HomeMy WebLinkAbout34-2117-002-04216 1 -71.t~--/~ d FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
0077
ELEVATION CERTIFICATE ~ O.M.B. ExpiresNo. 3067- December 31, 2005
C.O.R. 7.92
Important: Read the instructions on pages 1- 7.
.r a 7` O PR SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
Andres & Jessica Won
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number
16351 NW 45th Ave.
CITY STATE ZIP CODE
Miami FI 33054
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 11, Block 2 of "Venetian Acres" Plat Book 44, Page 92, Miami-Dade County Public Records
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 B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE
Unincorporated 12WM Miami-Dade Florida .
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)
1202500080
J
7-17-95
3-02-94
X
WA
t31 U. Indicate the source of the base Flood Elevation (BFE) data or base flood depth entered in B9.
El FIS Profile ®FIRM El Commu pity Determined ❑ Other (Describe):
B11. Indicate the elevation datum used for the BFE in 69: 0 NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System `(CBRS) area or Otherwise Protected Area (O PA)? ❑ 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, V1430, V (with BFE), AR, AR/A, AR/AE, AR/Al-A30, AR/AH, AR/AO
Complete Items C3.-a4 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 N A/13/04
r
Elevation reference mark used MDCBM Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No
o a) Top of bo tom floor (including basement or enclosure) 8. 90 ft.(m) p A `
o b) Top of next higher floor 9.04 ft.(m) r
o c) Bottom of lowest horizontal structural member (V zones only) NA. ft.(m)
N
o d) Attached garage (top of slab) ft.(m)
E
o e) Lowest elevation of machinery and/or equipment 1;
x,
servicing the building (Describe in a Comments area 8.12ft.(m)
o f} J Lowest adjacent (finished) grade LAS
I
o g) Highest adjacent (finished) grade (HAG) 8 2 ftm
,
N
.E
o h No. of permanent i s flood vents) within 1 ft: above adjacent grade WA'
ll 61 i1 Yf IBS
#4~
dill
o i) Total area of all permanent openings (flow 'vents) in h A sq
in
(sq ttm)
i.9 tll k4 l
;
.
.
hill
p
„
r
SECTION D - $Ui ~EYOR, EN Ii\iEER,'OR ARCHITECT CERTIFjdATION 11, j 11111
'IIL Ij
i
l!! i
This certification is to be si
ned and sealed b
' a land sueyor
'en
ineer
6i"ar6hitect authorized b
law
to certify'elevation'~infcrn~atioWo` '
1ii°' II
I i
I
g
y
,
g
,
y
certify that the information in Sections A, B, and C on t}iis ceifi>rcate represents my; best efforts to interpret the data avail le~!I II~'Ij I ~ €
;
~I~
I
~
f understand that an false statemenfma De punishable' by' rihe or im risd4ent under 18 U.S. Code, Section `b01~. t;
1,
J'
CERTIFIERS NAME : NESTOR G. RODRIGUEZ III -
LICENSE NUMBER`: 4277 111
[1111
TITLE REGISTERED LAND
ADDRESS
13113 NW 42 A
SIGNATURE
FEMA Form 81-31, January 2003
COMPANY NAME PENINSULA LAND SURVEYOR ING -
CITY
STATE ZIP CODE
OPA-LOCKA
FL ` I 33054
DATE
TELEPHONE
i
04-13-04
.
:
305-687 0191
k.
j
See reverse side for continuation.
Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A.
EUILGIN G STREET AEORESS p nlAvj Apt., tit, SWP, arx itor Big. N3.) OR P.C. R(-A1fE /4t\D BQ/, t1JO-
16351 NW 45th Ave
CITY STATE
Miami F1
:tsk bim
ZIP C,~?DE :xjr.~i w~i isP~~!C t,►urrib..;::: :
T
SECTION D - SURVEYOR, ENGINEER, OR AR01TECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) commu* official, (2) insurance agent/company, and (3) building owner.
COMMENTS
MDCBM = Mian*Dade County Benchmark
Item Cab) = Main floor of detached tucture at rear of property. Item Cie) = Nc Pad Elevation
❑ Check here f attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
ForZone AO"Zone A(&outBFE), complete fiefs E1 ho* E4. fthe Elevation CerfifiCate is fended for use as st ppating d on fora LOMAorLOMR-F,
Section C musk be completed.
E1. DAding Dag = Numt'_(Select the building &V= most sim1arto the building forwhich this certicate is bed completed- seepages 6 and 7. f no dagraf amrately
represents the bung, provide a sketch or photograph.)
EZ The top oFth a bottom f w (rig basement or Moats;) of The building is _ t(m) _n(cm) ❑ ire or ❑ below (check one) the highest a*cent grade. (Use
n&rM grade, il' av le).
E3. For Big Diagrams 6-8 with openings (seepage 7), the next hi Hoot' or elevated tiaor elevatron b o€the b is tt m` ^in. em wove the ' ST ad. .
grade. C%nplete ins C3.h and C3.i on fruit of fbim
E4. The top of the plat m, of machinery ardor equipment semci ng the building Is _ ft(m) -in(cm) ❑ above or ❑ below (dwk one) the highest a jacent grade. (Use
r grade, (agile).
E5. For Zone AO ontr. t no flood depth numberis available, is the top ofthe botton floor elevated in accordance with the cosmnu Ws floodplain management ordir e?
[:]Yes ❑ No ❑ IJnknown. The low official mustceffythis iron inSection G.
SECTION F - PROPERTY OWNER (OR OWNERS REPRESENTATIVE) CERTIFICATION
The pDpedy owner orownefs o€ted represert completes SectionsA B, C Gems Cah and C3J ors, and E forZone A (without a FEMA-issued txconr utly-
issued BFE) or Zone AO must n here. The sfatffne&h Sed=A, a C, and E are coed to 9w best oftnyk xvAdge
PROPERTY OAR'S OR OILER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY - STATE ZIPCODE
SIGNATURE DATE TELEPHONE
COMMENTS
- ❑ Check here if attachments
tr sEcTiON G. COMMUNITY INFORMATION (OPTIONAL)-
The bed is a~"d bybw rnt~r~e to a~stathe tornrnu *s fbodplan m emettorrfinance can complete Sections A, B, C (orq and G ofthis Elevation
Cie. Cohi~teum a n} `
G1. 11i dormation in se t C wa
orbcalIto ce~jr ate
GZ ❑ A comma ty official completed'
G3. ❑ The U g
G4. PERrVIIZ r 10BER
taken from other &c6n of on t has Sided anti embossed by a ceased arvela, u, or who is wed by state
Qnticate the ice and date of"the ele nAm data in the Ca rx& am below)
ecaon E i1i a building
bated in Zap A PEW a FE MAisstred or rorr mtutity4wied BFE) or Zone AO.
i4- `C is flu tin 1fY y t managen'tent Wpm.
G7. This 1ernt has been is d for. ❑ New Cohstrudion ❑ Substantial tmprovefer
G8. Elevation of as-tub lowest floor (including basement) of the building is fp(m) Datum:
M. WE or (in Zone AO) depth of flooding ate btu site is. _ fp(m) Dak m:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
Sr"TURE DATE
COMMENTS
f Check here if attaach rob
FEMA Farm 81-31, January 2003 Replaces all previous editions