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Home My WebLink About34-2114-012-0070, dupeERMNIIANII•-DADS PROCESS FINAL-EC Rev. JAN 01 2000 jam' 1' Jf-I / - 12 --OL9'W a ` • BUILDING OWNER'S NAME _ FEDERAL. EMERGENCY MANAGEMENT' AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE q )n ~~~q r 1 lX Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION O.M:B. No. 3067-0077 Expires July 31, 2002 -4--clod by Miami-aaae C"nty-0Mm Oct Igoe For insurance Company lase: Policy Number BUILDING STREET ADDRESS (including Apt., Unit, Suite; and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 1020 N. W. 155TH LANE BUILDING 2 CITY STATE ZIP CODE MIAMI FL 33168 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal. Description, etc.) TRACT 5 GOLDEN LAKES 96-35 BUILDING USE (e.g., Residential, Non-residentiai, Addition, Accessory, etc. Use Comments. section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):. ( - VP - or ##.###W ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1,UNNFIP COMMUNITY IN UNINCORPORATED NAME & COMMUNITY NUMBER ~ B2. MCOUN NAME IAMI DARE I 83. STATE FL " (Z- J B4. MAP AND PANEL 85. SUFFIX B8. FIRM INDEX B7. FIRM PANEL `B LOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REViSED DATE ZU E(S) (Zone AO, use depth of flooding) 12025C 0090 J 7-17-95 3-2-94 AE 7 ...810. Indicate the source of the Base Flood Elevation (B-FE data or base-flood de th e n B9. ❑ FIS Profile LA] FIRM 0 Community Determined ( ibe): B11. Indicate the elevation datum used for the BFE in 89: [M NGVD 192 + ❑ NA 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS a or erwise 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* 91 Finished Construction *A new Elevation Certificate will be required when construction o e uildlrig is complete. C2. Building Diagram Number- 1 (Select the building diag st. s iiar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the. 'ng, provide a sketch or photograph.) C3. Elevations - Zones AI-A30, AE, AH, A (with BFE), -V3a (with BFI=, AR, ARIA, AR/AE, AR/AI-A30, AR/AH, AR/AO Complete Items C3a-i below according to the build' dia i~ specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, cony, the tum that used for the BFE. Show field measurements-and datum conversion calculation. Use the space provided or theCo.~ ~ mer s area of Section D or Section G, as appropriate, to document the datum conversion. NGVD COUNTY BENCH MARK SYSTEM Datum Conversion/Comments . eve ion reference marls used appear on the FIRM? ❑ Yes Elevation reference mark used NSA Does } a) Top of bottom floor (includin in, t 'closure) 7 85 bj Top of next higher floor 16 47 N [A ft .(m) c 0 c) Bottom of lowest horizontal stru to[ member (V zones only) it(m) m U d) Attached garage (top of slab) at Ga[ age Door (Mia-Dade) N/A ft.(m) m 00 * 9 e) Lowest elevation of machinery and/or equipment servicing the building 7 . 89 It fl Lowest adjacent grade (LAG) 7 .0 ft.{ r) g) Highest adjacent grade (HAG) 7 . 3 ft.( r) e R h)Total area of all permanent openings (flood vents) in C3h sq. in. (sq. cm) „.2 Cl i) No. of Permanent-openings (flood vents) within 1 ft. above adjacent grade 5f D Highest crown of road (Mia-Dade) 6.58 , ft.( KI No W56 APRIL J0 , „2000 e" 1I a~'' Aii ROBERT C hiULDfR 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 cerffcate represents my best efforts to interpret the data available. i understand that an false statement may be punishable by fine or imprisonment under 18 U.S. Cade, Section 1009. CERTIFIER'S NAME LICENSE 756 NUMBER ROBERT C. MULDER, P.L.S. TITLE COMPANY NAME ASSISTANT VICE PRESIDENT SCHWEBKE-SHISKIN & ASSOCIATES, ADDRESS CITY STATE ZIP CODE 3240 CORPORATE WAY MIRAMAR FL 33025 SIGNATURE DATE APRIL 19, 2000 TELEPHONE 305-652-701 IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use.: BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number h, CITY STATE ZIP CODE Company NAIL Number 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 REFER ORDER NO. 181476 e) AC SLAB ❑ 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 informatlon 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 (ncluding basement or enclosure) of the building is ft. (m) „,„i . above or ❑ below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated o . e a ion b) of the building is fL(m) ~in.(cm) above the highest adjacent grade. ~s E4. For Zone AO only: if no flood depth number is available, is the top of the bottom floor;„el a ed in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. -The local offs al , s certify this information. in Section G. SECTION F - PROPERTY OWNER (OR OWNER'SSET►TiVE) CERTIFICATION . The property owner or owner's authorized representative who completes coons A, and E for Zone A (without a FEMA issued or community-issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE : r DXV TELEPHONE t COMMENTS` ❑ Check here if attachments SECTION G -,COMWI WITY INFORMATION (OPTIONAL) the local official who is authorized bylaw or ordinance adn1thister the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation if o N :.Complete the applicable item(s) and sign below. 31. The information in Section C was taken r',o,'rh.; ter'documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authori d M., taor local law to certify elevation information. (Indicate the source and date of the r . m'~~:elevation ta in the Comments m 32. ❑ A community official completed Section. E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or -Zone AO. 33. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED 37. Tfiis permit has been issued for: ❑ New Construction ❑ Substantial Improvement tion of as-built lowest floor (including basement) of the building is: Datum: .~8. Eleva, , a . • 39. BFE or (in"Zone AOj 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 =EMA Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS