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Home My WebLink About34-2117-004-0900FEDERAL EMERGENCY MANAGEMENT AGENCY Process No. 2 ® ! NATIONAL FLOOD INSURANCE PROGRAM Folio No. 3472117-004-090P O.M.B. No. 3067-0077 Cr vrw lot Road 8.10 Fee# NAV D, ELEVATION CERTIFICATE Expires: December 31, 2005 Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For insurance Company Use: BUILDING OWNER'S NAME Policy Number M & M DEVELOPERS, INC. BUILDING STREET ADDRESS (Including Apt., Unit, Suite; and/or Bldg. No.) OR,`P.O. ROUTE AND BOX NO. Company NAIC Number 16220 NW. 40 COURT CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) THE SOUTH 80' OF THE NORTH 200' OF THE EAST 1073T OF TRACT 10, "REVISED PLAT OF VENETIAN GARDENS', PB. 31-37, MIAMI-DADE CO. BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - or ❑ NAD 1027 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: N_A N/A SECTION B - F1Loob'INSURANCE RATE MAP (FIRM)'INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE 120635 (UNINCORPORATED AREAS) Miami-Dade Fi. B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 12025CO080 J 7-17-95 3-2-94 °X" N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in E39. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE 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 (OPA)? ❑ Yes ® No Designation Date: N/A SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: E❑ Construction Drawings* ❑ Building Under Construction* EJ 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 V30, V (with BFE), AR, ARIA, ARIAE, 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 NGVD 29. Conversion/Comments N/A Elevation reference mark used 7.62' Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ❑ a) Top of bottom floor (including basement or enclosure) 9. 26 it(m) m License No. LS 5938 ❑ b} Top of next higher floor NIA. #t.(m) Date: ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. _ft (m) W ?;;y4 00 ❑ d) Attached garage (top of slab) NIA. _ft.(m) _ ❑ e) Lowest elevation of machine and/or-equipment w 0 mT7l` } machinery m m `Srg"nature: servicing the building Describe in Comments Area 8. 96 ft. m .0 0 ' a ❑ f) Lowest adjacent grade (LAG) 7. 9 ft.(m) w 7Z ❑ g) Highest adjacent grade (HAG) 8. 1 fil(m) . -Jr ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A ❑ i) Total area of all permanent openings (flood vents) in C3h NIA sq. in. (sq. cm) M `I x IId ~3 ,W.l:~a ~ I Itlr^-~libi~ -s~~..~~~~~• I p SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATO 1 I. I ~ s 4 I f 13v This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. pliiizl It. 111h Inli I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interprets the data available r~ x 1:04 EI I understand that any false statement may be punishable by fine or imprisonment under 18 U. S_ Code, Section Im1. CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER: 5938 " !I X ,!I Illy TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CONSULTANTS, INC. I ilw Ii i' ADDRESS CITY STATE ZIP CODE cn RRACF MIAMI FL 33015 7830 NW- SIGNATURE l i a DATE TELEPHONE it I! Pli . ~ ion ' "I I !1'. I I€ sir' I - FFMA Fnrm _R1 .lamanr 9M.1 SFF RF\/FRSF g1nF FOR f (7NTiNi fATff1N RFPE A(-#=-, At i °PRFI~If )l IC Fi11TiC~N~ a lui kill IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance company use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Numbei 16220 NW. 40 COURT ; CITY STATE ZIP CODE Company NAIC Number MIAMI 3 FL 33054 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 El through E4. !f 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) _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. 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'certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNS S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS C C S TE ZIP C0 E -71 1 J, /X_06 SIGNATURE ATE TELEPH N COMMENTS ❑ Check here if attachments aci, i IVIV u- kou iMtiiyi i T IiyrUKIMi A I IVN (Vr I IUN j The 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. G1. ❑ The information in Section wass taken from other documentation that has been signed and embossed by a I~icensed surveyor, engineer, or architect who is authorized by statR or Ivoal law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official coit"iplete.I SeVtion E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. ,G3. [I The fol;awing infrmn clterr;~ G4I-G9) is provided for community floodplain management purposes. G4. PERMIT_NUMBER C5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for; n New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (in'luciing basement) of the building is: ~ft.{rri) Datum: G9. BFE or m Zone~A0) de Pthw of flyn9 at the building see is: ft.(m) Datum: ( LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here if attachments FFMA Fnrm R1-11 Annimm 7M.1 RFPI Ar.FS Al I PRFV101 IR Fn1T1r)N~