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Home My WebLink About34-2115-005-0040PROCESS # FEDERAL EMERGENCY MANAGEMENT AGENCY FOLIO # 1e,I l.~ ; r NATIONAL FLOOD INSURANCE PROGRAM Vo C.O.R. 10.42 feet, NGVD ELEVATION CERTIFICATE Important: Read the Instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME Ines Moore BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 1925 NW 155th Street O.M.B. No. 3067-0077 Expires July 31, 2002 Amended b MDC-DERM-OCT. 1999 For Insurance Company Use: Policy Number Company NAIC Number CITY STATE ZIP CODE Miami Florida PROPERTY DESCRIPTION (Lot and lock Numbers, Tax Parcel Number, Legal Description, etc.) Lot 4 less N 10', Block 1, PB 44-16 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: L_I GPS (Type): ( - - or L_J NAD 1927 LJ NAD 1983 L_J USGS Quad Map LJ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE Unincorporated Area 120635 Miami-Dade County FL 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) 12025C 0090 J July 17,1995 March 2, 1994 AE 6.00' 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. L_J FIS Profile FIRM L_J Community Determined Ll Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: RIJ NGVD 1929 JJ NAVD 1988 LJ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LI Yes JAI No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LJConstruction Drawings* "Building Under Construction* nFinished 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-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO 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 calculatiN~ I929 pace provided or the Comments area of Section D 'or Section G, as appropriate, to document the datum conversion. Datum Conversion/Comments N/A Elevation reference mark used B-65-2 Does the elevation reference mark used appear on, the FIRM? Li Yes KJNo 0 a) Top of bottom floor (including basement or enclosure) 11. A-1 ft.(m) 0 b) Top of next higher floor N/A ft.(m) C) c) Bottom of lowest horizontal structural member (V zones only) N/A ft.(m) r ~ - :f- O d) Attached garage (top of slab) N/A ft.(m) 0 e) Lowest elevation of machinery and/or equipment An. servicing the building 11. 45 ft T .(M) Ea ~ J 0 t) Lowest adjacent grade (LAG) 10. 70 ft.(m) 23 A? 0 g) Highest adjacent grade (HAG) 11. 00 ft.(m) 2 ca 0 h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade None ; 0 i Total area of all permanent openings flood vents in C3h N/A sq. in. cm Ls g3os6 2. 3 O 1 - - - - SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATIONS This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to cert y elevation information. I certify that the information in Sections A, B, and C on this cerdflcate represents my best efforts to interpret tt~e. &a available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Secb~on,w9001.;M I j i CERTIFIER'S NAME LICENSE NUMBER Jose F. Lopez 3086 TIT' nd Surveyor Mapper JCOVPAylypfE& ASSOCIATES, INC. ADDRESS CITY STATE ZIP CODE 555 E. 25th Street Suite 212 Hialeah FL SIGNATURE D TELEPHONEI I ICI' ~II~ 3 II ;t! December ~ , 2001 (305 3~-1... 22 . ~[i i FEMA FoJ- '6 1-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL k8V bUS E01TIONS N c, ill I 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 1925 NW 155th Street CITY STATE ZIP CODE Company NAIC Number Miami Florida 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 Highest crown of-road elevation fronting J?roFerty: 10.42 Ft_. N_G_V_D_ 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 LOMB-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 J-J-J ft-(m) J_J_Jin.(cm) J-J above or U 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 I_I_J ft-(m) J_J_Jin.(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? 1_1 Yes J_J No J_J 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)111 and -G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. J_J The information in S ction C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, br architect w-ho is authorized by state or local law to certify elevation information. (Indicate the source and date of the selevation data in the Co!Yients area below.) p G2. ~-J co AO. eted Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or community official Cot Zone G3 JL.J The fol"16-wrng'rnforrriatior? ~ (Items G4-G9) is provided for community floodplain management purposes. G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY G4. PERMIT'' NUMBER' ISSUED G7 This permit has been issued for: J_J New Construction LJ Substantial Improvement G8 Elevat ~ floor ilt lowest (including basement) of the building is: ft.(m) Datum: ion oa,, bu in done ~a of flooding the building site J ft. (m) Datum: G9B' F~ or( O) depth g at g k f LOCAL OFFICIAL'S NAME TITLE - - : TELEPHONE COMMUNITY NAME SIGNATURE DATE COMMENTS j, J_J Check here if attachments _ h FEMA Form 81-31, AUG 99 REPLACES ALL PREVIOUS EDITIONS