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FINAL ELEVATION CERTIFICATE
This certificate shall be submitted for compliance of llc3-3f to DERM Flood Plain Management Program to remove FINAL COMPLETION
HOLD
This cediflcate will not be accepted if all items are not completed
PROPERTY INFORMATION
(The following information to be provided by contractor, property owner or agent.)
FOLIO #>E 3 0 (NOT ACCEPTED WITHOUT FOLIO)
Address 17001 NW 28 Ave., ;Miami, FL. PROCESS Permit
xx . New Construction Addition, Reconstruction or combination
I certify that the above information represents my best effort to interpret the data required. I understand that any work undertaken prior to
obtain a certificate of completion or occupancy will be at the PERMIT HOLDER'S RISK. The County will review the elevation data
submitted. Deficiencies detected by such review shall be corrected by the permit holder imitg&tely and prior to further progressive work
being permitted to proceed. Failure to submit the elevation survey or certificate or failure to make said corrections required hereby shall be
cause to issue a stop work order for the project.
Name:
(print)
Date:
Phone #
(signature)
ELEVATION CERTIFICATE
This certificite is not valid if any items are altered or not completed.
Subdivision Name
PARK 24
2ND ADDITION TO GOLDEN GLADES Lot 23 &
Blk 1 PB 39 PG 83
R
d
Fl
Community #
Suffix
Panel #
Date of FIRM
M Zone
FI
oo
Base
120635
J
0080
3/2/94
X
Ft. NGVD
Using FEMA's Elevation Certificate instructions, indicate diagram found on Pages 5 and 6 that best describes the subject building's reference
level 1
LOWEST FLOOR ELEVATION (Top Reference level) 10.98 FT. N . G. V . D .
LOWEST ADJACENT GRADE ELEVATION 9.45 FT. N.G.V.D.
GARAGE OR STORAGE FLOOR ELEVATION N/A FT. N.G.V.D.
ELEVATION OF HIGHEST CROWN OF ROAD (Fronting Property).. 9.82 FT. N . G . V . D .
A/C COMPRESSOR (Provide top elevation of supporting structure) 9.98 FT. N . G . V . D .
I hereby certify that the information on this certificate is true and correct to the best of my knowledge and belief.
Date : July 23, 1995
Certifier's Name : JOSE F. LOPEZ, P.L.S.
Phone (305) 836-1822 (Print)
Certifier's Signature
Certificate # 3086 PLS
This form has been approved by The Federal Emergency Management Agency (FEMA) and may be used for flood insurance purposes-
Rev. May 31, 1995/ELEVCERT.195