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Home My WebLink About34-2117-001-0010PRU'CESS S. C2000121065' FEDERAL EMERGENCY MANAGEMENT AGENCY r O.M.B. No. 3067-0077 FOLIO 3021170010010 NATIONAL FLOOD INSURANCE PROGRAM! July 0311, 6 2002 Expires C.0 It 7.80 ELEVATION CERTIFICATE ~ - octant. Read the Instructions an a e 1.1. Amended b MDC-DERM- OCT,1999 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company User BUILDING OWNER'S NAME Policy Number. Florida Memorial College BUILDING STREET ADDRESS (Including Apt., Unit, Suits, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 15800 N.W. 42 Avenue f CITY STATE ZIP CODE • Miami ilorida 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) See attached ~OYDN a ge ~ P,,R sing % Ma j e t e r i addition, Accessory, etc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - #V - 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 B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE 7 / EFFECTI F QV SED DATE 3Y ~ ZONE(S) ' " (Zone AO, use depth of flooding) / 1202500090 J 17 95 Z 94 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 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)? ❑ Yesf] No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) c1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' M Finished Construction *A new Elevation Certificate will be required when construction of the building is corfiplete. C2. Building Diagram Numberl(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, V1430, V (with BFE), AR, ARIA, 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 th atum conversion. Datum Conversion/Comments Elevation reference mark used Does the elevation referen"ce`tmark used appear on the FIRM? ❑ Yes ❑ a) Top of bottom floor (including basement or enclosure) 9 .00 ft.(m) ❑ b) Top of next higher floor t'/ a ft ' " .(m) ❑ c) Bottom of lowest horizontal structural member (V zones only')' ft.(m) o 0 ❑ d) Attached garage (top of slab) n f a ft.(m) W c ❑ e) Lowest elevation of machinery and/or equipment servicing the building 9 - ft.(m) E I 2y ❑ f) Lowest adjacent grade (LAG) (3 g) Highest adjacent grade (HAG) 8.8 ft.(m) g J 2,, ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade :3 ❑ I) Total area of al permanent openings (flood vents) in C3hn / asq. In. (sq. cm) .ice 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 informsUon In Sections A, B, and C on this ceWflcate represents my best efforts to Interpret the data available. understand that any false statement may beuni, I b fr `e orim risonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER Alber Lorezo-L ce_ 3087 TITLE Land Surve r _ ~MP~ ~E Self em - -,U 7 ADDRESS 9 2 3.- S. W. 1 2 CITY Miami STATE F 1 ZIP CODE 33184 SIGNATURE DATE 3/11 /02 TELEPHONE 3105-220-6397 CoTq IMPORTANT: In these spaces, copy the corresponding Information from Section A For insurance Y Use: BUILDING STREET ADDRESS (Indudiing Apt., Unit, Suite.-and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number CITY STATE ZJP CODE Company NA1C Number - 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 ❑ 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 suppon`ing 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 _ ft.(m) _in.(cm) ❑ above or ❑ 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 _ ft.(m) _,in.(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? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. RFCTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and L Tor zone N twanuut a rciv"-jssuuu ul community-issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME CITY STATE ZIP CODE r',uJr:~aS SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) (he 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. 31. []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.) .22.--El A community official co, Tpleted ;section ~ for a building located in Zone A ;wiPiout a FEMA-issued or community-issued BFE) or Y Zone 33. ❑ The`#ollowing Information (Items G4-G9) is provided for community floodplain management purposes. G4 PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED 37. This permit has bee6lssued for. ❑ New Constr uction ❑ Substantial Improvement 38. Elevation of as-built lowest floor (incl9ding basement) of the building is: --A(m) Datum: 39FE or (in Zone AO) depth of flooding at the building site Is: ft.(m) Datum: