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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-00(18
Expires February'8. 2C09
Federal Emergency Management Agency
National Flood Insurance Program Important: Read the instructions on pages 1-8.
6-05135 SECTION A-PROPERTY INFORMATION For Insurance Company Use:
Al. Building Owner's Name H.ANTHONY ROLLE Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Company NAIC Number
129 NW 6th AVE.
City DANIA State FL ZIP Code 33004
A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
LOT 9,BLOCK 6'TOWN OF DANIA.MAP OF TOWN MODELO"PB B,PG 49.MIAMI-DADE CO.FOLIO#5042-34-01-0790 BROWARD CO.
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential
A5. Latitude/Longitude:Lat.N26D03.307' Long.W080D08.839' Horizontal Datum: 0 NAD 1927 ® IVAD'983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1
A8. For a building with a crawl space or enclosure(s),provide A9. For a building with an attached garage,provide:
a) Square footage of crawl space or enclosure(s) N/A sq ft a) Square footage of attached garage 288 s,q ft
b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage
enclosure(s)walls within 1.0 foot above adjacent grade N/A walls within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name 83.State
CITY OF DANIA-1200034 BROWARD FL
B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
12511C-0309 F 10/2/97 8/18/92 AE 7.0'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
0 FIS Profile 0 FIRM ❑Community Determined 0 Other(Describe)
B11. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 0 NAVD 1988 0 Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ®No
Designation Date ❑CBRS ❑OPA
SECTION C -BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: ❑Construction Drawings* 0 Building Under Construction* ®Finished Constructicn
*A new Elevation Certificate will be required when construction of the building is complete.
C2. 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 C2.a-g
below according to the building diagram specified in Item A7.
Benchmark Utilized BCTBM Vertical Datum NGVD 1929
Conversion/Comments N/A
Check the measurement used.
a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 13.20 0 feet 0 meters(Puerto Rico only)
b) Top of the next higher floor N/A._ 0 feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) N/A. 0 feet 0 meters(Puerto Rico only)
d) Attached garage(top of slab) 12.75 0 feet 0 meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 12.1.5 ®feet El meters(Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent(finished)grade(LAG) 11.65 ®feet 0 meters(Puerto Rico only)
g) Highest adjacent(finished)grade(HAG) 12.50 ®feet 0 meters(Puerto Rico only)
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. /certify that the information 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.
0 Check here if comments are provided on back of form.
Certifier's Name Guillermo A.Guerrero License Number PSM 6453 ill/
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Title Professional Surveyor and Mapper Company Name /�'
Address 682 E 21 City Hialeah State FL ZIP Code 33013 01
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Signature Date 03/14/07 Telephone 305-333-3328 ( I
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FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions