HomeMy WebLinkAbout126 NW 6 Ave P.N.3542-00 0,-�-6 /
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FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B.No. 3067-0077 1
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31,2002
ELEVATION CERTIFICATE I
Important Read the instructions on pages 1 -7. .,
SECTION A-PROPERTY OWNER INFORMATION For Yrusanc*Company Use.
BUILDING OWNER'S NAME Policy Number
J"I-L, TUNES cousi(2((crie 0 Co.
BUILDING STREET ADDRESS(Inckiding Apt.,Urrt,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
126 NW 6th Avenue ZIP CODE
CITY STATE
Dania Bea rt1 Florida 3 300'/ -
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Pared Number,Legal Description,etc.)
Lot 11,Block 7,'MAP OF THE TOWN OF MODELO",P.B.8,PG.49,B.C.R.
BUILDING USE(e.g.,Residential Nor esidenbal,Addition,accessory,etc. Use Comments section i(nece.sary.)
Residential
LATRUOEA.ONG(TUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: LJGPS(Type):
( I -INr-111.s5• or AA.MAeV) U NAD 1927 U NAD 1983 U USGS Quad Map LI Other -
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
81.NFIP COMMUNITY NAME&COMMUNITY NUMBER ' B2.COUNTY NAME ' 83.STATE
Dania 120034 Broward Florida
84.MAP AND PANEL " 135.SUFFIX ' 96.FIRM INDEX 87.FIRU AJ EL ' S8.FLOOD 89.BASTFLOOD ELEYATION(S i
NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of bcoding)
12011C0308/0308 F 10/02/97 08/18/92 AE 7
810.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
L i FIS Profile LI FIRM U Community Determined Li Other(Describe): —
B11 Indicate the elevation datum used for the BFE in 89:LXI NGVD 1929 U NAVD 1988 LJ Other(Describe): _
812.Is the budding located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? LJ Yes I XI No
Designation bete:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) _
C1 Building elevations are based on: L_IConstrucion Drawings' LJBuilding Under Construction' Ix'Finished Construction
'A new Elevation Certificate will be required when construction of the budding is complete.
C2 Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed-sire
pages 8 and 7 If no diagram accurately represents the budding,provide a sketch or photograph.)
C3. Elevations-Zones A1-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 conversi Dn.
Datum 1929 Conversion/Comments N/A —
Elevation reference mark used County# 1473 Does the elevation reference rgark used appear on the FIRM? L-I Yes IX I No
7 a)Top of bottom floor(including basement or enclosure) 12.5 N/A ft ft.(m)
ri
,a b) Top of next higher floor —ft.(m)
CIc)Bottom of lowest horizontal structural member(V zones only) NIA • ft•(m) = o
O d)Attached garage(top of slab) 11.7 -ft.(m) w g 1Z,,,1 �/ ,'
elevation of machineryand/or equipment ` . �'((„cc:: !�
O e)Lowest A/C 11.-t ft
servicing the building 11.2 • ft.(m) I g December 18,2001
O f)lowest adjacent grade(LAG) .Tr--ft.(m) z IT
y
U g)Highest adjacent grade(HAG) 11.7 tt•(m) 8 License# 4188
O h)No.of permanent openings(flood vents)within 1 ft. above adjacent grade N/A .,
3 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 LICENSE NUMBER 41
E. Cousins
Land Surveyor & Mapper Cousins Surveyors & Associates,
5365 SW 76th Avenue Davie lorida 33328
• SIGNATURE L \ �' Dber 54 680-9885
�U '•ember 18,2001
FFMA Form A1-11 AI IC,QQ SFF RFVFRSF SITlF FOR CONTINt IATICIN RFPI AC.FS AI I PRFVIOI IS FfITI(1NS