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Home My WebLink About34-2117-003-1550PROCES 3 FOLIO # 30- • CROWN OF ROAD 8 • 3 9 Ft NGV0 5o*2 [ !7Do 3 I SS0.. G2o030G89GS- FEDERAL EMERGENCY M44NAGEMENT AGENCY O.M.S. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE J te- important: Read the• instructions on pages 1 - 7. t 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. Company NAIC Number. . ` • ' 15730 N.W. 37th PLACE CITY STATE ZIP.CODE FLA MIAMI - PROPERTY DESCRIPTION (Lot and Block Numb°rs; Tax Parcel Number, Legal Description, etc.) LOT 11 BLOCK 13 PB-44 PAGE 81, DADE COUNTY, FL BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section If necessary.) RESIDENTIAL - - LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: L! GPS (Type): ( - - or Ll NAD 1927 LI NAD 1983 U USGS Quad Map L_.I Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1• NFiP COMMUNITY NAME & COMMUNITY NUkABER 82. COUNTY NAME B3. STATE UNINCORPORATED 120635 MIAMI-DADS FL B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX 87. FIRM PANEL A BS. FLOOD 89. BASE FLOOD ELEVATION(S) NUMBER A• EFFECTiVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 1202500090 J 7-1,1.-y5 3-2-94 "X" NONE B10. Indicate.,the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9... - - FiS i'rofiie`FiRM L) Comrnunirf _Qetertniried LJ Other (Deslbe),`^ B11. Indicate the'elevation datum. used for the BFE in BOW NGVD 1929 LJ.NAVD -1988, U Other (Describe): 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? U Yes L4INo Designation Date: N A - SECTiON C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LjConstruction Drawings" LBuilding Under Construction' ff 4FJnished 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 sketeor photograph.) . C3. Elevations - Zones Al-A30, AE, AH, A BFE), VE, V1430, V (with BFE), AR, ARM, 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 8FE 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 N G V D Conversion/Comments N/A Elevation references mark- used N.14 2 3 Does the elevation reference mark used appear on the FIRM? L_! Yes No - o a) Top of bottom floor (including basement or enclosure) 9.12 ft• r„ r. 0 b) Top of next higher floor NIA fL(m) h_ri 10 0 c) Bottom of lowest horizontal structural member (V zones only) N A. fL(m) ® d) Attached garage (top of slab) N / A- R(m) L ti A ® e) Lowest elevation of machinery and/or equipment' servicing the building k(m) ® f) Lowest adjacent grade (LAG) !L(m) 1' . P LL SL ®g) Highest adjacent grade (HAG) 9. 7 'Cl h) No. of permanent openings (flood vents) within 1 ft: above adjacent grade ® I) Total area of all permanent openings (flood vents) in C3h N / A... sq.. in. q: cm) f ~ i SECTION D•- SURVEYOR, ENGINEER, OR ARCHITECT 16 FItATION ~I Ills 4I~I~ ti• This certification,rs to be signed and sealed by a land surveyor, engineer, or architect authorized by law to ice it eevationnorrnat. • l certify that the mfa mahon in Sections A, 8, and C on this certificate represents my best efl'orts to interpret the i s ava~ye~ile i'understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Sectlon~~~~~ 1~' CERTIFIER'S NAME LICENSE NUMBER R0BERT0 R. BRI ZUELA II30~~+ ~~Illi L- Till: " TITLE PROF. LAND SURVEYOR COMPANY NAME ROBERTO BRIZUELA A COI' ADDRESS • .7323-8 WEST FLAGI,ER STREET CITY MIAMI STATE F L ZiP CODE 3 ' 44 SIGNATURE 2 _ _ $ _ . • • ' oAT€10 _ 0 _ 0 3 -TELEPHONE (305)551-43i93 ,1~` FEMA Form 81-31, AUG` SEE REVERSE SIDE FOR CONTINUATION REPLACE$ ALL PREVIOUS 15DMONS r... .`9o- - _ , r:r..ww iii i . t IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (including Apt., Unit, Suite, andlor Bldg. No.) OR P.O. ROUTE AND 3 NO. Policy Number CITY STATE ZIP CODE Company NAIC Number . SECTION D -'SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, 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 El through E3. 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 ft(m) I I lin.(cm) L_1 above or L_J below (cheat one) the highest adjacent grade. ; • E3. Far Zone AO only., If no good depth number is available, is the tt?p of the bottom floor elevated -in accordance with the community's floodpfain nsnagement erdirance?Yes ` J _J No ( {Unknown. The :oval official must certify this information in Section G. , ■__.a.m._c._._r. SECT ION F - PROPERTY OWNER (OR OWNER'S REPRESENTAMVE) CERTIFICATION The property owner or owner's authorized-representative who completes Sections A, B, and E for Zone A (without a FEMA4ssued or community-issued SFE) or Zone AO must Mign.here: ` r = PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME - ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS - - Chedc here if attachments r r `a. Y , SECTION G • COMMUNITY INFORMATION (OPTIONAL) 'y The local offt" who is aphorized by law or ordnance to administer the community's floodptain management ordinance can complete T S+ c aor;: A, 8, C (or E), and G of this Elevation Certificates Complete the applicable item(s) xId sign below. h _ W. L j The inf6hi iaftn in Section C was taken from other documentation that has been signed and embossed by a kmnsed surveyor. enginoe.:r itedwho is authored by state or tool taw to certify elevation information.- (Indicate the source and date of the * ele~ d in the Comments area below.) ' C2. 1-1 A commurr7 official completed Section E for a bum located in Zone A (without a FEMA4ssued or community4ssued BFE) or . Zone A0. ° !G3- , j,,,j' 't"e f ilowing information ptems G449) is provided tar community ftodplah mangy P • G4 PERMIT NUMBER G5. DATE PERMIT ISSUED GO. DA C>rRTIF1CA O COMPLWNCFJOCCiIPANCY ISSUED i This permit has been issued for. (,_j New Constncdon U Substantiat brpoverttent Ele~ of,w-bufit lowest floor (including b+asemeriQ of the building is: . r■ IL(m) Dab= BFE or (in Zone AO) depth of flooding at the buildng site im %(m) Datum: _ LOCAL o CIAB ; COMMUNITY NAME TELEPWN t ` SIGNATURE OA 9 COMMENTS ...,.y...- _ ;jell r ■