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Home My WebLink About34-2117-004-1650FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 Process No. NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 Folio No. 30-2117-004-1650 C.0A = S.W N.G.V.D. ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. - Z010 Z 0 Z -3 6) 3 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: REBUILDING OUR COMMUNITY, INC. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 3974 NW. 166 STREET CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) THE WEST 75 FEET OF THE EAST 307.50 FEET OF THE NORTH 120 FEET OF TRACT 24, "REVISED PLAT OF VENETIAN GARDENS", PB. 31-37, MDC BUILDING USE (e.g., Residential, Non-residential, Addition, Armory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type): ( W - or ❑ NAD 1927 [1 NAD 1983 ❑ USGS Quad Map ® Other: Automatic Level N/A SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE 120635 UNINCORPORATED MIAMI-DADE COUNTY Miami-Dade Fl. B4. MAP AND PANEL B5. SUFFIX B6. 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) 1202500080 J 7-17-95 3-2-94 "X" N/A 1310. 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 139: ® 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 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 N.G.V.D. ConversionfComments 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. aft-(m) License0. L,S 5938 ❑ b) Top of next higher floor N/A. _ft(m) Da#~~ ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. _ ft.(mj I r ❑ d) Attached garage (top of stab) N/A. _ft (m) 1~3 wm ❑ e) Lowest elevation of machinery and/or equipment m servicing the building 8 . Lw(m) " Ea r = ❑ f) Lowest adjacent grade (LAG) L. 9ft.(m) z -7 ❑ g) Highest adjacent grade (HAG) 8. 8-ft(m) ❑ h) No. of permanent openings (flood vents) within 1 It above adjacent grade N/A i ❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) - - SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION T- This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code Section 1001. 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. 174" JERRACE MIAMI FL 3301 SIGNATURE/-) -~v nATF TFI Faunmr FFMA Fnff R1-31 Al !r; G4 RFF RFVFRSF S1r1F FOR (A-)N nNI IATION RFPi ACFS Al 1 PRFVI01 IS FIIITIONS IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 3974 NW. 166 STREET CITY STATE ZIP CODE Company We 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 E1 through E4. lfthe 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 _ fL(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. 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. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP 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. 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. Q A oomtnunity offlciai"compfefiod Section E for a building located in Zone A (without a FEMA-issued or community4ssued BFE) or Zohe AO. G3. ( ThelollowingJal'ormation (items G4-G9) is provided for community floodplain management purposes. i G4. fitMIT NUMBER G5. DATE PERMIT ISSUED IG6. EADTE CERTIFICATE OF COMPLIANCE/OCCUPANCY G7. This permit has been issued for. ❑ New Construction ❑ 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 COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS Check here if attacnments FFMA Fnrm R1-31 Al lr 44 RFPI ACFS Al I PRFVIOI IS Fr11TIONS