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FEDERAL EMERGENCY MANAGEMENT AGENCY '—
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NATIONAL FLOOD INSURANCE PROGRAM OMB. 077
Expires December 31, 2005
1$—d-`t/ ELEVATION CERTIFICATE
��3�d Important: Read the instructions on pages 1 - 7.
BUILDING OWNER'S NAME SECTION A -PROPERTY OWNER INFORMATION Fei Insurance Company Use.
Policy Number
BUILDING STREET ADDRESS(Intl ing Apt., Unit,Suite,and/or Bidg. No.)OR P O. ROUTE AND BOX NO Company NAIC Number
'1 t IL S w 3 420 V L
0-
CITY STATE
ZIP DE
PRM!4Nallandal Bea h . orida r"L--
neone1rrrIr)N tl of and Block Numbers,Tax Parcel Number, Legal Description,etc.)
T,nt...l.7--El0 k 10, COLLBGE TRACT, 2nd ADDITION
BUILDING USE(e.g.,Residential Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
Residential
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM:
or #S.a#WR°) �—Xj NAD 1927 "NAD 1983 SOURCE: U GPS(Type):
j`I USGS Quad Map U Other
SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1 NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2 COUNTY NAME B3.STATE
L Hallandale Beach-125110 Broward Florida
84. MAP AND PANEL 1 85 .SUFFIY, B6 FIRM INDEX 87. FIRM PANEL _ 88 FLOGO B9 BASE FLOOD ELEVATIONS)
NUMBER DATE EFFECTIVE/REVISED DATE ZONES) (Zone AO,use depth of flooding)
L__12II�L F 10/2/97 18 92 �_ _ -- __ N/A
610 Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in 69
j_j FIS Profile IX I FIRM 1_I Community Determined 1_I Other(Describe):
�'1 Indicate the elevation daturn used for the BFE in 89 IX I NGVD 1929 j_I NAVD 1988 j_j Other(Describe)
612 Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area (OPA)? I_I Yes �X I No
Designation Date:
_ SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
3u11oing elevations are based on I_IConstruction Drawings' I_IBuildfng Under Construction' j LlFinished 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 V1-V30 V (with BFE), AR AR/A AR/AE AR/Al-A30 AR/AH AR/AO
Complete Items C3.a-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 Conversion/Comments
Elevation reference mark used crown O E roadDoes the elevation reference mark used appear on the FIRM? I_1 Yes L—1 No
a) Top of bottom floor(including basement or enclosure) 1 p .Q ft.(m) A
0 b)Top of next higher floor N/A ft.(m)
0 c)Bottom of lowest horizontal structural member(V zones only) N/per
O d}Attached garage (top of slab)
O e)Lowest elevation of machinery and/or equipment E I
w
servicing the building(Describe in a Comments area 7 () ft.(m) § �`\
J f) Lowest adjacent(finished)grade (LAG) E v
9 9 ft.(m) z
,D ' ���
g)Highest adjacent(finished)grade(HAG)
h)No. of permanent openings(flood vents)within 1 ft. above adjacent grade 0
-.1 i) Total area of all permanent openings(flood vents)in C3 h 0 sq in (sq cm) l
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CF_RTIFICATION
eruncaU�r�is to be ano by ; :uw tiur:- y,;r U,nyineer ,•r archtect authonzecl by law to certify elevation mforrnaUor
ertnty that the information in SActroos A B, and C,on this certificate represents my best efforts to interpret the data available
understand that any false s;atement may be punishable by fine or impnson4ent under 18 U.S Code, Section 1001,
CERTIFIER'S NAME LICENSE NUMBER
Mark A. Higgins #5549
TITLE FA NY NAME
Reg , Land Surveyor Higgins-Devi & Associates
ADDRESS STATE ZIP CODE
1721 North State Road 7 , `Rtar ate , Florida 33063
SIGNATURE DATE
3/4/05 TELEPHONE
j ( 954 )971-0540
=EMA Form 81-31, January 2003 See reverse side fnr continuation Replaces all previous editions