HomeMy WebLinkAbout34-1135-023-0050h FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
ORDER# 11-03-,-67 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
S#
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ELEVATION CERTIFICATE
C . 0 . R . 5.78 Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION For trtstlcance Company Use:
BUILDING OWNER'S NAME :<I?)it~t1er'..:
;sus: .ktf~`-<trs
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Gofinp§W AIC Nurnbe`r
1421 NW 2'07th Street y
CITY STATE ZIP CODE
Miami FL
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 5, Blk 1, North Dade Country Club`Estates Sec. One,Pb106,Pg77
BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
Residential
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM:
( - - or L_J NAD 1927 h) NAD 1983 SOURCE: LJ GPS (Type):
LJ USGS Quad Map I_ J Other
SECTION B.- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP COMMUNITY NAME & COMMUNITY NUMBER
B2. COUNTY NAME
B3. STATE
120635 K am'-D d
Miami-Dade
FL`
134. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
I
r", 15ATE
EFFECTIVE/REVISED DATE
ZONE(S)
(Zone A0, use depth of flooding)
1202 C 0080
J
-2 7 -9 5'
94
AE
6
B10. Indicate the source of the Base Flood Etevgtlon (tit-t) data or base vooa aeptn enterea in bu.
J_J FIS Profile (X,j FIRM J _--J Community Determined J_J Other (Describe):
611. Indicate the elevation datum used for the BFE In B9,: J._J NGVD 1929 J_J NAVD 1988 J`J Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? -Yes J~J No
Designation Date:
SECTION C - BUILDING ELEVATION 'INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: J_,JConstruction Drawings* J_JBuilding Under Construction* 11JFinished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. 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.)
Cl Elevations -Zones Al-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/Al-A30, AR/AH, AR/AO _
Complete Items C3.a-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 1929~onversion/Comments
Elevation reference mark used MiamiDadp, BM Does the elevation reference mark used appear on the FIRM? ( Yes I X I No
O a) Top of bottom floor (including basement or enclosure) 6 .95 ft.(m)
O b) Top of next higher floor n a ft.(m)
O c) Bottom of lowest horizontal structural member (V zones only) n a ft.(m), ° "s,kwt a
O d) Attached garage (top of slab) 6 .10 ft-(M) E 7 ~t
O e) Lowest of machinery and/or equipment
w st elevation o . t ~ > s
servicing the building (Describe in a Comments area.) ..6..20 ft.(
-M) E
43
O f) Lowest adjacent (finished) grade (LAG) 5 .8 ft.(m) Ae
O Highest adjacent finished grade (HAG) 6.0 ft.(m)
O h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade n /a O i) Total area of all permanent openings (flood vents) in C3.h n /a sq. in.. (sq. cm) PIS # _ SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certificaborils to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.''
I certify that 114e information in Soctiorts A, B, and C on this certificate re resents my best efforts to interpret the 'data available.
1 understand that any false statement tx ay be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIER'S NAME - LICENSE NUM ER
- JOSE A, PEREZ 285
,T TITLE COMPANY NAME
CONTINENTAL LAND SURVEYORS, INC.
LA VEYOR
ADG-RESS / CITY STATE ZIP CODE
sW 57"hAVE. S TITS 201 MTAMT FT, 331 55
,
DATE
SIGNATURE TELEPH3NF:
-262-1925
11-25-03
FEMA F 1-31, January 2003 Sep; reverse idu for cuntinuation. Replaces all previous editions