The URL can be used to link to this page

Home My WebLink About34-2117-004-0360yyyy FEDERAL EMERGENCY MANAGEMENT AGENCY 171'0 NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 ELEVATION CERTIFICATE Expires December 31, 2005 Z M5 01) -1)91 Important: Read the instructions on pages 1 - 7. I 8747 SECTION A- PROPERTY OWNER INFORMATION For Insurance Company Use, BUILDING OWNER'S NAME Policy Number Efrain Sandar BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 16035 N.W. 42 Avenue ft4.9z ie1~ 1 zzU4z ( ~E z ~.C Lek V CITY STATE ZIP CODE Miami Gardens FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Folio# 34-2117-004-0360 1 Ck ~ L at y>ro 3H BUILDING USE (e. g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments a a, 6 necessary.) Residential ( or #####W) ® NAD 1927 ❑ NAD 1983 USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NAP COMMUNITY NAME& COMMUNITY NUMBER B2 COUNTY NAME B3. STATE Unincorporated 120635 Miami-Dade Florida 84. MAP AND PANEL 87. FIRM PANEL NUMBE B5.SUFFIX B6. FIRM INDEX DATE F EFFECTIVER2EVISED DATE I~D ZONE(S) 7771 12025C 0080 J 7117/95 3/2194 X 310 . indicate fire source or the Base Flood Elevation (BEE) data or base flood depth entered in 89. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): _ B11, Indicate the elevation datum used forthe BEE in B9, ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (ORA)? ❑ Yes M No Designation Date nle 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 AK AE, AH, A (with BEE), VE, VI 430, V (with BFE), AR AR/A, APJAE, AR/Al A30, ARIAH, ARIAD Complete Items C3. a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used forthe BEE 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 1929 Conversion/Comments rile Elevation reference mark used MCBM Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No a) Top of bottom floor (including basement or enclosure) 8,6 iii b) Top of next higher floor IN Aft.mr) c) Bottom of lowest horizontal structural member (V zones only) N.Aft.(m) d) Attached garage (top of slab) 7.97ft. fie) e) Lowest elevation of machinery and/or equipment A/C 14W servicing the building (Describe in a Comments area) 8.43fI 0 Lowest adjacent (finished) grade (LAG) 7.27ft.# g) Highest adjacent (finished) grade (HAG) 7.46fl.(a) h) No. of permanent openings (flood vents) within 1 ft above adjacent grade NA I) Total area of all permanent openings (flood vents) in C3.h NA sq. In. (sq. cm) v m a w~ v6 E~ z'm vN v I/Ll/r 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 information in Sections A, S and C on this certificate represents my best efforts to interpret the data available, I understand that any false statement maybe punishable by fine or irnpasonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME. Odalys C. BellmIznaga LICENSE NUMBER #6169 TITLE. Professional Surveyor and Mapper COMPANY NAME Bello &-Bello Land Surveying Corporation ADDRESS CITY STATE ZI CCODE 12230S.W. 1315'Avenue,Suite201 Miami Florida 33186 JIbNAIURt I UAfE 1? 0 (305)2510606 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, coin the corresponding information from Section A. For Insurance company a e. 16035 N.W. 42 Avenue I CITY STATE ZIP CODE Company NAIC Number Miami Gardens FL 33054 SECTION D- SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agemilcompany, and (3) building owner. Crown of Road Elevation: 6.98' ❑ 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 I E2 The top of the bottom floor (including basement or enclosure) of the building is _ chrh in fcm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available), E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ft.(m)_in f cm) above the highest adjacent grade. Complete items C3 h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft .(m) in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade, (Use natural grade, if available). E5. 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 codify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, C (Items C3 h and C3,i only), and E for Zone A (without a FEMA-issued or community- issued BEE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best army knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS SIGNATURE DATE TELEPHONE SECTION G - The local official who is authorized by law or ordinance to administerthe 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. ❑ 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. ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or communityassued BFE) or Zone A0. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G7. This permit has been issued for ❑ New Construction ❑ 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: _fl.(m) Datum: COMMUNITY NAME DATE COMMENTS Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions