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HomeMy WebLinkAbout34-1136-011-1200PROC# C 97044783 FOLIO # 3011360111200 PER CLIENT FROM BUILDING PERMIT FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION Forihsurance, Company`Use.: BUILDING OWNER'S NAME Policy Number Morais Lloyd Witter BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. C&np,any NAIL Number 20685 NE 2nd Avenue CITY STATE ZIP CODE Miami Florida PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) L. 1 Bl. 37 "Third Add. to Andoyerll 84/88 Dade BUILDING ~JSE (e.g. Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Resi ential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: ( or 0% NAD 1927 NAD 1983 SOURCE: GPS (Type): USGS Quad Map Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE Unincor orated Dade. 120635 Dade Florida B4. MAP AND PANEL B5. SUFFIX 136. FIRM INDEX B7. FIRM PANEL 68. FLOOD L,; 139. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 120250 0081 d 7/17/95 312/94 ~X1 - B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_1 FIS Profile I Xi FIRM J_1 Community Determined 1_1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: IX I NGVD 1929 1_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)? I_1 Yes 1-I No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings* 1_1Building Under Construction* IXlFinished 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 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 29 Conversion/Comments Elevation reference mark used Dade County B'M Does the elevation reference mark used appear on the F!RM? I_I Yes I 'I No ❑ a) Top of bottom floor (including basement or enclosure) 8 . 0 ft. (m) ❑ b) Top of next higher floor N/A. ft.(m) 2/9/04 member ❑ c) Bottom of lowest horizontal structural I ❑ d Attached em er .~zones only) _b garaa a ixga lh (top o~fsla)QADI A6 (m'11 r W ❑ e) Lowest elevation of machin6u VipAnt , ; ~ it servicing tie! uilding egeribe in'a Comments area.) 7 2 ft.(m) i,~ l it I 7: 0 ft (m) ZA NI C3 f) Lowest adjacent (finished) gre (LA G) 2 U) U) El g) Highest adjacent (finished) grade (HAG) 7 ft.(m) I I~ ❑ h) No. of permanent openings ovents) within 1 ft. above adjacent g~ede L. S. NO 327 i90, 11 in. (sq. ~cm) ❑ i) Total area of all permankfopernngs (flood vents) Hin C3.h 6ii ~~i~~i S~~Ct1t~N 8 SILIAV8YO;k, ENGINEER, OR'ARCHIf ECT CCRTIFICATION ~ ~ - I I 1011ai ii i i i I I 9I ~I This certification is to be signed and sealed by a land '~urv6yor, engineer, or!'ar~hi+ect au horiz d~ b law to"certify elevation information. I4 'I IIJI~' I~ ~ `Ili! w~i~I I certify that the information in Sectior'$ A,;$, 'and C on this certificate reprea iil' my best erfonslyfo interpret the data available. SActlon 1001. a I understand that any false statement~ih6y be punishable by fine or imprisoAhie'nt und6 18 U.S. Codo, a; CERTIFIER'S NAME - LICENSE NUMBER ° ROBERT I BOGLE Q L.S. No..-3277 TITLE COMP F~NY NAME T ' BOGLE & AS SO NC. - REGISTERED LAND SURVEYOR R. ADDRESS f CITY S, S.ATE j ZIP CODE 7080 TAFT STREET o I HOLLYWOOD X__ -FLORIDA 33024 SIGNATURE t DATE TELEPHONE 2/ 9/ 04 " _C .54 X61'-$008 FEMA Form 81-31, January 2003 See reverse 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 20685 NE 2nd Avenue CITY STATE ZIP CODE Company NAIC Number Miami Florida 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 l J 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 E5. 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) in. (cm) above or below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1_1-1 ft- (m) 1_1_1in. (cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is 1-1_I ft. (m) 1-I.-1 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? I Yes ( 1 No 1_1 Unknown. The local official must certify this information in Section G. i r SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS (,_l 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 (o _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. A community official completed Section E fora building located in Zone A (without a FEMA-issued or community-issued BFE) or - -Zone AU G3. 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 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: E or (in Zone AO) depth of flooding at the building site is: ft. (m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITYfNAME i- TELEPHONE SIGNATURE _ DATE COMMENTS .«j{. k , i~Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions