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Home My WebLink About515 NW 3 PL FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 'I -7. AUG Z 8 ZUU4 SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: B IJG OWNER'S NAME Policy Number a B ILDING STREET ADDRESS(fn�cludin 3 Apt., Unit,Suite,and/or Bldg. No.)OR P.O. ROUTE AND BOX NO. Company NAIC Number CITY STATE ZIP CODE Dania Florida 33004 PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description, tc. V Lots 46 & 47 Block B "Hansen—Nelson Subdivision ' 76 Broward BUILDING USE(e.g.,Residential, Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) Residential LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_1 GPS(Type): or ##.#il#kli#°) 1_1 NAD 1927 1_1 NAD 1983 1_1 USGS Quad Map 1-1 Other: SECTION B-FLOOD INSURANCE RATE MAP (FIRM)INFORMATION B1. NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE Dania 120034 Broward Florida B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX 67. FIRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZQNEt(S) (Zone AO,use depth of flooding) 0309 F 10/2/97 8/18/92 X - B10. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in B9. 1-1 FIS Profile lal FIRM 1_1 Community Determined 1-1 Other(Describe): B11. Indicate the elevation datum used for the BFE in 139: iXl NGVD 1929 1_1 NAVD 1988 1_1 Other(Describe): 612. Is the building located in a Coastal-Barrier Resources System (CBRS)area or Otherwise Protected Area(OPA)? 1_1 Yes 1ILI No Designation Date: SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings" 1_1Building Under Construction" IX 1Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (Select the building diagram most similar to the building 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,V1430,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 appropriate,to document the datum conversion. Datum NGVD 29 Conversion/Comments Elevation reference mark used Broward Cty.BM Does the elevation reference mark used appear on the FIRM? 1_1 Yes 1_1 No ❑ a)Top of bottom floor(including basement or enclosure) 12 30 ft.(m) ❑ b)Top of next higher floor N/A.—ft.(m) 8/27/02 ❑ c) Bottom of lowest horizontal structural member(V zones only) N/A._ft.(m) o 0 ❑ d)Attached garage(top of slab) N/A._ft.(m) ❑ e) Lowest elevation of machinery and/or equipment w ° servicing the building 11 . 70 ft.(m) E ' , ❑ f) Lowest adjacent grade(LAG) 11 . SO ft.(m) v N; ❑ g)Highest adjacent grade(HAG) 11 70 ft.(m) IT. 'a aW ❑ h) No. of permanent openings (flood vents)within 1 ft.above adjacent grade N/A L,S, N0. 3277 ❑ 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, 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 LICENSE NUMBER Robert T. Bogle T No 3277 TITLE COMPANY NAME Regis eyed Lauid Surve or R T o ADDRES% CITY STATE ZIP CODE 708111aft SJU SIGNATU ,>VJ 8�2gT�02 TELEPHONE / r FEMA Form 6`I131,,LUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS(Including Apt.,Unit, Suite, and/or Bldg. No. 515 NW 3rd Place )OR P.O. ROUTE AND BOX NO. Policy Number CITY Dania STATE ZIP CODE Company NAIC Number Florida 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 Check here if attach SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT B E)nts For Zone AO and Zone A(without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed— see pages 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 1_I_I ft•(►n) 1-1—Iin.(cm (check one)the highest adjacent grade. ) 1�I above or 1_1 below E3. For Building Diagrams 6-8 with openings (see page 7),the next higher floor or elevated floor(elevation b)of the building is 1_I_I ft.(m) I—I_lin.(cm) above the highest adjacent grade. E4. 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? 1_1 Yes 1_1 No 1_1 Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. PROPERTY OVA/NER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS (_1 SECTION G -COMMUNITY INFORMATION (OPTIONAL) Check here if attachments The local official who is authorized by law or ordinance 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. 131. 1_1 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 authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. 1_I 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. 1_1 The following information (Items G4-G9)is provided for community floodplain management purposes. G4. PEUbiIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7.This permit has been issued for: 1_1 New Construction 1_1 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 NAPAE TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS -I Check here if attachments FEMA Form 81-3'1,AUG 99 REPLACES ALL PREVIOUS EDITIONS