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Home My WebLink About34-2117-004-0910FEDERAL EMERGENCY MANAGEMENT AGENCY Process®--~~ NATIONAL FLOOD INSURANCE PROGRAM . Folio No. 334-2117-004-099. O.M.B. No. 3067-0077 Chown bf Road 8.24" Feet N b/t`.D. ELEVATION CERTIFICATE Expires: December 31, 2005 Important: Read the instructions on pages 1 - 7.~ /Z SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use, BUILDING OWNER'S NAME Policy Number M & M DEVELOPERS, INC. BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 16295 NW. 41 AVENUE CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) THE NORTH 320' OF THE WEST Y 20F TRACT 10, "REVISED PLAT OF VENETIAN GARDENS", PB. 31-37, MIAMI-DADE COUNTY RECORDS. BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( - - or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: N.A N/A - n - - IrYYYYYYr ■ YYIYSrYYrrY0~1Y1 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE 120635 (UNINCORPORATED AREAS) Miami-Dade Fl. B4. MAP AND PANEL B5. SUFFIX 66. 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 7-17-95 3-2-94 "X" N/A 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile [D FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: Z 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 ®No Designation Date: N/A Y n1Y ■ Yr~YYYrY~~~YY~YY~Yn~r w~YrrrrMr.nr lrr~Y.YrrrriY~riaYY r~~ Yrr ■ ■m 1~~n®1 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) r~YIY~Y rnYl ■ - - rYnl~l Y11rIr ~IrYYYrYYYrns 101/IYIrrUM\IYn YIYY~10•IYn1OYYYlYYIYIY~YpY~IY C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* 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, 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 8, 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 29. Conversion/Comments N/A Elevation reference mark used 7.52' Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ❑ a) Top of bottom floor (including basement or enclosure) 9.24 ft.(m) 2 License No. LS 5938 ❑ b) Top of next higher floor N/A. #t.(m) V) Dafo:.. .11 - • . ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. _,_ft.(m) g o ❑ d) Attached garage (top of slab) N/A. _ft.(m) a ❑ e Lowest elevation of machinery and/or - ry equipment m Sina ur ~ w W y n servicing the building (Describe in Comments Area) 8. 97 ft. (m) ❑ f) Lowest adjacent grade (LAG) 8 . 2A(m) ❑ g) Highest adjacent grade (HAG) 8. 4 ft.(m) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade NIA ❑ 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 bylaw to-'certiy elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret th`e Fdafa available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER: 5938 TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CONSULTANTS, INC. ADDRESS CITY STATE ZIP CODE SIGNATURE DA' FFMA Fnrrn/S 1 Al Agnimrv 9M.'A SFF RF%IFR..RF RMF FOR r:{' XITIM-1 IATIC' N RFP1 Ar.1I Al i PRII ItII m FnMr TELEPHONE IMPORTANT: In these spaces, copy the'corresponding information from Section A. For instil raco Cornpanyt~se: BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 16295 NW. 41 AVENUE CITY STATE ZIP CODE Company NAIC Number MIAMI FL 33054 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (9) community official, (2) insurance agent/company, 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 E1 through E4. Of the Elevation Certificate is intended for use as suppor#ing 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 _ ft.(m) _in.(cm) ❑ 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 floor (elevation b) of the building is ft.(m) _ in.(cm) above the highest adjacent grade. E4. The top of the platform of machinery and/or equipment servicing the building is _ft.(m)__jn.(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 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. lZ LA 1`131 o v L f A-S PROPE RTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME~t gaoa 91A-A41 3:3 0 ADDRESS CITY STATE ZIP CODE ~ 2 86 -546 --0 SIGNATU ATE TELEPHONE COMMENTS Check here if attachments SECTION G'- COMMUNITY INFORMATION (OPTIONAL) he 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 hem 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 architect who is authorized by state or local laen to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official competed ~ec9on E for a building located in Zone A (without a FEMA-Issued or community-issued BFE) or Zone AO. G3. ❑ The followin inforr cation (items G4=-v9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED ~7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement <.;8. 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 rFMA Fnrm A1_11 Annimrv 9M.l RFPI Ar.F. Al I PRFX/101 IR FnITInNA