. B7. FIRM PANEL EFFECTIVE/REVISED DATE 7-17-95 138. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 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: 0 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 430, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO 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 Conversion/Comments Elevation reference mark used 6 Does the elevation reference mark used appear on the FIRM? ❑x Yes DNo ❑ a) Top of bottom floor (including basement or enclosure) 9.09 ft. ❑ b) Top of next higher floor 0.00 ft. u f - ❑ c) Bottom of lowest horizontal structural member (V zones only) 0.00 ft. ❑ d) Attached garage (top of slab) at Garage Door (Mia-Dade) 0.00 ft ` o _ v rx ❑ e) Lowest elevation of machinery and/or equipment servicing the building 0.00 ft. 42 W_ ca ❑ f) Lowest adjacent grade (LAG) 7.62 ft. if r ❑ g) Highest adjacent grade (HAG) 7.90 ft ❑ h)Total area of all permanent openings (flood vents) in C3h sq. in. (sq. cm) z ❑ i) No. of permanent openings (flood vents) within 1 ft. above adjacent grade ❑ 4') Highest crown of road (Mia-Dade) 7.82 ft F ~ fl :I III : W41 Ilk SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATIONw 3EThis certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. .14 1 I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the dada mailable. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 9001: CERTIFIER'S NAME LICENSE NUMBER JOHN IBARRA 5204 TITLE COMPANY NAME PROFESSIONAL LAND SURVEYOR NOVA SURVEYORS INC. is AnnRFSS CITY STATE ZIP''CODE 5582 NW 7 STRE # 202 MIAMI FT 12126 SIGNATURE n DATE 91 . ~ 1 M) ; TELEPHONE r 1 _F7_1-04- ?_10f. a CSC ~ 0/,0 d , M~~ , , . _ ~ ~ y . n Id ~ ys4, I, r:i III ~ iV III I lii I ~ . - i ds i t.: I I ( I I i ~ L CIS ' I W~ i i h'~. ~i ~ ~ i ~ I lid ~ ~ f it . ~ _ I Irt °I~-,. i . - _ - - _ , - - - ~ .