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Home My WebLink About34-2117-004-3730FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 PROCESS FOLIO NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 # ELEVATION CERTIFICATE C.O.R. 7 9 8 ' - ortant Read the instructions on pages 1 - 7. SECTI(SN'A - PK61PERTY OWNER INFORMATION For. Insurance Company Use: BUILDING OWNER'S tyAME Policy Number L.P.BUILDER S BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number. 16425 N.W. 37th P1 r~TY S LTE ZIP CODE ' iami PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lots 11 and 12,Block 84 in PB:17-37,Dade County,Florida. BUILDING USE ``e.gg.~ Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: L_L GPS (Type): ( - or ##.#ftW) L_i NAD 1927 LJ NAD 1983 L_) USGS Quad Map ~j Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE -I ` _ _ T n A -nV COUNTY FLORIDA 1GVVJJ-vvv V-.. - 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) 120635-0080 1 07--17-•95 03-•02-94 "X" NONE BTO. Indicate the source of the Base Flood tlevation (ter-t) data or base nooa aeptn entered in au. (_J FIS Profile JX J FIRM LJ Community Determined Other (Describe): 1311.) 988;. J_J Other (Describe): ndicate the elevation datum used for the BFE in B9: Jy J NGVD 1929 N; D 1 . V B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or' Otherwise Protected Area (OPA)? L_I Yes° Ix..J l~to Designation Date: N/A . SECTION C - BUILDING ELEVATION. INFORMATION (SURVEY REQUIRED) on: J_JConstruction Drawings* J_JBuilding Under Construction* JX JFinished Construction C1 Building {ete. Elevation Certificate will be required when construction of the building is comp 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 th. a 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-q.V D Conversion/Comments N / A Elevation reference mark used M i am i -Dade Does the.elevation reference mark used appear on the FIRM? J_J Yes 130, No ❑ a) Top of bottom floor (including basement or enclosure) ft m) b) Top of next higher floor A ft.(m) C] c) Bottom of lowest horizontal structural member (V zones only) _77. 47- A ft.(m) 00 C3 d) Attached garage (top of slab) ---`m) w _QE a C] e) Lowest elevation of machinery and/or equipment W servicing the building 9 0 m _.8 O f) Lowest adjacent grade (LAG) ft rh) z ❑ g) Highest adjacent grade (HAG) 3 tt m) 0 8 - 2 1- 2 0 01 ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A J LN '3064 ❑ 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. l understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER Roberto R Brizuela 3064 TITLE COMPANY NAME Prnf T and 19urve~znr and MaJ212er ROBERTO R BRIZUELA AND ASSOC. ,.INC. ADDRESS n CITY STATE ZIP CODE 1 ?I N -W 1'16t•h rmirt Miami FL 33182-19.57 SIGNATURE DATE TELEPHONE 08-x_21-2001 (305)551-4393 EDITIONS orm 81- UG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS gffiI STRUT ADpgEgS udin Apt., Unit, Suite, and/or Bldg. No. OR P.O. ROUTE AND BOX NO. Poll Number CITY STATE ZIP CODE Company NAIC Number Miami FL :M 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 REFERS TO OUR JOB #00-06-124 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 o, photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is L_L:1 ft.(m) L-L-lin.(cm.) L_I above or L,i. below , (check one) the highest adjacent grade. r 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 (No IUnknown The local offcial must rectify 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 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. LJ 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. L_( A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or " Zone A0. G3. L_1 The following information (Items G4-G9) is provided for community floodplain management purposes. G6. DATE CERTIFICA ISSUED G7. This permit has been issued for. New Construction L_) 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