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HomeMy WebLinkAbout34-2110-006-3270EDERAL EMERGENCY MANAGEMENT AGENCY C_2d©~ d 4~ Z NATIONAL FLOOD INSURANCE PROGRAM boa ~b~q ELEVATION CERTIFICATE O.M.B. No. 3067-0077 Expires July 31, 2002 aj _ al 10. M((,k 7(J Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAMES _ r 0 -905 BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. mph ='1 2931 . N . W . 165TH ST. .CITY STATE ZIP CODE MIAMI FLORIDA 33054 PROPERTY.DESCRIPTION (Lot and Block Numbers Tax Parcel Number, Legal Description, etc.) LOT 13, BLOCK 29, PB 46, AT PAGE 75 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory..atc. Use Comments section if necessary.) LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: U GPS (Type): ( - - or ##.##M) U NAD 1927 U NAO 1983 U USGS Quad Map U Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 1 120635 (AI`-U V-- DdaDE I MIAMI-DADE I FLORIDA I B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7.' FIRM-PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTNFJREVISED DATE ZONE(S) (Zone AO,. use depth of flooding) 1202500080. J 7/17/95 3/2/94 X N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base-flood depth entered in B9. Lj FIS Profile . IJ,FIRM.. L! Community Determined . U Other (Describe): 1311. Indicate the elevation datum used for the BFE in B9: (X I NGVD.1929 u NAVD,1988 U Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LJ Yes . M No. Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl., Building elevations are based on; . LJConstruction Drawings' LlBuilding Under Construction' M 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, V1430, V (with BFE), AR, ARIA, AR/AE, ARIA1-A30, AR/AH, AR/AO Complete Items. C3a4 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 Elevation reference mark used R lWj MARK Does the elevation reference mark used appear on the FIRM? LX_J Yes LI No ❑ a) Top of bottom floor (including basement or enclosure) ' - 10-.,.35 fL(m) a ❑.b) Top of next higher floor 10.45 ft.(m) o E3 c) Bottom of lowest horizontal structural member (V zones only) N/A R(m) o m ❑ d) Attached garage (top of slab); N/A - f w ❑ e) Lowest elevation of machinery and/or equipment - servicing the building 9: 97 ft .(m) ❑ f) Lowest adjacent grade (LAG): 9. 86 ft.(m) y ❑ g) Highest adjacent grade (HAG) 992 2 fL(m) ❑ h) No. 'of permanent openings (flood vents) within.1f. above adjacent grade N/A ❑ ) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) 5 /8/03 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. I certify that the information in Sections A, B, 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 LICENSE NUMBER eIIVIWII . , / : -..._U V _IA L" "r 5/8/03 (3ATW 1200. FEMA Form 81-31 AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information"from Section A. F"or Insurance cornparryM. BUILDING STREET ADDRESS (Including.Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Tolicy'Number 2931 N.W. 165TH ST. CITY STATE ZIP CODE AIC'Nunjt~er " _ MIAMI . . 31094 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION. (CONTINUED) Copy both-sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS CROWN OF ROAD ELEVATION: 8.92' ON EAST CENTERLINE ON CENTER OF ROAD BM# N-484 LOCATOR41 2132 ELEV. 9.41' I_I Check here if a'ttachmeglts 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 similarto 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 enclosure) of the building is t I 1 ft.(m) I J,_lin.(cm) L) above or U below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings"(see pag o o - e n-b)-of#wbakfing is - I-Ift.(m) LUin.(cm) above the highest adjacent grade. E4. 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? I-I Yes 1 No I_I 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, and E for Zone A (without a FEMA-issued or community4ssued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP-CODE SIGNATURE 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 community's 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. G1. "The information in Section C was taken from other documentation that has been signedand 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. (J A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. - - I" - - - _ , - G3. "The following information (Items G4-G9) is provided for community floodplain-management purposes. G7. This permit has been issued for. L1 New Construction IJ 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 DA COMMENTS I_J Check here if attachments FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS