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Home My WebLink About34-2117-004-2510FEDERAL EMERGENCY MANAGEMENT AGENCY Process No. - NATIONAL FLOOD INSURANCE PROGRAM Folio No. 30-2311.004-25i Q O.M.B. No. 3067-0077 Crown of Road = 9.0r Feet N.G.V.D. ELEVATION CERTIFICATE Expires.- December 31, 2005 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 15610 NW. 38 COURT CITY STATE ZIP CODE MIAMI FL 33054 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A PORTION OF TRACT 57 OF uREVISED PLAT OF VENETIAN GARDENS", PS. 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 r SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION I 81. 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) 12025CO090 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 ED FIRM ❑ Community Determined ❑ Other (Describe): 1311. Indicate the elevation datum used for the BFE in 139: 0 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 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) 10. 10 ft.(m) Li No.S LS 5938 ❑ b) Top of next higher floor N/A . -ft. (m) a to A ❑ c) Bottom of lowest horizontal structural member (V zones only) N/A. ft.(m) ,i ❑ d) Attached garage (top of slab) N/A. _ft.(m) fl ❑ e) Lowest elevation of machinery and/or equipment Stignure. - A . servicing the building (Describe in Comments Area) 9.64 ft. (m) ❑ f) Lowest adjacent grade (LAG) 8.8 ft-(m) z a="~'"~~-Y' y ❑ g) Highest adjacent grade (HAG) 8. 9 ft.(m) Woo ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A (D - ❑ i) Total area of all permanent openings (flood vents) in C3h NIA sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION` i iii ~ ~ This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law t i b certify eMevatiogg n Information. E ~ 9~ 9 `i. I III 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interprIlket; e iba available S Iltl i~ I I I'.I § ~ a'.i III understand that any false statement maybe punishable by fine or imprisonment under 18 U. S. Code, Sec'ian 1 1. CERTIFIER'S NAME: JOSE SENAS LICENSE NUMBER: 5058 u t iii. j JI TITLE: PROFESSIONAL LAND SURVEYOR AND MAPPER COMPANY NAME: SUNSHINE UNITED CONSULTANTSI ,INC. ADDRESS CITY STATE ZIP CODE 7830 NW_ 170TERRACE MIAMI F.( 3301 SIGNATURE O Z~l/ DATE TELEPHONE FFMA Fnrm &I_,11 Tnjmrv 7nl ..,FF RFvFPRF fiinF FOR I-OKITINI IATiON PI I Ar ;',S Al I OR1=1hoi m ;=nr `it7NS ilk ~ it I ~ N jIII, 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 BOAC NO. Policy Number, 9 569 0 NW. 38 COURT 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 El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. El. 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)_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 ordnance? ❑ Yes ❑ No ❑ Unknown. The focal 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 6v 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`. Cor&plete the applicable item(s) and sign below. G1. ❑ The information in Secti.cn C rN s taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or ;Deal law is certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) O2. ❑ A community official compl ted Secs pn E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The folte-wing infortbation (I#emc,,G4 9) is provided for community floodpiain management purposes. ! G4. PERMIT NUMBER r ~55. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY y z ' ISSUED G7. This permit has been ;ssued for ❑ New Construction ❑ Substantial Improvement G8. Elevation oas built lowest door (including basement) of the building is: _ft (m) Datum: ~Fr Zone A0)depth of flooding at the building site is: , ft (m) Datum: G9. BFE or (in A01 LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS _ ❑ Check here if attachments ;=FMA Fnrm R1-R1 .larniarv 7n[1R RFPI A(:Ffi Al 1 PRFVir)l iS FnIT1ONR