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Home My WebLink About210 NW 12 Ave O.M.B.No 3067-077 ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION:Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable floodplain management ordinances,to determine the proper insurance premium rate,and/or to support a request for a Letter of Map Amendment or Revision(LOMA of LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER IGC Construction STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.number)OR P.O.BOX ROUTE AND BOX NUMBER COMPANY NAIC NUMBER i© NW i2 AY15 OTHER DESCRIPTION(Lot and Block Numbers,etc.) Parcel A, COLLINS PARC PLAT NO . 2 CITY STATE ZIP CODE Dania Florida SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM See instructions): COMMUNITY NUMBER 2.PANEL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION 120034 0308 F 7/21/9 5 AE (IN AO Zones,use dep 1. th)) +7 .0 , 7. Indicate the elevation datum system used on the FIRM for the Base Flood Elevation(BFE): jK NGVD'29 ❑ Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site,indicate the community's BFE:I I I I I I_U feet NGVD,or other FIRM datum-see Section B,Item 7). SECTION C BUILDING ELEVATION INFORMATION 1.Using the Elevation Certificate Instructions,indicate the diagram number from the diagrams found on Pages 5 and 6 that best decribes the subject building's reference level 1. 2(a).FIRM Zones A-1-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of +8 .0 feet NGVD(or other FIRM datum-see Section B,Item 7). (b). FIRM Zones V1430,VE,and V(with BFE).The bottom of the lowest horizontal structural member of the reference level from the selected diagram,is at an elevation of I I I I I I.LI feet NGVD(or other FIRM datum-see Section B,Item 7). (c). FIRM Zone A(without BFE).The floor used as the reference level from the selected diagram is 111_U feet above❑or below❑(check one)the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is feet above❑or below❑(check one)the highest grade adjacent to the building. If no flood depth number is available,is the building's lowest floor(reference level)elevated in accordance with the community's floodplain management ordinance?❑Yes❑No❑Unknown 3.Indicate the elevation datum system used in determining the above reference level elevations:®NGVD'29❑Other(describe under Comments on Page 2).(NOTE:If the elevation datum used in measuring the elevations is different than that used on the FIRM(see Section B,Item�1,then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4.Elevation reference mark used appears on FIRM:❑Yes®No(See instructions on Page 4) 5.The reference level elevation is based on:®actual construction❑construction drawings (NOTE:Use on construction drawings is only valid if the building does not yet have the reference level floor in place,in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required one construction is complete.) 6.The elevation of the lowest grade immediately adjacent to the building is: +7 . 2 feet NGVD(or other FIRM datum-see Sect�on B,Item 7). SECTION D COMMUNITY INFORMATION 1.If the community official responsible for verifying building elevations specified that the reference level indicated in Section C,Item 1 is not the"lowest floor' as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor'as defined by the ordinance is:I I t I I I.0 feet NGVD(or other datum-see Section B,Item 7), 2.Date of the start of construction or substantial improvement SECTION E 'CERTIFICATION This certification is to be signed by a land surveyor,engineer,or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones At-A30,AE,AH,A(with BFE),V1430,Ve,and V(with BFE)is required. Community officials who are authorized by local law or ordinance to provide floodplain management information,may also sign the certification. In the case of Zone AO and A(without a FEMA of community issued BFE),a building official,a property owner,or an owner's representative may also sign the certification. Reference level diagrams 6,7 and 8-Distinguishing Features-if the certifier is unable to certify to breakaway/non-breakaway wall,enclosure size,location of servicing equipment,area use,wall openings,or unfinished area Feature(s),then list the Feature(s)not included in the certification under comments below. The diagram number,Section C,Item 1,must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. l unde,stand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. Michael J. Hitt #2771 CERTIFIER'S NAME LICENSE NUMBER(or Affix Seat) Registered Land Surveyor Deni Associates of Florida, Inc. TITLE COMPANY NAME 5701 PINE ISLAND ROAD, Suite 260 Tamarac, FL 33321 ADD SS/� r �� +� f CITY STATE ZIP CODE .1/20/98 (305)-720-1042 SIGNATURE V DATE PHONE NUMB ER