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Home My WebLink About34-2117-004-1011Process No. C ZOO o Z o 'Z'S°i t 6 FEDERAL EMERGENCY MANAGEMENT AGENCY Folio No. 30-2117-004-1011 NATIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 3067-0077 Crown of Road = 7.83 Feet N.G.V.D. ELEVATION CERTIFICATE Expires: December 31, 2005 2002 - 060915 Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number REBUILDING OUR COMMUNITY, INC. BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PORTION OF TRACT 11, "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 d necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( W-##'-##.##" or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: N_A N/A 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 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 7-17-95 3-2-94 "X" N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): 811. Indicate the elevation datum used for the BFE in B9: ® 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construc tion* EJ 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 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 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. 47 ft(m) m ❑ b) Tap of next higher floor N/A. ft(m) U) ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. ❑ d) Attached garage (top of slab) NIA. _ft.(m) E ❑ e) Lowest elevation of machinery and/or equipment w servicing the building (Describe in Comments Area) 9.27 fL(m) ❑ f) Lowest adjacent grade (LAG) z ❑ g) Highest adjacent grade (HAG) 8. 7A(m) ❑ h) No. of permanent openings (flood vents) within 1 It above adjacent grade NIA J ❑ 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, 8, 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. 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 7830 NW- 174"TERRAGE MIAMI FL 33015 SIGNATURE Z--~,7 DATE TFI FPHONF FFMA Fnnn R1, Annimm 7nn3 SFF RFVFRSF ftlnF Ff)n rnNTINI IATInN RFPI Ar:FR Al I PRFVInl IS FnITInN.R IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suae, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Policy Number 16085 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 (1; 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 E 1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMB-F, Secfion C must be conWileted. 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 71;, 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)_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 owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA4ssued or community4ssued 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 whc is authorizedby:aw 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. ❑ The information in Section C was ta`cen from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by date or lir, uia to Certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A tomninnky-+W.4at'oompk4kr'-,wtion E for a building located in Zone A (without a FEMA4ssued or community-issued BFE ) or Zone AO. G3. ❑ The following infor~tlon (ti4rri3 C4-0 8) is provided for community floodplain management purposes. G4. PER vtiU BicR 65. DATE PERMIT ISSUED I G6. DATE CERTIFICATE OF COMPLIANCUoccurANUY ISSUED G7. This permit has.bgea issued for. [].New Construction ❑ Substantial Improvement G6. Elevation of as-bubltlovrest floor (including basement) of the building is: H.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the budding site is: _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachments FFNIA Fnrm R1-A1 .laniianr 7WA RFPI Ar.F-O AI I PRFVint IC FnITIr1NR