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03/ H��� FEDERAL EMERGENCY MANAGEMENT AGENCY
O NATIONAL FLOOD INSURANCE PROGRAM OMB No 3067-0077
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ELEVATION CERTIFICATE Expires December 31, 2005
Important: Read the instructions on pages 1 - 7.
SECTION A -PROPERTY OWNER INFORMATION For Insurance Company Use.
BUILDING OWNER'S NAME
J ahnda Policy Number
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldp No.)OR P O ROUTE AND 80X NO
Company NAIC Number 122 Ph i ppen Raod
CITY
STATE ZIP CODE
Hallandale Beach, Florida
PROPGDTV n«^orr+rrnN(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.)
Lot-LB:—Block 10, COLLEGE 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:
( ##°-##'-*kWor ##.##it##°) Ix NAD 1927 L__I NAD 1983 SOURCE I`:GPS(Type):
I_i USGS Quad Map jj Other
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
I B1 NFIP COMMUNITY NAME&COMMUNITY NUMBER 82. COUNTY NAME
L_ Ha 1 1 andale Beach-125110. Broward Bs.STATE
L
Florida
84 MAP AND PANEL f 85.SUFFIX 86. FIRM INDEX 87. FIRM PANEL
NUMBER B8 FLOOD I 89 BASE FLOOD ELEVATION(S)
i DATE EFFECTIVE/REVISED DATE ZONE(S) i (Zone AO,use depth of flooding)
L 12011C0318 I F 10/2/97 8/18/92 X l
810. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in 89 N/A
I_I FIS Profile IX I FIRM II Community Determined iI Other(Describe)
?11 Indicate the elevation datum used for the BFE in 89 IX I NGVD 1929 II NAVD 1988 jj Other(Describe)
B12 Is the building located in a Coastal Barrier Resources System (CBRSi area or Otherwise Protected Area (OPA)? II Yes IX I No
Designation Date:
SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
.,i Building elevations are based on 1 (Construction Drawings' I_(Building Under Construction' i X(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 diagram accurately represents the building, provide a sketch or photograph )
C3 Elevations—Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30. V (with BFE), AR,AR/A. AR/AE, AR/A1-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 of rOadDoes the elevation reference mark used appear on the FIRM? II Yes L_I No
a a) Top of bottom floor(including basement or enclosure)
1 2 1 ft.(m) A
J b)Top of next higher floor v
J c) Bottom of lowest horizontal structural member(V zones only) N/A ft.(m) V
J d)Attached garage (top of slab) /A_ )
N/�ft.(m) w /`
J e)Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area.) 12 1—ft.(m) 1
J f) Lowest adjacent(finished)grade (LAG) 1 1 • —ft
.L .(m) z / �4.
O g) Highest adjacent(finished)grade(HAG) 11 .3-ft.(m) fift
J h) No. of permanent openings(flood vents)within 1 ft. above adjacent grade 0 a i) Total area of all permanent openings(flood vents)in C3.h 0 sq. in. (sq cm)
SECTION D - SURVEYOR, ENGINEER. OR ARCHITECT CERTIFICATION
.ertnccation is to be signed and Sealed by ti land surveyor engineer nr architect authorized by law to certify elevation information
i/rify that the information in Sections A, B and C 3n this certificate repro vents my best efforts to interpret the data available
understand that any false statement Yby P
may be punishable fine or i nsnr 'ent under 18 CS Code, Section 1001
CERTIFIER'S NAME _ p ._m_--o_
Mark A. Higgins LICENSE NUMBER
TITLE C pANYNAME #5549
Reg , Land Surveyor Eiggins-Deni & Associates
ADDRESS
1721 North State Road 7 , Margate , FloridaTATE 33063 ZIP CODE
SIGNATURE ���
i�%�'t�� j7-- DATE TELEPHONE
3/4/09 ( 954 ) 971-0540
=EMA Form 81-31, January 2003 See reverse side for continuation
Replaces all previous editions