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Home My WebLink About34-2117-004-3420C.0-R- = 8.22' FEDERAL EMERGENCY MANAGEMENT AGENCY bog NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 Expires July 31, 2002 221~ ELEVATION CERTIFICATE 0.300m ortant: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION Forinsurance Company Use: BUILDING OWNER'S NAME Policy Number MR. MARCEL HENRY BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 15780 NW 37th Court Company NAIC Number MIAMI Ft E Z15RSE PROP.~RRTY DESCRIPTION (Lot and Block Nu ers, Tax P ceI Number, Le al,,De iption, et AV ry 1,.--r A K15 W S L BUILDING USE (e.g , esidential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_1 GPS (Type): ( _ or NAD 1927 1-1 NAD 1983 1-1 USGS Quad Map Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE FLORIDA UNINCORPORATED 120635 MIAMI DADE 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, se depth of flooding) Y 12025 C 0090 J 7/17/95 3/2/94 X A N B10. Indicate the source of the Base Flood Elevation (BFE) data or nase tiooa aeptn enterea in rsy. 1_I FIS Profile M FIRM 1_1 Community Determined l-1 Other (Describe): 1311. Indicate the elevation datum used for the BFE in 139: El NGVD 1929 I-1 NAVD 1988 1_1 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes -l No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings* 1-113uilding Under Construction* YXIFinished 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, V1 430, 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 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 1_1 Yes (ri No ❑ a) Top of bottom floor (including basement or enclosure) _ 1 0.6 3 _ ft.(m) ft.(m) ❑ b) Top of next higher floor N/A ft.(m) o 0 ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A ❑ d) Attached garage (top of slab) N/A ft (m) w IN ❑ e) Lowest elevation of machinery and/or equipment servicing the building (A/ C) 1 0 . 6 {f.(m) E ft.(m) z . co: ❑ 0 Lowest adjacent grade (LAG) 9.8 __T_0 . 0 0 co eo7l~ ❑ g) Highest adjacent grade (HAG) A ft.(m) O ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N7 EN IN ❑ i) Total area of all permanent openings (flood vents) in C3h N / A sq. 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. 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. ChWHPA~I! RAMIREZ LICENSE7"BER T5 ND SURVEYOR & MAPPER ATERMT I6N RVICES OF FLORIDA A83 41 S S19UJ A SET DRIVE MIAMI ST&,E• zP39o~ SIGNATURE MA'QATf 2 0 0 2 TELEPHONE (305) 596-0888 FEMA Form 81-31, AUG 99 SEE RASE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS 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 CITY STATE ZIP CODE Company NAIC Number 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 E3. 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 1_1_1 ft.(m) 1_1_lin.(cm) 1_1 above or 1_1 below (check one) the highest adjacent grade. E3. 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? 1_1 Yes 1_1 No 1 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 CODE SIGNATURE DATE TELEPHONE COMMENTS -I 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. 1_1 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. 1_1 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO,. G3. 1_1 The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER _ G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY r r f ISSUED 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 attachments FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS