HomeMy WebLinkAbout508 NW 3 Ter �]31.` Oto O 1 0 F�nERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
��`O _ 'ATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 20011
071 0a_ -Oy ELEVATION CERTIFICATE -
Important: Read the instructions on pages 1-7.
5 SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNER'S NAME Policy Number
H.ANTHONY ROLLE
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,arxi/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
508 NW 3RD TERRACE
CITY STATE ZIP CODE
DANIA FL 33004 _
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOTS 9 AND 10,BLOCK B OF HANSEN AND NELSON,PLAT BOOK 3,PAGE 76,PUBLIC RECORDS MIAMI-DADE CO.LYING IN BROWARD CO.FL
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL
LATITUDEILONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
-##'-##.##" or ##. ) ❑NAD 1927 ❑ NAD 1983 ❑USGS Quad Map ®Other.NCIVD
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
Bt,NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
CITY OF DANIA 120034 BROWARD 7 FLORIDA
B4.MAP AND PANEL B7.FIRM PANEL B9.BASE FLOOD ELEVATIOI•I(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone AO,use depth of floc irg)
12011C 0308 F 10-02-1997 08-18-92 `X' NIA
B10.Indicate the source of the Base Flood Elevation(BFE)data or tease flood depth entered in B9.
❑FIS Profile ®FIRM ❑Community Determined ❑Othet(Describe):
B11.Indicate the elevation datum used for the BFE in B9:®NGVD 1929 ❑NAVD 1988 ❑Other(Desaibe):_
B12.Is the buildng 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.Buildng elevations are based on:❑Construction Drawings" ❑Buildng Under Construction" ®Finished Construction
'A new Elevation Certificate will be required when construction of the buildng is complete.
C2.Buildng Diagram Number 1(Select the buildng dagam most similar to the buiking for which this certificate is being completed-see pages 6 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,ARIA,AR/AE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3.-a-i below according to the bulling diagram specified in Item C2.State the datum used.If the datum is dfierent from the datum used for the BF E in
Section B,convert the datum to that used for the BFE.Show field meas<rernenLs and datum conversion calculation. Use the space provided or the Comments arga of
Section D or Section G,as appropriate,to document the datum conversion. -
Datum NGVD ConversiadCornments NONE
Elevation reference mark used X_Does the elevation reference mark used appear on the FIRM? ❑Yes ®No
o a)Top of bottom floor(rock dng basement or enclosrre) 13. 50 ft(m) m
o b)Top of next higher floor WA._ft(m)
o c)Bottom of lowest horizontal structrrai member(V zones only) N/A._ft(m) H //
o d)Attached garage(top of slab) 12. 94 ft(m) w
o e)Lowest elevation of machinery ardor equipment m m
servicing the buiking(Describe in a Comments area) 13.15 ft(m) E
o t)Lowest adjacent(finished)grade(LAG) 12.5 ft(m) m.0 -30
o g)Highest adjacent(finished)grade(HAG) 12. 8 fL(m) m
o h)No.of permanent openings(flood vents)within 1 ft above adjacent gade WA
o )Total area of all permanent openings(flood vents)in C3.h WA sq.in.(sq.am)
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.
l 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 FILAR SOLER LICENSE NUMBER 6310
TITLE PROFESSIONAL SURVEYOR AND MAPPER COMPANY NAME PSM&ASSOCIATES,P.A. LB# 7149
ADDRESS CITY STATE ZIP CODE
311 NW 136TH AVENUE MIAMI FL 33182-1952
SIGNATURE DATE TELEPHONE
06-30-04 305-226-4334
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