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Home My WebLink About133 NW 6 Ave D bI- to 6 F DERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 oa39-oi_07g I NATIONAL FLOOD INSURANCE PROGRAM � Expires December 31, 200! OS itl 0/0(0 ,, ELEVATION CERTIFICATE Important Read the instructions on pages 1-7. Ps- 705 SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use BUILDING OWNER'S NAME ,a J Policy Number H.ANTHONY ROLLE / /i./r • - t-"?.Op5R'b Oep. 4<> G BUILDING STREET ADDRES (Including Apt.,Unit,Suite,andtor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 133 NW 67"AVENUE CITY STATE ZIP CODE DANIA FL 33004 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOTS 8,BLOCK 6,TOWN OF DANIA,PLAT BOOK B,PAGE 49,PUBLIC RECORDS MIAMI-DADE CO.LYING IN BROWARD CO.FL,ID#504234010781 BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.) RESIDENTIAL LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type): ( ##°-##'-##.##" or ##.#####°) ❑NAD 1927 0 NAD 1983 0 USGS Quad Map ®Other:NGVD SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE CITY OF DANIA 120034 BROWARD FLORIDA B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATION(S) NUMBER B5,SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE FLOOD ZONE(S) (Zone AO,use depth of flooding) 12011C 0308 F 10-02-1997 08-18-92 "AE" B10.Indicate the source of the Base Flood Elevation(BEE)data or base flood depth entered in B9. ❑FIS Profile ®FIRM 0 Carnmunity Determined ❑Other(Describe): B11.Indicate the elevation datum used for the BFE in B9:®NGVD 1929 0 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 SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1.Building elevations are based on:0 Construction Drawings* ❑Building Under Construction* ®Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2.Building Diagan Number 1(Select the building diagram most similar to the building fa which this certificate is bung completed-see pages 6 and 7. If no diagarn accurately represents the building,provide a sketch a 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 C3.-a-i below according to the building diagam 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 1929 Conversion/Canments NONE Elevation reference mark used XDoes the elevation reference mark used appear on the FIRM? ❑Yes ®No o a)Top of bottom floor(including basement or enclosure) 13. 15 ft(m) o b)Top of next higher floor N/A._ft(m) 0 o c)Bottom of lowest horizontal structural member(V zones only) N/A._ft(m) a o (#) �/--te-t-- o d)Attached garage(top of slab) 12. 27 ft.(m) w CO o e)Lowest elevation of machinery and/or equipment m /0 servicing the building(Describe in a Corrmrents area) 12.75 fL(m) E Tri o f)Lowest adjacent(finished)wade(LAG) 11 .5 ft(m) ,k 6 5- /a-D C; o g)Highest adjacent(finished)gade(HAG) 11. 9 ft.(m) o h)No.of permanent openings(flood vents)within 1 ft.above adjacent gade N/A — o )Total area of all permanent openings(flood vents)in C3.h 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. CERTIFIER'S NAME PILAR SOLER LICENSE NUMBER 6310 TITLE PROFESSIONAL SURVEYOR AM)MAPPER COMPANY NAME PSM&ASSOCIATES,PA LB# 7149 ADDRESS CITY STATE ZIP CODE 311 NW 136TH AVE MIAMI FL 33182-1952 SIGNATURE `� . DATE TELEPHONE 1/�_,1!.,�-.. .....)F-C_a--,,--, 05-12-06 305-226-4337 iitiPORTANT: In these spaces,copy the correr-'nding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,anc. ,dig.No.)OR P.O.ROUTE AND BOX NO. Policy Number 133 NW 6TH AVENUE CITY STATE ZIP CODE j Company NAIC Number DANIA FL 33004 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 CROWN ELEVATION: 11.15' BENCH MARK USED:MANHOLE AT THE INTERSECTION OF NW 7 H AVENUE AND 3RD STREET,RIM ELEVATION 10.32' AIR CONDITIONER/CONCRETE.SLAB ELEVATION: 12.75' ELEVATION CERTIFICATE FOR BUILDING FINAL ❑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 sknilarto the building for Wnich this certificate is being completed—seepages 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)0 above or 0 below(check one)the highest adjacent grade. (Use natural grade,if available). 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. Complete items C3.h and C3.i on front of form. E4.The top of the platform of machinery andlor equipment servicing the building is_ft(m)_in.(cm)0 above or ❑below(check one)the highest adjacent grade. (Use natural grade,if available). ES.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? 0 Yes 0 No 0 Unknown. The local ofitial must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The properly owner or owner's authorized representative who completes Sections A,B,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or community- issued BFE)or Zone AO must sign here. The statements in Sections A B,C,and E are coned to the best of my knowledge. 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 by law or ordnance 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. GI.❑The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who is authcthrd by site or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.0 The following information(Items G4-G9)is provided for community floodplain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7.This permit has been issued for.❑New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building is: —_ft.(m) Datum: G9.BFE or(in Zone AO)depth of flooding at the building site is: ._ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check here if attachments