Loading...
HomeMy WebLinkAbout34-2112-041-0140PROCESS NO. C odd 09 I•tUll tMtKtatNVY MANAUtMtNI AUhNLY O.M.B. No. 3067-0077 FOLIO NO. NATIONAL FLOOD INSURANCE PROGRAM 3v2 I t ~ ! ©140 Expires December 31, 200 c. o. R. 9.83' ELEVATION CERTIFICATE Important: Read the instructions on pages 1.7. SECTION A - PROPERTY OWNER INFORMATION Forlr►suroe Corrapany Use: BUILDING OWNER'S NAME Policy Number D. K. Development I11, 1 nc. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 304 NW 179th Street - CITY STATE ZIP CODE Miami, FL I'KUll I Y UtSCKII' I ION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lots 76, Block 1 of "CLOVERLEAF GARDENS DUPLEXES", P.B. 157-39 bUILUINU U5t (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - All - ##.#E#" or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 62. COUNTY NAME B3. STATE Unincorporated Miami-Dade County 120635 Miami-0ade County FL B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTWAEVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of flooding) 12025C 0080 J 7117/95 03/02/94 X _ L) . v. luIL-OW a IV oUl l u IC oabt:;rwUU C:icVdUU[ kDr-M) uala Ul UdW IIUUU UUpin en[erea In MI. - ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 69: ® 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 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 430, V (with BFE), AR, AR/A, AR/AE, AR/A1 A30, AR/AH, AR/AO Complete Items C3.-a4 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 tievation reterence mark used V Uoes the elevation reterence mark used appear on the FIRM? LJ Yes N No E - w.r o a) Top of bottom floor (including basement or enclosure) 10. 73 ft.(m) r o b) Top of next higher floor N/A. _ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) WA . o o o d) Attached garage (top of slab) N/A. _t(m) LU o e) Lowest elevation of machinery and/or equipment . servicing the building (Describe in a Comments area) 10.73 ft.(m) - C5 a ai ~E ~ 7 C o f) Lowest adjacent (finished) grade (LAG) 9.PLO) Z.0 .I , y I 53H o g) Highest adjacent (finished) grade (HAG) 9. 90 ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade WA lS 0 ~f3A6 o i) Total area of all permanent openings (flood vents) in C3.h WA sq. in. (sq. cm) _ I III Ills K w iI SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ,r III I This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation~info atlo', ~ , ( I t. ; I I 1 1 I it I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data avaAple. r I i li ,I 4 1 7' I understand that an false statement maybe punishable b fine or imprisonment under 18 U. S. Code, Section 1001. =il CERTIFIERS NAME JOSE F. LOPEZ LICENSE NUMBER M6 ' I TITLE LAND SURVEYOR & MAPPER COMPANY NAME J. F. LOPEZ & ASSOCIATES, ING: Ir 3II i i ' muumcao 7900 NW 155TH STREET, SUITE 104 SIGNATURE / kal I T MIAMI LAKES DATE 05/15/03 Fhic _'33016 TELEPHONE I II I 305) 828-272 iI ( I4 ?f ie I IIY!'e.~~!I ~.I I I I I.. FEMA Form 81-31, January 2003 See reverse side for continuation. Replaced all previous edition's' IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company User BUILDING STREET ADDRESS (Induding Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX No. Poicy Number 304 NW 179TH STREET CITY STATE ZIP CODE lc nb y NAIL Number MIAMI FL SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. COMMENTS HIGHEST CROWN OF ROAD ELEVATION IN FRONT OF PROPERTY: 9.83 FEET, NGVD ❑ 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 enclosure) ofthe 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 _ 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) _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 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 owner's authorized representative who completes Sections A, B, C (Items C3.h and 03.i only), and E for Zone A (without a FEMA4ssued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are confect to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS f -r ❑ Check here if attachments F SECTION G - COMMUNITY INFORMATION (OPTIONAL) The ►ocal cif fic al w'ho is authorized by few or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate C&bpletc-e applicable item?i) and sign below. G1. ❑ T6ie info~7nattpn in Section d was ta4en from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state br iocal lbw till2"certify elevation mfennatlon. (Indicate the source and date of the elevation data in the Comments area below.) G2. ; f A cor Vnuil offiaa) completed Coon E for a building located in Zone A (without a FEMA~issued or community4ssued BFE) or Zone A0. G3 ❑ The foltovnny information (Items C4-G9) is provided for community floodplain management purposes. s ~ . ..i 549145 JNr .d4^ tp I~, 1'A , G4. PERMIT NUMBER w G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit liar 11 been issELu i ~~~~~i New Construction ❑ Substantial Improvement ed fo lti~, ilk G8. Elevation of as-built lowest t oor (including basement) of the building is: Datum: ( ) p the building site is: ft.(m) Datum: G9. BFE or in Zone AO de thl of~flooding at LOCAL OFFIC1C AL'S NAME TITLE COMMUNITY NAME _,TELEPHONE f