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Home My WebLink About34-2117-004-1190FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL-FLOOD INSURANCE PROGRAM O.M.B. No.'3067-0077 Expires December 31; 2005 3 ° ELEVATION CERTIFICATE ;OWN OF ROA( .26 Ft NGVD Irnportanf Read the Instructions on pages 1- 7. N H-4903 SECTION A PROPERTY OWNER INFORMATION ~compase~;:f wT?o1ic~ N be BUILDING OWNER'S NAME $ MARCd, it ,..`J..Jxs<., ,;.?."r,' 4 . I~'ENRY . BUILbfNG STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR;P.O. ROUTE,AND BOX NO. =GompariIGNaiYiler„:i_ I..ICI it .v=i e`t f I!. j.. lit N tyl Cour b; G SM. ..`~;F_ v .r{t OIN ZIP CODE;.;..:: miami. 31054 PROPERTY DESCRIPTION (Lot and Block Numbers;~Tax Parcel Number, Legal Description-etc.) . N 80 ' : E ' , :'Z' 1.3, REV35ED PLAT OF VE TM_'. C~kRDENS, (31-37) :Dade Court BUILDING; t1SE (e)g., Residential; Non-residential, Addition, Accessory, etc. Use a Comments area, ff necessary.}... LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPs (Type): ( - - or. ❑ NAD 1927 NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B -FLOOD INSURANCERATE MAP (FIRM) fNF0RMA710N - j B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. CULINI Y NAMk W. 5 r A 1 k UNINCORPORATED 120635 MIAMI D.ADE FLORIDA. B4. MAP AND PANEL B7: FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTNE(REVISED DATE B8. FLOOD ZONE(S) . (Zone AO, use depth of flooding) 12025 C 0090 J 7/17/95 3/2/94 X N/A 10. Indicate the source of the Base Rood Elevation (BFE).data or base flood depth entered in 69. ❑ FIS Profile [2 FIRM, ❑ Community Determined ❑ other (Describe): 1 l . Indicate the elevation datum used for the BFE in 139: M NGVD.1929 ❑ NAVD 1988 ❑ other (Describe): 12- Is the buildin located in a Coastal Barrier Resources System CBRS) area or otherwise Protected Area OPA ? Q Yes LM No Designation Date SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) -1. Building elevations are based on: ❑ Construction-Drawings* ❑ Building Under Construction* -1JRn1shed Construction *A new Elevation Certificate will be required when construction of the building is complete. Building Diagram Number 1(Select the building dagram most similar to the building for which this certificate is being completed - see pages 6 and 7. tf no diagram accurately represents the building, prWde a sketch or photograph.) 3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, ARIAE, AR/Al A30, AR/AH, AR(AO Complete Items C3.-a4 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, GVEQonve.rsiorVOomments Elevation reference mark usdd32-1 Does the elevation reference mark used appear on the FIRM?. ❑ Yes o No ❑ a) Top of bottom floor (including basement or enclosure) 9.41. ~ft,(m) ❑ b) Top of next higher floor N/A ft.(m) ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. ~ft.(m) N 0 ❑ ❑ d) Attached garage (top of slab) NFT7 ---ft,(m) E ❑ e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) A/C 8.50 . `ft.(m) E ❑ f) Lowest adjacent (finished) grade (LAG) - - ft.(m) ❑ g) Highest adjacent (finished) grade (HAG) 8.7 ft (m) NjA .L.S. 2779 ❑ h No. of permanent openings (flood vents) 1 within 1 ft. above adjacent grade ❑ I) Total area of all permanent openings (flood vents) in C3.h Nq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION "This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information; ! certify that the information in Sections A, B, and 'C on this certificate represents my best efforts to interpret the data available. ! understand that an false statement may be punishable b fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIERS NAME LICENSE NUMBER NARCISO J. RAMIREZ 2779 TITLE COMPANY NAME LAND SURVEYOR & MAPPER ATLANTIC SERVICES OF FLORIDA ADDRESS' CITY STATE ZIP CODE 8 41 SUNSET DR lI . FL. 33143 TUBE DATE TELEPHONE r DECEMBER 11, 2004 (305) 596-0888 %AA Fnrm R1-Z1 rant inni 90nI qpp rpvprSp sidt= for nnntinimfinn_ ReolacPS all nrpviniic arittinnc =JUK I ANT: In these spaces, copy the corresponding information from''Sbction A. Forinsurance Companyt7se : i BUILDING STREET ADDRESS (induding Apt, Unk Suite, andor Bldg. No.) OR P.O. ROUTE AND BOX-NO. Policy Number ' CiTY STATE .ZIP CODE CompanyNAlGN0Mw.- . > •::4 SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) I 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 kpITHOUT SIFE) . 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 _ ft(m) _,-_in.(cm) Q above or Q below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings seepage 7), the next higher floor or elevated floor elevation b of the building is ft m in. cm above, the highest adjacent grade. Complete items C3.h and C3.i on front of fomr E4. The top of the platform of machinery and/or equipment servicing the building is ft.(rn) _in.(cm) ❑ agave 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,aocordance with the community's floodplain management ordinance? Q Yes ❑ No Q Unknown. The IocaI.pfJdai 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, 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, 8, C, and E are correct to'the best ofmy knowledge. PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS Q 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. ❑ 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. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or community4ssued BFE) or Zone A0. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. OATE PERMIT tSSUEO G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED ' G7. This permit has been issued for. Q New Construction Q Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building is: ,_ft.(rri) 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 =EMA Fr)rm R1-11 .farniarv 9nn~