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17985 Biscayne BLVD
U.S. DE.-ARTMENT OF HOMELAND SECURITY Federar Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -9. A - PROPERTY INFORMATION OMB No. 1660 -0008 Expires March 31, 2012 Al. Building Owners Name aAm maneyc, no,n w,p.,,....ny .........� - - A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Company ,fn"' P 17985 Biscayne Blvd. (Olive Garden) City Aventura State FL ZIP Code 33160 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A portion of Northwest 1/4 of Sec. 10- 52-42. Portion of Folio 28- 2210 -0000 -0090, Public Records of Miami -Dade County. Florida A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Non - Residential A5. Latitude /Longdude: Lat. 25 °56'30.9" Long. -80 °08'53.5" Horizontal Datum: ❑ NAD 1927 E NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 0 sq ft a) Square footage of attached garage 0 sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.1b 0 sq in d) Engineered flood openings? ❑ Yes E No d) Engineered flood openings? ❑ Yes E No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B7. NFIP Community Name & Community Number B2. County Name B3. State Aventura - 120676 Miami -Dade FL B4. Map /Panel Number B5. Suffix 86. FIRM Index 87. FIRM Panel B8, Flood 89. Base Flood Elevation(s) (Zone 1208600134 L Date EffectivedRevised Date Zone(s) AO, use base flood depth) 9 -11 -09 I 9 -11 -09 AE 8.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile E FIRM ❑ Community Determined ❑ Other (Describe) _ B11. Indicate elevation datum used for BFE in Item B9: E NGVD 1929 ❑ NAVO 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date N/A ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' E Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARIAE, AR/Al -A30, AR/AH, AR/AO. Complete Items C2.a -h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized oCBM H400 Elev 6.28Vertical Datum NGVD 1929 Conversion /Comments None Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 9.1 E feet ❑ meters (Puerto Rico only) b) Top of the next higher floor NIA._ ❑ feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N /A._ ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) WA._ ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 9.6 E feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 8.8 E feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 8.9 E feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including WA._ E feet ❑ meters (Puerto Rico only) structural Support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is 'to signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information 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. E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a i licensed land surveyor? E Yes ❑ No ' Certifie Name Daniel O Fortin License Number L52853 rw., oe,. im,e.ed i.s 3urvevnr Comoanv Name Fortin, Leavy, Skiles, Inc10- 0647/2010 -022 North RLS #2853 State of Florida FEMA Form 81-31, ar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For la3uranee CPr7lFany Use;' Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Po1[cj!- q Y 17985 Biscayne BNtl. City Aventura State FL ZIP Code 33160 Cpmpany. ¢'plum SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUEDI iCopy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A5: Latitude & Longitude were established by LABINS survey data interactive moo. iit No. 09 -2063. ,n of Road + 8.7 C2e: Equipment is hot water heater and electrical panels at Elev. + 9.6. E: FPL Transformer at Elev. + 8.5 SECTION E - BUILDING`, ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE1 For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For hems E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, of enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.1b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION he property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA - issued or community- issued BFE) r Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owners or Owner's Authorized Representative's Name ZIP Code SECTION G - COMMUNITY INFORMATION (OPTIONAL) le local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, 8, C (or E), Id G of this Elevation Certificate. Complete the applicable hem(s) and sign below. Check the measurement used in Items G8 and G9. h. