The URL can be used to link to this page

Home My WebLink About34-2115-001-36901 3`t l°~ FEDERAL NATIONAL FLOOD INSURANCE PROGRAM Expires CY B.December No. 077 31, 2005 ELEVATION CERTIFICATE f (p r~ 7 Important: Readlthe instructions on pages 1- 7. 2 SECTION A - PROPERTY OWNER INFORMATION For Insurance C Tany Use: IR'S NAME '\RD Company NAIC Number m= TADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 15800 NW 17 PLACE 7~j ZIP CODE CITY STATE OPALOCKA FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Nu ber, Legal Description, etc.) BUILDING USE (e.g., Residential, Non-residential, Addition, Accessor)r, etc. Use a Comments area, 'rf necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 63. STATE B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME FLORIDA 120635 -UNINCORPORATED AREA DAIDE B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE I EFFETIVEIREVISED DATE B8. FLOOD ZONE(S) (Zone A0, use6depth of tloodbg) 1202500090 J 7/17/95 03102~t B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 I ❑ 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 EL ATION 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 buiJing is complete. C2. Building Diagram Number 1(Select the building diagram most similar to the building for which this certificate is being completed - see panes 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) l C3. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, VI 430, V (with bFE), AR, ARIA, ARIAE, AR/A1-A30, ARIAH, ARIAO Complete 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 NIA Elevation reference mark used COUNTY B.M Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (including basement or enclosure) 8 . 45 ft.(m) o b) Top of next higher floor o c) Bottom of lowest horizontal structural member (V zones only) N A f t.(m) N L- 0-0) W d) 00 o d) Attached garage (top of slab) N . A ft.(m) .0 o e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) 8 . 15 ft.(m) 2 :3 C o f) Lowest adjacent (finished) grade (LAG) 7.90 ft.(m) Z m o g) Highest adjacent (finished) grade (HAG) 8 05 ft.(m) h hi of rmanent openings (flood vents) within 1 ft. above adjacent grade N/A o ) W. pe o i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) SECTION D - SURVEYO , 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. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME NOE AGUILAR LICENSE NUMBER 5571 TITLE P.S.M COMPANY NAME CARIBBEAN INSPECTIONS AND SURVEYING 7911 NW 72 SIGNATURE CITY MEDLEY DATE 5/25/05 STATE ZIP CODE FL 33166 TELEPHONE (305)889-1100(239)549-5911 FEMA Form 81-31, Jan6ary 2003 See reverse side for continuation. Replaces all previous editions A IMPORTANT: In these spaces, copy the corresponding informatin from Section A. Fortnsurance CanpanyUse- BUILDING STREET ADDRESS (Indudirg Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number . 15e A NW 17 PLACE CITY STATE 7JP CODE Company NAIL Number OPA LOCAA FL 33054 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 CROWM OF ROAD 6.46 IN FRONT OF 15800 NW 17 PLACE O RA LOCAA, FL 33054 ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (S RVEY 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 EI vation 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 dagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) 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 _ ft.(m) _in.(crn) 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 ~s _ 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 owners authorized representative who completes Sections A, B, C (Items C3.h and C3.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 correct 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 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 ordnance 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 signed and embossed by a licensed surveyor, engineer, or architectwho is authorized by state or local law to certify elevation information. (indicate the source and date of the elevation data in the Comments area buow.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA4ssued or communityassued BFE) or Zone A0. G3. ❑ The following information (items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER ISSUED G6. DATE ISSUED G7. This permit has been issued for. ❑ New Construction ❑ 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 TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMEN7S ❑ Check here if attachments FEMA Form 81-31, January 2003 Replaces all previous editions I