HomeMy WebLinkAboutEC 117 NW 6 Ave P.N.3541-00 �(9 0 a '6/
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FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31,2002
ELEVATION CERTIFICATE
Important. Read the instructions on pages 1 -7.
SECTION A-PROPERTY OWNER INFORMATION For W.issnce Company We:
BUILDIN 04i . -J O JCS C iU U CT Z U 'Poky Number
BUILDING STRRREETT (()ADDRESS(Including Apt.,Unit,Suite.and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIL Number '
117 NW 6th Avenue
CITY STATE ZIP CODE
Dania Br7£N Florida 3304`-i
PROPER PTDESCRIPTION(lot and Biotic Numbers,Tax Parcel Number,Legal Description,etc.)
Lot 16,Block 7,"MAP OF THE TOWN OF MODELO",P.B.8,PG.49,B.C.R.
BUILDING USE(e.g.,Resapr4ia1,Non-residential,Mdtion,Accessory,etc. Use Comments section if necessary).-
Residential
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: U CPS(Type):
( SV-se-ever or A/.N.0111 U NAD 1927 U NAD 1983 LI USGS Clued Map (_1 Other
• SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Bt.NFIP COMMUNITY NAME a COMMUNITY NUMBER ' 82.COUNTY NAME 83.STATE
I Dania 130KI-I 120034 Broward Florida
64.MAP AND PANEL - 135.SUFFIX T 136.FIRM INDEX " BT.FIRM-PANEL EL ` 88.FLOOD ' 89.SASE FLOOD ELEVATION(S)
NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of boding)
12011C0308/0308 F 10/02/97 08/18/92 AE 7
1 a_
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
Li FIS Profile LI FIRM LI Community Determined LI Other(Describe):
811 Indicate the elevation datum used for the BFE in 89:I_N NGVD 1929 LI NAVD 1988 LI Other(Describe):
812. Is the building located in a Coastal Barrier Resources System(CURS)area or Otherwise Protected Area(OPA)? LJ Yes LI No
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1 Building elevations are based on: IJConstruction Drawings' I (Building Under Construction' Ix'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 8 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
calculation. Use the space provided or the Comments area of Section D or Section G.as appropnate,to document the datum conversion
Datum 1929 Conversion/Comments N/A
Elevation reference mark used County#1473 Does the elevation reference mark used appear on the FIRM? LI Yes IX I No
ft
O a)Top of bottom floor(including basement or enclosure) 11.5 ft.(m) Ti
:.J b) Top of next higher floor N/A _ft.(m)
CI c)Bottom of lowest horizontal structural member(V zones only) N/A ft.(m) S o �
• d)Attached garage(top of slab) 10.8 ft.(m) w 6 G L'
O e)Lowest elevation of machinery and/or equipment A/C 11.2 ft •
servicing the building ft-(m) $ P December 18,2001
ra f)Lowest adjacent grade(LAG) 10.1 if ft.(m) z'
O g)Highest adjacent grade(HAG) 11.2 Eh•(m) rLicense# 4188
O h)No. of permanent openings(flood vents)within 1 ft. above adjacent grade N/A Li
3
O 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,B, and C on this certificate represents my best efforts to interpret the data available.
/understand that any false statement may be punishable by line or imprisonment under 18 U S. Code, Section 1001.
CERTIFIERS NAME [TCENSE NUMBER
chard E. Cousins #4188
TIT Land Surveyor & Mapper WWWN""ECousins Surveyors & Associates,
ADDREgr5 SW 76th Avenue GTY Davie STAT lorida 33328
SIGNATURE }t /1 DATE 954 680-9885
tJ�%�'I (, December 18,2001
FFMA Form R1-31 Al If;VI SFP RFVFRSF S1f1F MR C.ONTINI IATION RFPI AC.FS Al I PRFVIO1IS Ff11TICNS