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Home My WebLink About34-2117-004-1670FEDERAL EMERGENCY MANAGEMENT AGENCY Press No. C 2403 / 277 NATIONAL FLOOD INSURANCE PROGRAM Folio No. 34-2117-004-1670 O.fUI.S. No. 3067-0077 Crown of Road = 8.22 Feet N.G.V.D. ELEVATION CERTIFICATE ~ Expires: December 31, 2005 Important: Read the instructions on pages 1 - 7.1 13 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. Company NAIC Number 3980 NW. 166 STREET CITY STATE ZIP CODE MIAMI GARDENS FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) THE EAST 75' OF THE WEST 232.5' OF THE NORTH 120' OF TRACT 24, -REVISED PLAT OF VENETIAN GARDENS", PB. 31-37, MIAMI-DADE CO. 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 ❑ 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 - J 120635 (UNINCORPORATED.AREAS) Miami-Dade Ft. B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL 138. 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 W7 N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile Z FIRM ❑ Community Determined ❑ Other (Describe): 1311. Indicate the elevation datum used for the BFE in 139: 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 Drawinge ❑ 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, ARIAE, 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 1Z No. ❑ a) Top of bottom floor (including basement or enclosure) 9.AB-ft-0) License No. L 5933 ❑ b) Top of next higher floor N/A. ,ft.(rn) Date: - ❑ c) Bottom of lowest horizontal structural member (V zones only) NIA. _ft.(m) - 54 + Ky ❑ d) Attached garage (top of slab) N/A. #t.(m) ~L A` F w ❑ e) Lowest elevation of machinery and/or equipment ; "Signatdre: 1- :0 servicing the building (Describe in Comments Area) 2, 32 ft. (m) = ' ",P~ Y ❑ f) Lowest adjacent grade (LAG) 8.3 ft-(m) z .0 A ❑ g) Highest adjacent grade (HAG) 8. AA(m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade NIA "-All III> ❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm)~-~ SECTION D - SURVEYOR (ENGINEER, OR ARCHITECT CERTIIFICATON 11 vii ii r 1~i ; ~ _ t I I This certification is to be signed and sealed by a land surveyor' engineer, or architect authorized by law to ''brt~Gr i el6va ionyinformation. II certify that the information in Sections A, B and C on this certificate represents my best efforts to interpret Me data avaiilaible l;ll I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Sec 101 1; CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER 5938jl kk~~ f41 l TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CONSULTANTS, INC. ADDRESS CITY STATE ZIP CODE, 7830 NW_ t170TPRRACE MIAMI FL 3301511 SIGNATUR DATE TELEPHONI ill FFMA Fnr R1_'~1 .larniarv 7t)(l AFF RFV1=RSF AIM: MR C'.i"')NTIN1 IATION Al 1 pm=Vint 1S Fnl'! 1C1Nr, Iii I~, II',I I ' 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 3980 NW. 166T" STREET CITY STATE ZIP CODE Company NAIi✓ Number MIAMI GARDENS FL 33054 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUER) 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. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMB-F, Section C must be completed. 1. 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. 0 9 L A ,-1.D O s5E J,1,4.S PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME 8004 N t _ A- 3 2 O A .-41 LAi<asF R_ - 33~ l ADDRESS Cl STATE ZIP CODE 1V -46 - C) 6 6 3 SIGNATURE s DATE/' TELEPHONE UUMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is autficirized by law or ordinance to administer the community's floodpiain management ordinance can complete Sections A, 8, C (or E), and G of this Elevation Certii;cate. -Complete the applicable item(s) and sign below. G1. ❑ The information in Section C,wzs taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized _by state: or loc I~iW to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official co _pleted Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The following information (items 4-G9) is provided for community floodplain management purposes. G4. PERMIT .NUIaER GS. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as built lo*est floor '(Including basement) of the building is: ft. (m) Datum: iii... G9. BFE or (in Zone AO) depth of 00oding at the building site is: _ ft.(m) Datum: Wi! LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME - TELEPHONE DATE COMMENTS ❑ Check here if attachments MA Fnrm R1_R9 AAnimrv W10.1 RFP1 AnP.q At 1 PRFxhoi 1S r:n1T10NS