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) 2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA - issued or community- issued BFE) or Zone AO. p. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes. G5. Date Permit Issued I G6. Date Certificate 7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement B. Elevation of as -built lowest floor (including basement) of the building: _ _ ❑ feet ❑ meters (PR) Datum B. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum 10. Community's design flood elevation ❑ feet _ ❑meters (PR) Datum .ocal Officials Name Title ommunity Name Telephone 6ignature Date omments III ❑ Check here if attachments MA Form 81 -31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Ft011C1@ NUMDer 17985 Biscayne Blvd City Aventura State FL ZIP Code 33160' If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. Pictures shown hereon were taken on August 4, 2010 Rear View (East Side) Left Side View (North Side) Front View (West Side) Right Side View (South Side) _4W PA'm18 I6vm4 ApOlcstlm nuiLer M MM Apwl..nm [Lluc, aa. 6NnflmE 01`0 NLY ..0 �Propmig nvlISSISMM BM 'FCL.IO M NIHEH avio Wm j Mlorn[to SomcM WLpW �Zming 82 WNMLMItY8u51NE5S pl81 Appll.[tlm I" mTX [IMIMFRCN NEW it Ippuo 1. A. arzIIH Tonmt Mm , n[mo gwF WREN Maim plen n ubc, -Iou a ep Pe Ectlm bj vallatlan 1. Tot9. uma bongo put Public WildiM NO I W.,* tlaxtlptlory pwnlltg Pl. wmbv 691692 F]e.VOnl[ anWW A,11.1on MVC antlArvmga. —lu. rtw lot mllW OK I Wt I C-ul ET. IP.olph U.S. DEPARTMENT FEDERAL HOMELAND MANAGEMENT FLOODPROOFING CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Natloaol Flood Insuran¢ Profirmn FOR NON- RESIDENTIAL STRUCTURES O.M.B. N0. 1660 -0008 Expires March 31, 2012 The floodproofing of non - residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however, a floodproofing design certification is required. This form is to be used for that certification. Floodproofing of a residential building does not alter a community's floodplain management elevation requirements or affect the insurance rating unless the community has been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. BUILDING OWNER'S NAME 'I't 1e .0 we 45;&gC st ( }*s� STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER 17°!65 f>i oc yii BLVD. OTHER DESCRIPTION (Lot and Block Numbers, etc.) FOR INSURANCE COMPANY USE POLICY NUMBER COMPANY NAIL NUMBER CITY STATE ZIP CODE T�7P. I'� tl1rV`1 ��.QR►��y 9yijl !�!'t SECTION I -FLOOD INSURANCE RATE MAP (FIRM) INFnPMATInu COMMUNIINUU]MBEn IoZ lV! PANEL NUMBER 413 I (SUFFIX f�- G pD01 OF FIRM�I1 1 J�11• 1�r4�8 /F�1 PIA ZONE f BASE FLOOD ELEVATION (In AO Zones, ©QDepth) SECTION II- FLOODPROOFING INFORMATION Floodproofing Design Elevation Information: a Registered Professional Engineer or Architect) - q�1- '- -•• 1 wNTu Building is floodproofed to an elevation of.......�0'. .t�........... feet NGVD. (Elevation datum used must be the same a• s that onthe FIRM. ) 0.65 Height of floodproofing on the building above the lowest adjacent grade is .........J.'? ..................... fee[. (NOTE: For insurance rating purposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to receive rating credit. If the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result In a higher premium.) SECTION III - CERTIFICATION Non - Residential Floodproofed Construction Certification: SIGNATURE a Registered Professional Engineer or Architect) I certify that, based upon development and /or review of structural design, specifications, and plans for construction, the design and methods of construction are in accordance with accepted standards of practice for meeting the following provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, including the effects of buoyancy, and anticipated debris impact forces. I certify that the information on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by One orimprisonment under 18 U.S. Code, Section 1001. °" 11 LICENSE NUMBER tar Affix Seal) - r zzHvmtkcra}c g13 Co - COM PA NY NAM Eye CITY STATE ZIP CODE 1!11 1 # Zoo lbs -m`i 0.644 FOII1144A 12i8o DATE PHONE to •25.10 714 • �:7 copies snuulo De made or tnls Certificate for: 1) community official 2) Insurance agent /company, and 3) building owner. FEMA Form 81 -65, REPLACES ALL PREVIOUS EDITIONS F -056 (3/09) U.S. DEPARTMENT OF HOMELAND SECURITY FLOODPROOFING CERTIFICATE O. M.B. N0. 