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HomeMy WebLinkAbout34-2109-008-01851 ~2 406 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM L f- -'--I - I'1 ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires December 31, 2005 Important: Read the instructions on pages 1.7. / 1 oq - © 012) - 0 1 5 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 3149 NW 168TH TERRACE CITY STATE ZIP CODE MIAMI FLORIDA 33056 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 15 & 16 BLOCK 3 OF " GOLDEN GLADES PARK" PLAT BOOK 39 PAGE 46 BUILUING USt (e.g., Kesidentlal, Non-residential, Addition, Accessory, etc. Use a Comments area, it necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - #7f.#ft" or ##.fff##it✓°) ❑ NAD 1927 ❑ NAD 1983 ❑ LEGS Quad Map ❑ other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE UNINCORPORATED AREAS 120635 MIAMI-DADE COUNTY FLORIDA &1. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEIREVISED DATE B8. FLOOD ZONE(S) (Zane AO,use depth of flooding) 1202500080 J 07/17/95 03102/94 X N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the buildina located in a Coastal Barrier Resources Svstem (CBRS) area or Otherwise Protected Area (OPAR ❑ Yes ® No Desiqnafion Date SECTION C - BUILDING ELEVATION C1. Building elevations are based on: ❑ Construction Dravings' ❑ Building Under Construction' ® Finished 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, V1-V30, V (with BFE), AR, ARIA, ARIAE, AR/A1-A30, ARIAH, AR/AD Compete 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 Conversion/Comments N-445 ELEV. 8.36' Elevation reference mark used BM Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ❑ a) Top of bottom floor (including basement or enclosure) 10.7 ft.(m) ❑ b) Top of next higherfloor NIA ft.(m) ❑ c) Bottom of lowest horizontal structural member (V zones only) WA H.(m) cc ❑ d) Attached garage (top of slab) WA ft.(m) E g ❑ e) Lowest elevation of machinery and/or equipment w d servicing the building (Describe in a Comments area) 10_14 ft.(m) E ❑ f) Lowest adjacent (finished) grade (LAG) TO-1-ft .(m) Z in ❑ g) Highest adjaoent(finished)grade (HAG) 10.7ft.(m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade WA ❑ i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, 8, and C on this certificate represents my best efforts 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 OSCAR EMILIO BAEZ-CUSIDO, P.S.M. LICENSE NUMBER 5034 TITLE REGISTERED SURVEYOR AND MAPPER COMPANY NAME BAEZ & ASSOCIATES, INC. ADDRESS CITY STATE ZIPCODE 2000 SW 83~ CT. MIAMI FL 33155 SIGNAI UHL /~j(/~. UAIt ItLtYtIUIVt Ak 04/27/06 305-265-1002 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 Co mpany Use: BUILDING STREETADDRESS (Inducing Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number TERREACE CITY STATE ZIP CODE I Company NAIC Number MIAMI FLORIDA 33056 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community otfidal, (2) insurance agent/company, and (3) building owner. CROWN OF ROAD ELEVATION = 9.17' ❑ 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 E4. 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 endosure) of the building is _ 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 (seepage 7), the next higher floor or elevated floor (elevation b) of the building is _ fI _m(an) 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 _ ft.(m) _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 cemmunirys floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. 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 communily- issued BFE) or Zone AO must sign here. The statements m Sections A, B, C, and E are correct to the hest ofmy knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE DATE TELEPHONE COMMENTS Check here If attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the commudys floodplain management ordinance can compete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable Hem(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 for a building located in Zone A (without a FEMA4ssued or communityissued BFE) or Zone A0. G3. ❑ The following information (Items G4-G9) is provided for community floodpam management purposes. G4. PERMIT NUMBER G7. This permit has been issued for: ❑ New Construclion ❑ Substantial Improvement G8. Elevation of as-built lowest floor (including basement) of the building is: _ft.(m) Datum: G9. BFE or (in 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 attachments FEMA Form 81 -31, January 2003 Replaces all previous editions