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Home My WebLink About34-2109-007-0410flku(;L~ # F-EUEFU1LENIlE RGENCY MANAGEMEN'T' AGENCY O.M.B. No. 3067-0077 FOLIO# 30 L)`,, ffC) NATIONAL FLOOD INSURANCE PROGRAM Expires DECEMBER 31, 2005 ~ l ELEVATION CERTIFICATE C.O.R. EL - 9.16' Im octant: Read the instructions on ages 1- 7. 1Z SECTION A - PROPERTY OWNER INFORMATION For Insurance Compary Use: BUILDING OWNER'S NAME Policy Number VASIL WILLIAMS BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 2817 N.W. 168TH TERRACE CITY STATE ZIP CODE MIAMI FLORIDA 33056 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 15, BLOCK 3, "FIFTH ADDITION TO GOLDEN GLADES PARIC PLAT BOOK 47 AT PAGE 3 BUILDING USE (e.g., Residential, Non-residentlel, Addition, Accessory, etc. Use a Comments area, if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME B3. STATE UNINCORPORATED AREAS MIAMI-DADE i 120635 MIAMI-DADE FLORIDA B4. MAP AND PANEL B5. SUFFIX 86. FIRM INDEX DATE B7. FIRM PANEL B9. BASE FLOOD ELEVATIGN(S) NUMBER J 7-17-95 EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone AO, use dFth of flooctng) 12025c 0090 3.2-94 " X. N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89. ❑ FIS Profile X FIRM ❑ Community Determined ❑ Other (Desaft): 1311. Indicate the elevation dol m used for the BFE in 139: X NGVD 1929 ❑ NAVD 1988 ❑ Other (Desmbe): 1312. Is the buldi localed in a Coastal Barrier Resources sham CBRS area or Otherwise Protected Area OPA ? ❑ Yes X No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Ci.Building elevatiam are based on: ❑ Constriction DrannnW ❑ Building Under Construction* XXX Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1(Select the bung diagram most similar to the building for Wkh this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, prcvide a sketch or photograph) C3. Elevations - Zones Al 4W, AE, AH, A (with BFE), VE, V1 V30, V (wish BFE), AR, ARIA, AR/AE, ARIA1-A30, ARIAH, ARIAO Complete items C3.-a-i below according to the buildng diagram specified in Item C2. State the datum used If the datum is different from the datum used fa the BFE in Section B, convert the dai m to that used for the BFE. Show field mewxemerfs and dal um conversion cakwWon. U3e the space provided or the Commer ft area of Section D or Section G, as appropriate, to document the datum conversion. Daturn NGVD29 CorversioNCom meets NONE Elevation reference mark used COUNTY BM Does the elevation reference mark used appear on the FIRM? ❑ Yes X No ❑ a) Top of bottom floor (including basement or enclosure) 11. 15 t(m) CHARLES W. CARR ❑ b) Top of next higher floor NIA -ft. (m) V) ❑ c) Bokm of lorwest hoizonlal stuchnal member (V zones only) WA. (rn) 26 ❑ d) Attached garage (fop of slab) WA. ~t(m) a FEBRUARY 3, 2005 ❑ e) Lowest elevation of machinery ardor equipment W STATE OF servicing the buvldrng (Desa>be in a Comments area) l1 . 0 R(m) E i FLORIDA PLS NO. ❑ Q Lowest ac~acent (finished) grade (LAG) 9. 2 ft.(m) Z . 1060 ❑ g) H,nest ac~acent (finished) grade (HAG) 1_- -Aft(M) ❑ h) No. of pemnarnernt opedngs (flood vents) v& in 1 ft. above a4acent grade NSA A .J _~&4z 1~9_14 ❑ Q Total area of all permanent openings (flood vents) in C3.h (VAN in. (sq. an) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the Information in Sections A, B, and C on this certificate represents my best efibrts to Interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME CHARLES W. CARR LICENSE NUMBER PLS NO. 1060 TITLE PRESIDENT COMPANY NAME CHARLES W, CARR SURVEYING, LLC. ADDRESS CITY STATE ZIP CODE 9245 S.W. 44TH STREET MIAMI FLORIDA 33165 SIGNATURE DATE TELEPHONE FEBRUARY 3RD 2005 (305) 221-3416 IMPORTANT: In these spaces, copy the corresponding information from Section A For Insurance Company Use: BUILDING STREET ADDRESS (Irdudng Apt., Una, Suite, and►or Bldg. No.) OR P.O. RCUTE AND BOX No. Policy Number 2817 N.W. 168TH TERRACE CITY STATE ZIP CODE Company NAIC Number MIAMI FLORIDA 33t} SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) communk official, (2) insurance agent/company, and (3) bung owner. b ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A WTHOUT BFE) For Zone AO and Zone A (w lout BFE), complete Items E1 Iva* E4. if die Elevation Certillcate Is intended for use as supporting intmnatlon for a LOMA or LOMB-F, Section C must be completed. E1. Buldng Diagram Number _(Select the building diagram most similar b the bteldi ng for whim this cafficabe is being completed -see pages 6 and 7. If no diagam accuately represents the building, provide a sketch or photograph) E2. The trop of the bottom floor (including basement or enclosure) of the building is _ ft(m) _inlc n) ❑ above or ❑ below (check one) the highest adacent grade. (Use natural grade, I avdabfe). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft(m) _in.(an) above the highest adjacent grade. Complete items C3.h and C3.i on front of lam. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the canmunity's floodlplain management ordnance? ❑ Yes ❑ No ❑ Unknown The local official must certif this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property amw or owner's authorized representative who depletes Sections A, B, C (Items C3.h and C3.1 only), and E for Zone A (without a FEMA-issued or communily- issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are cared to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE FLORIDA SIGNATURE DATE TELEPHONE UUMMEN TS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorised by law or odnance to administer ft ca mmurliy's "lain 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. ❑ The infamation 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 stale 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 for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone A0. 03. ❑ The following lnfomnation (Items G4-G9) is provided for oommw* ikx#Wn management purposes. PERMIT ISSUED DATE G7. This permit has been issued for: ❑ New Conslnrctlon ❑ Substantial Improvement G8. Elevation of as-built lowest Boor (including basement) of the building is: -ft(m) Datum: G9. BFE or (n 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 attact rents