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FEnFRAL EMERGENCY MANAGEMENT AGENCY
TIONAL FLOOD INSURANCE PROGRAM O.M.B. No. 077
Expires December 31, 2,0,0'�
ELEVATION CERTIFICATE 4101t)h
Important Read the instructions on pages 1-7.
r _ /�> SECTION A-PROPERTY OWNER INFORMATION For Insurance Comparry Use
BUILDING OWNER'S NAME Policy Number
KURT AND JACKIE PUGHSLEY
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Numbei
718 SW 3RD STREET
CITY STATE ZIP CODE
DANIA BEACH FL 33004
PROPERTY DESCRIPTION(Lit and Block Numbers,Tax Parcel Number,Legal Description,etc.)
LOT 2,OF MINNIS MANOR,RECORDED IN PLAT BOOK79,PAGE 5,PUBLIC RECORDS OF BROWARD COUNTY,FLORIDA
BUILDING USE(e.g.,Residential,Nor residential,Addition,Accessory,etc. Use a Corrxnents area,if necessary.)
RESIDENTIAL -
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( ##°-##' ##.##" or ❑NAD 1927 ❑NAD 1983 ❑USGS Quad Map ®Other:NGVD
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER 82.COUNTY NAME B3.STATE
CITY OF DANIA 12OM4 BROWARD FLORIDA
B4.MAP AND PANEL B7 FIRM PANEL B9.BASE FLOOD ELEVATI(N t(S)
NUMBER B5.SUFFIX B6.FIRM INDEX DATE EFFECTIVE/REVISED DATE B8.FLOOD ZONE(S) (Zone AO,use depth of flowing)
12011C 0309 F 10-0297 08-18-92 IV N/A
1310.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile 0 FIRM ❑Community Determined ❑Other(Describe):
B11,Indicate the elevation datum used for the BFE in W®NGVD 1929 ❑NAVD 1988 ❑Other(Describe):—
2112 Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)?C]Yes ®No Designation Date_
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Ct.Building elevations are based on:0 Construction Drawings" ❑Bu►icing Under Construction* 0 Finished 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 diaganr
amntely represents the building,pouide a sketch or photograph.)
C3.Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARM,AR/AE,AR/Al-A30,AR/AH,AR/AO
Complete Items C3.-a-i below according 110 the braking diagram speafied in Item C2.State the datum used If the datum is different from the datum used for the HE 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 a rea of
Section D or Section G,as appropriate,to document the datum conversion.
Datum NGVD 1929 ConversiorVComments NONE
Elevation reference mark used X Does the elevation reference marts used appear on the FIRM? ❑Yes 0 No
o a)Top of bottom floor(including basement or enclosure) 10. 84 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)
o d)Attached garage(top of slab) 9. 89 ft.(m) w S
o e)Lowest elevation of machinery ardor equipment
servicing the building(Describe in a Comments area) 10.29 ft.(m) M r_ D/_/
o 0Lowest adjacent(finished)grade(LAG) 9.4 ft.(m) Z;Q'
o g)Highest adjacent(finished)grade(HAG) 10. 5 ft.(m)
o h)No.of permanent openings(flood vents)within 1 fL above adjacent grade NIA
o i)Total area of all permanent openings(flood vents)in C3.h NIA sq.in.(sq.an)
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 AND MAPPER COMPANY NAME PSM&ASSOCIATES,P.A. LB# 7149
ADDRESS CITY STATE ZIP CODE
311%V 136TH AVENUE MIAMI FL 33182-1952
SIGNATURE 1�� �) DATE TELEPHONE
,C 01-17-06 305-2264337