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HomeMy WebLinkAbout34-2117-004-1030ROWN=7:84' O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires December 3'I , 2005 NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important Read the instructions on 1 7. SECTIONA PROPERTY OWNER INFORMATION ForlrtsuanoeCoinpariSrUse BUILDING OWNER'S NAME Policy NUmt r FREDERICK FOWLER _X NAiC Numtxer BUILDING STREET ADDRESS (including: Apt., Unit, Suite, andlor Bk1g_ No.) OR P.O. ROUTE AND BOX NO.. EQmPan 15830 Nw 4e COURT CITY STATE ZIP CODE OPA LOCKA FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc_} FOLIO: 34-2117-004-1030 BUILDING USE (e.g., Residential, Dion-residential, Addition, Access©ry, etc. Use a Comments area, it necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - or #t#.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE DADE COUNTY UNICORPORATED 120635 MIAMI-DADE FL 134.1W AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEiREVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of flooding) 1202500090J J 7117/95 3)2194 X WA B1 U. Inditcate tree source of w base Hooa tievanon t dia or >ODUoemenwrea in w. ❑ AS Profile ED FIRM unrtjr Determined` ❑ Other (Desate): B11. Indicate the elevation daburn used fortheBFE in 89: NG 1929 ❑ MID 1988 0 Other Pes~ey S~ ' Yes 'o No Designation Date B12. Is the building located in a Coastal Barrier Resources stl ri GBRS area or ~(~ervuise Pttected Area OP ? SECTION C WILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Co ion Drawer * ❑ Buikting Under Constroction* 0 Finished Corislruclim *A new Elevation Certificate will be re edwhen const h, of the building iscomptete. C2. Buikting Diagram Number 1(Sekd the building loon. ` i W s~rular to the building for wl ch ft cerficate is being completed - see des 6 and 7. If r o dagrarn =w reprvisents the burg, provide a sket-h or phdtograph ) C3. Elevations - Zones AI A30, AE, AH, A (Wth BFE), , VII-1l V (with BFFE), AR, ARIA, ARIAE, AR I :A30, AFuiAH, ARM Complete Iterns C3.-a4 below 9 to the building A, dagm specified In Item C2. State the datum used Iftie datum is dfferent 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 NI 1929 ConversionlComrments NIA. Elevation reference marts used DCBM Does the dwation reference rm1k used appear on the FIRM? Q Yes 0 No 8. 55 ft {m} o a) Top of bottom ftoar (inducting basement cr enclosure) I b) Top of next higher tbor NA. -AM o I Bottom of lowest horizontal stnrctual nwrdx r N zones only) N/A . _ft(m) o di) Attached garage (top of slab} NlA. _ft{m) I e} Lowest elevation of machinery andbr equipment F ~uil ~(»n ul_ 9c servicing the burg (Destxibe in a Caivmm arEa 7 . ~t3 rri} Z ~ Io f) Lowest adjacent (finished} grade (LAG) m o 9) Highest a *cent (fin' grade (HAG) 7- 5l MM) o h) No. of permanent openings (flood vents) m6in 1 ft. above ac(acerit grade NA ~ ems? o r Total area of all permanent openings M... oodvents} in Cah N(Asq in. (,s4 an - ) This certification is to be signed and sealed by -a gland tutlirVej+br-engrt~-w o arnitect aumcnzeo oy iaw m cerrny eievanon iinmrmaaon. ! certify that the information in Sections A, BY Con on s V4A ate "ents my best efforts to interpret &e data available. I understand that anv false scat h~ Vie; by i ii!e or irir}prisonment_under 18 U .S. Code, Section 1001. . IMPORTANT: In these spaces, copy the corresponding information from Section A Foy tnsucance Company Use: BUILDING STREET ADDRESS (including Apt., Unit, Suite, andlor Bldg. No.) OR P.O. ROUTE AND BOXNO. Policy Number 15830 NW 40TH COURT CITY STATE ZIP CODE Compartp NAIC Nurriber OPA LOCAA FL 33054 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVico mpany, and (3) building owner. COMMENTS REFERENCE BENCH MARK: DADE COUNTY BENCH MARK NO. N-423, ELELVATION 7.63' ❑ Check here if attachments 4 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 itroui E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMB F, Section C must be completed E1. Building Diagram Nurrther _(Select the building diagram most sirnilar to the building for which this d Bate is being cold - see pages 6 and 7. If no diagam accurately represents the building, provide a sketch or photoi E2. The trop of the bottom flora "udng basement or enclosure) of the building is _ ft(m) _in.(crm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3 For Budding Diagrams 6-8 with openings (seepage Y 7), the next higher floor or elevated floor (elevation b) of the budding is ' ft.(m) in.(cm) above the h' ighest adjacent 3 k t'] ~ S T 9 i 3 4 Bade Completems C3 tr and C3.i on front of forrrr. 3 j' Yy II' :.a. ~:of mach E4. The top of ttie~Platfaminery aricYor q rrrent servicing the building is ft(m) _in.(cm above or [l beiow (dieck one) tie highest adjacent grade. (Use 11i , grade, natural ff available). For Zone AO . only: If no flood depth number is available, is the t~ of the bottom floor elevated in accordance wdh thecanmunilys floocpfai h rrraragemFxrt ordnance? El Yes El No El Unknown. The local official must ca* this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION r The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.hand C3.i cry), and E for Zone A (W hout a FEMA4ssued or conmunly- issued BFE) or Zone A0 must sign here. Thestaterne inSechbwA, B, C, a7dEare cormtoMebest ofmy10ow k ~ PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here Ff attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to ac#minister the community's floodlain management ordnance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G 1. ❑ The information in Section C was taken tom other documentation that has been signed and embed 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. El A carxmun Ky official completed Section E for a building located in Zone A with a FEMA-issued or carmunr ` ~ Q information ded for d arran -issued BF or Zane. AO. G3: The foNowi !?9 0hems G4 C9) is T muru~ - flood in agem„entpub G4. PERMIT NUMBER UANCEIC=UPANCY IS, . G5. DATE E PERMIT ISSUED G6. DATE CERTIFICATE OF COMP SUED G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as4x ift lumd-i'loor (including basement) of the building is. _fL(m) Datum: G9. BFE or (n 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