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Home My WebLink About34-2117-004-0970FEDERAL EMERGENCY MANAGEMENT AGENCY Process No. Z003 / q~'~ NATIONAL BLOOD INSURANCE PROGRAM Folio hlta,. 34 Z'f ~7-fl4~-Q9'~~1 O.M.B. No. 3067-0077 Craven of Road = 8.26. Feet 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. I Company NAIC Number 16271 NW. 41 AVENUE CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) THE SOUTH 60' OF THE NORTH 180' OF THE WEST % OF TRACT 10, "REVISED PLAT OF VENETIAN GARDENS", PB. 31-37., MIAMI-DADE CO. FL. 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 CI NAD 1983 ❑ USGS Quad Map ❑ Other: N_A NIA SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE I 120635 (UNINCORPORATED AREAS) Miami-Dade Fl. B4. MAP AND PANEL B5. SUFFIX 136. 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 ")C N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation -datum used for the BFE in B9: 0 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: ❑ 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/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 7.52' Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ❑ a) Top of bottom floor (including basement or enclosure) 9. 40 ft.(m) License No. LS 5938 ❑ b) Top of next higher floor NIA. ft.(m) Date ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. ft.(m) ❑ d Attached garage (top of slab) N/A. _ft.(m) E D7 E~ ❑ e Lowest elevation of machine and/orequipment W `Q } machinery Zm Signaf~ir~: _ servicing the building (Describe in Comments Area) 9.26 ft.(m) E -6 ❑ f) Lowest adjacent grade (LAG) 8. 1 ft.(m) z a LL - ❑ g) Highest adjacent grade (HAG) 8.3 ft. (m) ❑ 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) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION""' 4i rmatio This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certif,, o e'vatioriir,f n a ~ =I~ ~I ~ ai i, ~l ~ICI certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret X1e a s vas/able. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 01 CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER: 593$` i lei TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CONSULTANTS, INC. ADDRESS CITY STATE ZIP CODE 7830 NW 174t'TFRRACE MIAMI FL 3301 SIGNATURE ~~-Ji DATE TELEPHONE ; ; 07-26-04 (305) 362-2742 I'd i FFMA Fnrm R 1 AAmiarv 70O.'A RFF F?F\IFRCF A:~1nF Fr)R f'ONTIN11AT1r)N RFP1 At' Aill 1 PRF1r1r)11fi !1hITIONfR IMPORTANT: In these spaces, copy the corresponding information from Section A. Por Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 16271 NW. 41 AVENUE CITY 4 STATE ZIP CODE Company NAIL Number:.. MIAMI 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 E 1 through E4. ff the Elevation Certificate is intended for use as suppot#ing 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. lez"~A) Do PROPERTY Ov11NE 'S OR OW R'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE 3 - SIGNATURE 41 ATE TELEPHONE COMMENTS ❑ Check here if attachments r rr+r® SECTION G -COMMUNITY INFORMATION (OPTIONAL) -she 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 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 Inca, taw to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community, official omplOed Section E for a building located in Zone A (without a FEMA-issued or community4ssued BFE) or Zone AO. G3. ❑ The full; >rving 16formatia:i (Items 4-G9) is provided for community floodplain management purposes. G4. PERM 31T NUMBER a H ~ G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED G7. This permit has been issued for: ❑.1 New Construction ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building is: Datum: ~9. BFE or {I Zonp r 0) depth pf,.. ooding at the building site is: ft.(m) Datum: " LOCAL OFFICIALS, ~ TITLE NAME , COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachments FFMA Fnrm R1_R1 Annrrarv 7M.1 RFPi Ar.Pq Al I PRFVI0I IR FnITIONIA