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Home My WebLink About34-2115-003-0620- L/~~~~ a 15-- oSo ` FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 C.O.R. 10.581 ELEVATION CERTIFICATE Z0a 0- a0+f * Important: Read the instructions on pages 1 - 7. SLjRvsy No. 02-1738 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME I Policy Number CHARLES L. RICHARDSON III & DIANE RICHARDSON 161306 STREET A DVE SS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO, Company NAIC Number NW 26 CITY STATE ZIP CODE MIAMI F' ,0RIDA 33054 P EbLI LY DESCRIPTION (Lot and Block Numbers Ta ParcelPA Nu BLOCK 1, BUNCHE PARK, ~ B 0 a5egal Description, etc.) , BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_1 GPS (Type): ( ' or 1_.1 NAD 1927 1-1 NAD 1983 1_,•1 USGS Quad Map 1_1 Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME 63. STATE UNINCORPORATED 120635 DADE F?ARIDA l B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 1202500080 J 07-17-95 3-2-94 X n/a B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_1 FIS Profile 1X1 FIRM 1_1 Community Determined 1_1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: IXI NGVD 1929 1_1 NAVD 1988 1_„_1 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1._1 Yes 11 No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1`1Construction Drawings* 1_113uilding Under Construction* 1.X_1Finished 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 X Complete Items C3a-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 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM?. 1_1 Yes 1-1 N(l Q a) Top of bottom floor (including basement or enclosure) 12 .35 ft. (m) ❑ b) Top of next higher floor n / ft. m1 I + p O c) Bottom of lowest horizontal structural member (V zones only) n,/a ft.(m) ❑ d) Attached garage (top of slab) n/c2 ft.(m) w O e) Lowest elevation of machinery and/or equipment servicing the building 11 70 ft.(m) ❑ 0 Lowest adjacent grade (LAG) 11.20 ft.(m) z' r N ❑ g) Highest adjacent grade (HAG) ft.(m) N ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade n/a Q i) Total area of all permanent openings (flood vents) in C3h n/a sq. in. (sq. cm) ' 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 an false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 9009. CER IFIER'S NA B LICE NNUMBER A' 5-10-2002 `(~nr'l-44-7692 FEMA or -31, AUG 99 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, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number CITY STATE ZIP CODE Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVcompany, and (3) building owner. COMMENTS 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 E 1 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) of the building is 1_1.-.-.1 ft.(m) 1-.-.-1._._1in.(cm) 1---..1 above or 1_1 below (check one) the highest adjacent grade. E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1_1_1 ft.(m) 1_1_lin.(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? 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, 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 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. 1^1 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 local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2, i^1 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. 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 G7. This permit has been issued for: 1_J New Construction l~l 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 DATE COMMENTS Check here if attachments FEMA Form-81-31, AUG 99 . REPLACES ALL PREVIOUS EDITIONS