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Home My WebLink About34-2110-003-0050FEDERAL EMERGENCY MANAGEMENT AGENCY 0. B. No. 3067-0077 C q 003 7+1.3+ NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE Z CJ 2 , C~ s Important: Read the instructions on pa es 1.7. SECTION A- PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING STREET ADDRESS (Inducing Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number' 17708 NW 22° Ave. CITY STATE ZIP CODE Miami FL 33056 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 5, less the W 100', and less the E. 10' there of, of RADIO GARDENS, according to PB 8-97 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, d 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 B2. COUNTY NAME B3. STATE Unmoorpomted Areas 120635 MiamiAade County FL B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVEREVISED DATE B8.FLOODZONE(S) (Zone A0, use depth of flooding) 12025C 0180 J 7/17195 OA294 AE 70' B10, Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 89: ® 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 0 No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ ConsWction Drawings' ❑ 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 At A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3: ai 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 EI tt' mark used N'65D the a at reference mark used tit FIRM? ❑ Y ® N eva on re erence u oes a ev on rence ma u appear on a es o o a) Top of bottom floor (including basement or enclosure) Woft(m) o b) Top of next higher floor N/A. Ito) ti 0 o c) Bottom of lowest horizontal structural member (V zones only) N/A. _ft.(m) 0 o d) Attached garage (top of slab) 7. 90 ft.(m) E g o o of Lowest elevation of machinery and/or equipment u, servicing the building (Describe in a Comments area) 801m) m) E m o 0Lowest adjacent (finished)grade (LAG) 7.30fl.(m) z' m o g) Highest adjacent (finished) grade (HAG) 7.6l~fl.(m) ` n h) No. of permanent openings (flood vents) within 1 ft. above adj acent grade NONE v Total of all t ni flood v t) in C3 h N/A in ( an) f N O i) area of permanen ape rigs ( ens _sq. sq. 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, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement maybe punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME Jose F. Lopez LICENSE NUMBER 3086 TITLE LAND SURVEYOR & MAPPER COMPANY NAME J. F. LOPEZ & ASSOCIATES, INC. ADDRESS CITY STATE ZIP CODE 7900 NW 155th Street, Suite 104 Miami Lakes, FL 33016 09/25/06 305 828-2725 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, anrllor Bldg. No.) OR P.O. ROUTE AND BOX NO. Poky Number 17708 NW 22ND AVE. CITY STATE ZIP CODE Company NAG Number Miami FL 33056 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVoompany, and (3) building owner. HIGHEST CROWN OF ROAD ELEVATION IN FRONT OF PROPERTY IS 69T N.G.V.D. _ U 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. EL 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 (inducing basement or enclosure) of the building is _ III _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 _ ft.(m) _in.(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 _ ft.(m) _n(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? ❑ 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 owners authorized representative who compleles Sections A, B, C (Items C3.h and C3.i only), and E for Zane A (without a FEMA-issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, G and E are coned to the best ofmy knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ZIP CODE SIGNATURE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The locai offdal who is authorized by law or ordinance to administer the communitys floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. GL ❑ 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 laal 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 communityissued BFE) or Zone A0. G3.El The following inf^m- (ion(ItemsG4G9)isprovidedforcommunity floodpain management purposes. DATE PERMIT ISSUED G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8 Elevation of as-built lowest floor (inducting basement) of the building is: (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 COMMENTS Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions