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7 FEDERAL NATIONAL EMERGENF FLOOD Y MANAGEMENT AGENCY
FOLIO#: 302117004099
rt IN ' kANCE PROGRAM
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LEVA E~C~1N TIFICATE
C.O.R.: 8. 34 'FT . r ~1111 ~a 0111I'i'III
Im ortant Rea 6' instructions on pages 1 -7.
4 =x'005947 SECTION`.A - Ph , 4 y„ -
OPtI2lY„fthltR INFORMATION
O.M.B. No. 3067-Cb77
Expires December 31, 2005
II!
For Insurance Company User
N' 'S~ NAME Policy Number
'-'JOSEbPH G WR
BUILDING STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) C ~R P.O. ROUTE AND BOX NO. Company NAIC Number
15900 NW 40 CT
CITY STATE ZIP CODE
MIAMI FL 33054
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot Block of
REVISED PLAT OF VENETIAN GARDENS according to the plat thereof as recorded in Plat Book 31 at Page 37 of
`the public records of MIAMI-DADE County, Florida.
BUILLDING USE (e.g. Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: I I GPS (Type):
( - - or I I NAD 1927 1 1 NAD 1 q83 1-I USGS Quad Map 12 I Other. NGVD 192 9
it Ilullp II I
SECTION B - FLOOD INSURANCt''kATP- MAP (FIRM) INFORMATION
H B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER
MIAMI DADE 120635
B2. COUNTY NAME B3. STATE
MIAMI-DADE FL
B4. MAP AND PANEL
65. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
DATE
EFFECTIV8/REVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
1202500090
J
07/17/1995
03/02/1994
X
N/A
1310 Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
I FIS Profile I X I FIRM I I Community Determined I I Other (Describe):
1§11 Indicate the elevation datum used for the BFE in B9: IX I NGVD 1929 1 1 NAVD 1988 1 (Other (Describe):
B12_s the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date: p
i ~ kMATION (SURVEY REQUIRED)
SECTION C BUILDING ELEVATION WFlO
' ~ ~Buildinq Under Construction* I X (Finished Construction
C1 Buildinq elevatio ns are based on: I I Construction Drawings
4A new Elevation Certificate will be required when construction of the building is complete.
C2. nuildinq Diagram Number 1 (Select the building diagram most similar to the buildinq for which this certificate is being completed -see
"pages 6 and 7. If no diaqram accurately represents the buildinq, provide a sketch or photoqraph.)
C3. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, V1430, V (with 3 E), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO
w 'Complete Items C3.a-i below accordinq to the buildinq diaqram 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 Lased for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section or Section G, as appropriate, to document the datum conversion.
'Datum NGVD 1929 Conversion/Comments N/A
Elevation reference mark used 6 Does the elevation reference mark used appear on the FIRM? IXI Yes 1,_1 No
E3
a) Top of bottom floor (including basement or enclosure)
10.00
ft.(m)
13
b) Top of next higher floor
N/A
ft.(m)
c) Bottom of lowest horizontal structural member (V zones only)
N/A
ft.(m)
d) Attached qaraqe (top of slab)
N/A
ft.(m)
e) Lowest elevation of machinery and/or equipment
I !III II I
2
servicing the building (Describe in a Comments area.)
8.3
ft.(m)
f) Lowest adiacent (finished) qrade (LAG)
8.17
ft.(m)
q) Hiqhest adjacent (finished) qrade (HAG)
8.57
ft.(m)
U h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade NSA License Number, Embossed Seal,
0 Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) Siqnature, and Date
SECTION D -SURVEYOR, ENGINEER ARCHITECT CERTIFICATION
, OR
l~'l hitect authorized by law to certify elevation information.
IoW
Iw ! This certificationis t be signed and sealed by a land surveyor,, enginee arc
~I n1 A a:nd Con this certicate``' I' e . y
l c that
r~ rma , terpret the -data av
fy the infoqq ~ t~on in SGc tio _s ~ts°rhy bes) efforts o ►nailable~ ;
100
nl understand that any false statement may be punishable by fine or imprisori'm6nf under-1 a U.S. Code, Section
CERTIFIER'S NAME LICENSE NUMBER
_ John Ibarra 5204
TITLE COMPANY NAME
Professional Land Surveyor NOVA SURVEYORS, INC.
55
SIG
(;III :
il,,. FEM,
~II
:SS CITY STATE ZIP CODE
N.W. 7TH S E SUITE 202 MIAMI FL 33126
DATE TELEPHONE
05/11/2004 A (305)264-2660
Form 81-31,JIA 2003
SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
Yes ~ X ~ No
e'
IMPORTAN r: In these spaces, copv the corresponding information from Section A. 4-0005947 For Insurance Company User
BUILDING STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P;O. ROUTE AND BOX NO. Policy Number
15900 NW 40 CT
CITY STATE ZIP CODE Company NAIC 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 SECTION C3(E) LOWEST ELEVATION OF MACHINERY IS THE A/C PAD
I_I 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.)
E2. The top of the bottom floor (including basement or enclosure) of the building is I I ( ft.(m) ( 1 ( in.(cm) I I above or I I below
(check one) the highest adjacent grade. (Use natural grade, if available.)
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is
I I I ft.(m) I I I in.(cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form.
E4. 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? I I Yes I I No I I Unknown. The local official must certify this information in Section
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's 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 BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the
best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
JOSEPH YEATER
ADDRESS CITY STATE ZIP CODE
15900 NW 40 CT MIAMI _ FL 33054
SIGNATURE DATE TELEPHONE
COMMENTS
I_J 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.
G1. I I 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. I I A community official completed Section E for a building located in Zone A (without a FEMA-issued or community=issued BFE) or
Zone AO.
33. I I The following information (Items G4-G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OR COMPLIANCE/OCCUPANCY
ISSUED
G7. This permit has been issued for: I I New Construction I I 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: ft.(m) Datum:
LOCAL OFFICIAL'S NAME
TITLE