HomeMy WebLinkAbout34-2117-004-0960FEDERAL EMERGENCY MANAGEMENT AGENCY
Process o,op'j NATIONAL FLOOD INSURANCE PROGRAM
FoI No. 34-2117-004-0960 O.M.B. No. 3067-0077
Crown of Road = 7.91 let N G.V.D. ELEVATION CERTIFICATE Expires: December 31, 2005
o Important: Read the instructions on Pa9 es 1 - 7. 7)-J
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
16200 NW. 40 COURT
CITY STATE ZIP CODE
MIAMI FL 33054
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
PORTION OF TRACT 10, "REVISED PLAT OF VENETIAN GARDENS", PB. 31-37, MIAMI-DADE COUNTY RECORDS.
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 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: NTA
N/A
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER
B2. COUNTY NAME 7
B3. STATE
120635 (UNINCORPORATED AREAS)
7
Miami-Dade
Fl.
B4. MAP AND PANEL
NUMBER
1202500080
B5. SUFFIX
J
B6. FIRM INDEX
DATE
7-17-95
B7. FIRM PANEL
EFFECTIVE/REVISED DATE
3-2-94
B8. FLOOD
ZONE(S)
"X"
B9. BASE FLOOD ELEVATION(S)
(Zone AO, use depth of flooding)
N/A
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other (Describe):
811. Indicate the elevation datum used for the SFE in B9: ED NGVD 1929 0 NAVD 19.88 ❑ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: NIA
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 II (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/Al-A30, ARIAH, ARIAO
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 NIA
Elevation reference mark used 7.52' Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No
❑ a) Top of bottom floor (including basement or enclosure) 9.32 it (m)
m License No. LS 5938
❑ b) Top of next higher floor N/A. ft.(m) Date
❑ c) Bottom of lowest horizontal structural member (V zones only) NIA. !ft.(m)
❑ d Attached garage to of slab N/A. ~ft. m
W cc
❑ e) Lowest elevation of machinery and/or equipment. Sign,#~~reservicing the building (Describe in Comments Area) a.. $3 ft(m)
❑ f) Lowest adjacent grade (LAG) 7. 9 ft.(m) z . 4
❑ g) Highest adjacent grade (HAG) 8. 2 ft. (m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade NIA
❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICAT`IM" -
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by lawto~&' 'Alfy elevation information.
I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret t „ e data available.
L~ i Ilts l
I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Sect" 1061.
CERTIFIER'S NAME. JOSE SENAS LICENSE NUMBER: 5938
TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CONSULTANTS, INC.
ADDRESS CITY STATE ZIP CODE
7830 NW cn
TERRACIE MIAMI FL :33015
SIGNATURE ~ DATE TELEPHONE,
OL-08-04 f305) 362-2742
FFMA Fnr 1-11 Agnm;rv 9MA RIZF RFV1=R:g1= R!lr)F FOR CONTINI RATION RFPI AN=.R A] I PRF\1101 IR MITIC3NS
IMPORTANT: In these spaces, copy the corresponding information from Section A. for Insi ranee company Use:
BUILDING STREET ADDRESS (including Apt., Uhit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOAC NO. Pok.yNumber
16200 NK 40 COURT
CITY STATE ZIP CODE Company NAI+C Number
MIAMI FL 33054
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (3) 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 E 1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or
IOMR-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) __jn.(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 FEiUTA-issued or
community-issued BFE) or Zone AO must sign here.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
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.
C-1. ❑ The information in Section G'vtins 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.)
_ fem.
C-2. ❑ A community official completed Sect on E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.
G3. ❑ The foli~cwing information (items G4- 9) is provided for community floodpiain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY
ISSUED
C37. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
38. Elevation of as-bvi;t 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: ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS
Check here if attachments
=FMA Fnrm Al-'41 .1PnmQrv 9nn.A RFPI Ar.Ffi Al 1 PRFV101 IR Fr)1T1nMR