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HomeMy WebLinkAbout34-2117-002-0670FEDERAL EMERGENCY MANAGEMENT AGENCY PROCESS# NATIONAL FLOOD INSURANCE PROGRAM FOLIO# 34-2117-002-0870 O.M.B. No. 3067-0077 ELEVATION CERTIFICATE , Expires December 31, 2005 C.O.R. 7.T Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number GISELA AGUILA BUILDING STREET ADDRESS (Including Apt., Unit, Suite; and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 16131 NW 4577 AVENUE CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 4 BLOCK 4 OF "VENETIAN ACRES" PB 44 PG 92 OF DADE COUNTY RECORDS BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NAP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE UNINCORPORATED -120635 MIAMI-DADE FLORIDA B4. MAP AND PANEL B5. SUFFIX B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B6. FIRM INDEX DATE EFFECTIVEIREVISED DATE B8. FLOOD ZONE(S) (Zone A0, use depth of flooding) 12025 C 0080 J 7/17/95 3/2194 X N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile E FIRM ❑ Community Determined ❑ Other (Describe): 1311. Indicate the elevation datum used for the BFE in 69: E 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 E No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* E 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, ARIA, 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 1929 Conversion/Comments NONE Elevation reference mark used N-421 Does the elevation reference mark used appear on the FIRM? ❑ Yes E No o a) Top of bottom floor (including basement or enclosure) HAM ; o b) Top of next higher floor N/A. ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) NIA. ft.(m) y f o o d) Attached garage (top of slab) N/A.E a 7 o e) Lowest elevation of machinery and/or equipment w f° servicing the building (Describe in a Comments area) 8_5 ft.(m) E o f) Lowest adjacent (finished) grade (LAG) 7_8 ft.(m) z o g) Highest adjacent (finished) grade (HAG) 8.0 ft.(m) C s o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A *<5~ 0 o i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 5 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 certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIERS NAME : PABLO J. ALFONSO LICENSE NUMBER: #5880 TITLE PROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME ROYAL POINT LAND SURVEYORS ADDRESS 41 ? CITY STATE ZIP CODE 6175 NW 153, ST I 1 7 MIAMI FL 33014 SIGNATUf E DATE TELEPHONE 7/15/04 T: 305-822-6062 F: 305-827-9669 ( IJI ZW4 FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS