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Home My WebLink About5331 SW 43 Ter FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31 , 200E ELEVATION CERTIFICATE -- Important Read the instructions on pages 1-7. 1L J /VS SECTION A-PROPERTY OWNER INFORMATION For InsuranoeCompery Jse: BUILDING OWNER'S NAME_�( � Policy Number pvt i✓( < ►J t'f 1 L-s L.,LG BUILDING STREET ADDRESS(Including Apt. Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Nurer _ 5 ? f 5%v/l• 31 -b o 'r�2R-A-ts- CfTY e( OFp�, ,1C1, STATEF�, • ZIP CODE PROPERTY D SCRIPTION(Lot and Block Num ,T Parcel Number,Legal Description,etc.) Lor5 -- 10 0� • (' Su13�tvtSta� 0/ 36 � 00/0 BUILDING USE(e.g.,Residential,Npn-residentia�A-d5di Addition, ��c. Use a Comments area,if necessary) W / a/i 6 Id ,> CC) LATITUDE/LONGITUDE(OPTIONAL) l`- HORIZONTAL DATUM: SOURCE: ❑GPS(Type): ( ##°-tir-#S.tir or #41.111i#C 0 NAD 1927 ❑NAD 1983 ❑USGS Quad Map ❑Other. SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NFIP COMMUNITY NAME&COMMUNITY NUMBER 82.COUNTY NAME B3.STATE 3RO ),0 0 kJ mIccee 1256 t3 - o Ac 1::Lo>2(D21- 84.MAP AND PANEL B7.FIRM PANEL 89.BASE FLOOD ELEVATION(S) NUMBER t B5.SUFFIX 86.FIRM INDEX DATE EFFECTIVEIREVISEDDATE 88.FLOOD ZONE(S) (Zone AO,�pthoffooding) I2o11C.03C - F 6-6.-a 2 - E-18 -92 /A,��, B 10.Indicate the source of the BasOood Elevation(BFE)data or base flood depth entered in B9. ❑FIS Profile IRM ❑Comm ity Determined ❑Other(Describe): B 11.Indicate the elevation datum used for the BFE in B9: IM-NGVD 1929 ❑NAVD 1988 ❑Other(Describe): B12.Is the building bated in a Coastal Barrier Resources System(CBRS)area cr Otherwise Protected Area(OPA)? ❑Yes ❑No Designation Date SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1.Building elevations are based on:El Construction Drawings` ❑Building Under Construction" P4ished Construction *A new Elevation Certificate will be required when construction of the buildings complete. C2.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 buidng,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,ARAA1-A30,AR/AH,AR/AO Complete Items C3.-a-i below accondlig to the building diagram specified in Item C2.State the datum used.If the datum is different from the datum used fate 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 Conversion/Comments Elevation reference mark used LLCA Qoes the elevation reference mark used appear on the FIRM? ❑Yes IR No ,, f a)Top of bottom floor(including(including basement or enclosure) Lft(m) �54t-4U3 b)Top of next higher floor 0,1 ft.(m) rn / c)Bottom of lowest horizontal structural member(V zones only) J1 �ft.(m) 0 CD y m / ...c2_____ d)Attached garage(top of slab) N/A ft(m) k _,.___ e)Lowest elevation of machinery and/or equipment in m ti servicing the building(Describe in a Comments area) 0/ ft(m) E m f)Lowest adjacent(finished)grade(LAG) Co.&ft.(m) z g)Highest adjacent(finished)grade(HAG) .Z.Zft(m) 0 in h)No.of permanent openings(flood vents)within 1 ft.above acent grade I- J (2—t et—03 i)Total area of all permanent openings(flood vents)in C3.h 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 DONALD P.PROUD LICENSE NUMBER 4037 TITLE PROFESSIONAL SUR S PER COMPANY NAME RALPH D.DENUZZIO& ASSOCIATES ADDRESS CITY STATE ZIP CODE 6100 BOULEVA D OF C NORTH LAUDERDALE FL 33068 SIGNATURE DATE TELEPHONE ( 2-1 a1-e 954.969.5100 IMPORTANT: In these spaces,copy the corresponding information from Section A For InsurarnceCompany Use ' Bl'LDING STREET ADDRESS(Including,Apt_ / .,Un&Suite,and/a Bldg.No.)OR P.O.ROUTE AND BOX NO. Polo/Number CRY STATE ZIP CODE C t OP 1>hN fa .(� --tom • c«npa<y NAIc Number SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) _ Copy both sides cf this Elevation Certificate for(1)community official,(2)insurduut agent/company,and(3)building owner. COMMENTS ❑Check here if attach nests SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A WITHOUT BFE) For Zone AO and Zane A(without BFE),complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. El.Building Diagram Number_(Select the building diagram most similar to the building for which this certificates being completed—see pages 6 and 7. If no diagram accr irately represents the buiding,provide a sketch or photograph.) EZ The top of the bottom floor(including basement or enclosure)of the buildings _ft(m)_in.(cn)❑above or ❑below(check one)the highest adjacent grade. (We natural grade,if available). E3.For Building Diagrams 6-8 with openings(see page 7),the next higher floor or elevated floor(elevation b)of the building _ft(m)_in.(cm)above the highest adjacent grade. Complete items C3.h and C3.1 on front of form. E4.The top of the platform of machinery and/or equipment servicing the buildings ft(m)_in.(an)❑above or ❑below(check one)the highest adjacent grade. (We natural grade,if available). E5.Fa Zone AO only: If no flood depth numbers available,s the top of the bottom floor elevated in accordance with the community's floodplai n management ordinance? ❑Yes ❑No ❑Unknown. The local official must certify the 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,C(Items C3.h and C3.i only),and E for Zone A(without a FEMA-issued or cornmu ssued BFE)or Zone AO must sign here The stafements in Sections A,B,C,and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who s authorized by law or ordinance to adminsterthe community's f o dplain management ordinance can complete Sections A,B,C(or E),and G of this Iievaticn Certificate. Complete the appicable item(s)and sign below. G1.❑The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,engineer,or architect who s 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.❑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.❑The folowi g information(Items G4-G9)is provided for community tloodplain management purposes. G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPIJANCE/OCCUPANCY ISSUED G7.This permit has been ssued for. New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(induding basement)of the buildings: ._ft.(m) Datum: G9.BFE or(in Zone AO)depth ct flooding at the building site is: _ft(m) Datum: LOCAL OFFICIAL'S NAME TfTLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check here if attachments