HomeMy WebLinkAbout721 SW 4 St unCRUCwI.T IVIAIVA(ItIVItN I AULN(
NATIONAL FLOOD INSURANCE PROGRAM a O.M B No. 30E7 OC77 !
E fires December 31, 200E
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ELEVATION CERTIFICATE
1 0 - -036 Important: Read the instructions on pages 1.7.
BUILDING OWNER'S NAME SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use:
SHERELLE&LEROY BROWN Policy Number
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO.721 SW 4 ST. Company NAIC Number
cITY
DANIA STATE ZIP CODE
FL 33004
PROPERTY DESCRIPTION(Lot and Blodk Numbers,Tax Parcel Number,Legal Description,etc.)
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,'rf necessary.)RESIDENTIAL
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS##.##" or ##.# #k#� ❑NAD 1927 ElNAD 1983 ❑USGS Quad Map ❑Other;
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER Ei COUNTY NAME
CITY OF DANIA 120034 BROWARD 83.STATE
FL.
B4.MAP AND PANEL ::: B7.FIRM PANEL
NUMBER 85.SUFFIX 86.FIRM INDEX DATE EFFECTIVEIREVISEDDATE B8.FLOOD ZONES �'BASE FLOOD ELEVATION(S)
12011 C0308 F 10/2197 8r1 t�92 ( ) (Zone A0,use depth of tloodirg)
AP
810.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
❑FIS Profile ®FIRM ❑Community Determined
B11.Indicate the elevation datum used for the BFE in B9:®NGVD 1929 Other(Describe):
B12.Is the building located in a Coastal Barrier Resources System(CBRS area or Otherwise Protected Aea OPA?? Other(Describe):
( ❑Yes ®No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Construction Drawings" ❑Building Under Construction
`A new Elevation Certificate will be required when construction of the building is complete. r ®Finished Construction
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 C3:a-i below according to the building diagram specified in Item C2.State the datum used,ff the datum is different from the datum used for the BFE in
Sectiori 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 Does the elevation reference mark used appear on the FIRM? ❑Yes ®No —
❑ a)Top of bottom floor(including basement or enclosure) 11, 3 ft.(m)
❑ b)Top of next higher floor N.A ft.(m) �n
❑c)Bottom of lowest horizontal structural member(V zones only) N.A ft.(m) N
❑ d)Attached garage(top of slab) 10. 6 ft.(m) °
❑e)Lowest elevation of machinery and/or equipment W
servicing the building(Describe in a Comments area) 11.2 ft.m
❑ f)Lowest adjacent(finished)grade(LAG) 10 3 ft.(m) _ 6
❑ g)Highest adjacent(finished)grade(HAG) 10. 6 ft(m) Z
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade N/A
❑ i)Total area of all pen nanent open!'cgs(flood vents)in C3.h 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:WILLIAM MICHAEL CARR
LICENSE NUIVI3ER 5092
TITLEVICEPRESIDENT COMPANY NAME ALL COUNTY SURVEYORS
ADDRESS CITY
5950 W OAKLAND I�RK BLVD#108 LAUDERHILL STATE ZIP CODE SIGNATURE FL 33313DATE
TELEPHONE
7/22/04 954-777-4747
FEMA Form 81-31,January 2003
See reverse side for continuation. Replaces all previous editions