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Home My WebLink About34-2109-008-0021FOLIO# 34-2109-008-0021 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 ell r NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE 05-1363 ~ Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number DONREY SENIOR BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 3061 NW 170TH STREET CITY STATE ZIP CODE CAROL CITY FL 33056 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 139 14 & 15, BLOCK 1, "GOLDEN GLADES PARK", PB 39, PG 46, MIAMI DADE COUNTY BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( or W ❑ NAD 1927 ❑ .NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE UNINCORPORATED - MAP AND PANEL 134 B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) . NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEIREVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of flooding) 1202500080 J 07-17-1995 03-02-1994 X N/A 1310. Indicate the source of the Base Flood Elevation (BFE) data or base tlooa aeptn enterea in MI. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11 • Indicate the elevation datum used for the BFE in 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number I (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, V1-V30, V (with BFE), AR, ARIA, 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 NGRor~vr tot/Comments NONE Elevation reference mark used SEE "D" Does the elevation reference mark used ap ear on the FIRM? ❑ Yes ®No o a) Top of bottom floor (including basement or enclosure) 1 1 ft.(m) •(m) o b) Top of next higher floor o c) Bottom of lowest horizontal structural member (V zones only) ft•(m) N o 00 o d) Attached garage (top of slab) N -Yft.(m) w c o e) Lowest elevation of machinery and/or equipment servicing the building Describe in a Comments area 9 , 4 ft m 2173 o f) Lowest adjacent (finished) grade (LAG) 9 5 ft•(m) z T (D o g) Highest adjacent (finished) grade (HAG) 10. 0 urn) i 27' , 20b o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 o i) Total area of all permanent openings (flood vents) in C3.h -RZAsq• in. (sq. cm) i~ ; Ili; ~II _ I SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION r _I t all Iil~l;' J hl._ -I This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation i 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data availat I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME LOUIE P. JOHNSTON ` LICENSE NUMBER i 21173 ! III TITLE PROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME PROFESSIONAL SURVEYORS, INC. ADDRESS CITY STATE ZIP CODE 7744 TAFT STREE PEMBROKE PINES FL 33024 SIGNATURE DATE TELEPHONE 06-27-2005 (954) 962-933. 1 I (IP I I V FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces!,all previous editions fl Quill I ~h. 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