1660 -0008 FEDERAL EMERGENCY MANAGEMENT AGENCY FOR NON - RESIDENTIAL STRUCTURES Expires, March 31 ,2011 National Flood Inmrana Program The floodproofing of non - residential buildings may be permitted as an alternative to elevating to or above the Base Flood Elevation; however, a floodproofing design certification is required. This form is to be used for that certification. Floodproofing of a residential building does not alter a community's floodplain management elevation requirements or affect the insurance rating unless the community has been issued an exception by FEMA to allow floodproofed residential basements. The permitting of a floodproofed residential basement requires a separate certification specifying that the design complies with the local floodplain management ordinance. BUILDING OWNER'S NAME FOR INSURANCE COMPANY USE 'rt% r�taJ� �izDefi.l }a�Tfx.7R.y�i' STREET ADDRESS (Including Apt, Unit, Suite, and /or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER POLICY NUMBER 11" i 0116akYt1>` I WD- OTHER DESCRIPTION (Lot and Block Numbers, etc.) COMPANYNAIC NUMBER ATE CITY {`/ MAIX :�i�1pA zIP�1 CGO T� 1 SECTION I -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM: COMMUNIP( NUM NUMBER SUFFIX DATE OF FIRM INDEX FIRM ZONE BASE FLOOD ELEVATION nn AD Zones, Use Depth) IZo &�� O F72LF 1-- ` Pr II, ?.crB E boo SECTION II- FLOODPROOFING INFORMATION (By a Registered Professional Engineer or Architect) I�� Floodproofing Design Elevation Information: r-Pe + PUli fr� ""'i 1.19 + 1.9 = i Building is floodproofed to an elevation of .......I �.'....�."�............ feet NGVD. (Elevation datum used must be the same as that On the FIRM.) Height of floodproofing on the building above the lowest adjacent grade is ...... .......1'.C%................... feet. (NOTE: For insurance rating purposes, the building's floodproofed design elevation must be at least one foot above the Base Flood Elevation to receive rating credit. If the building is floodproofed only to the Base Flood Elevation, then the building's insurance rating will result In a higher premium.) SECTION III — CERTIFICATION (By a Registered Professional Engineer or Architect) Non - Residential Floodpfoofed Construction Certification ) certify that, based upon development and /or review of structural design, specifications, and plans for construction, the design and methods of construction are in accordance with accepted standards ofpractice for meeting the following provisions: The structure, together with attendant utilities and sanitary facilities, is watertight to the floodproofed design elevation indicated above, with walls that are substantially impermeable to the passage of water. All structural components are capable of resisting hydrostatic and hydrodynamic flood forces, !ncludingthe effects of buoyancy, and anticipated debris impact forces. 1 certify that the information on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine orimprisonment under 18 O.S. Code, Section 1001. CERTIFIER' NAME LICENSE NUMBER (or Affix Seal) -tec x. ti0K4AczK 913 fo TITLE COMPANY NAME -. f{zo7lsor 1f.P�NItRGl Gfz•t�o ,&?436rwcm, ,1�c• ADDRESS - ^ I \C 1 CITY STATE I'vi YIM T'uF•i�l� \Z�O� SIGNATURE / DATE PHONE ` �— _ ' to •2y .l o Ici . 0,74- l Apie!i be made of this Certificate for: 1) community official, 2) Insurance agent/company, and 3) building owner. FEMA FC,m 81 -65, Me 09 1 1 REPLACES ALL PREVIOUS EDITIONS F -056 (3/09) IMPORTANT: In these spaces, copy the corresponding information from Section A. Forlesurance Company Use: Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number 17985 Biscayne Blvd. City Aventura State FL ZIP Code 33160 Comipany NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) '. Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A5: Latitude & Longitude were established by LABINS survey data interactive map. Permit No. 09 -2063. Crown of Road + 8.7 Item C2e: Equipment is hot water heater and electrical panels at Elev. + 9.6. NOTE: FPL Transformer at Elev + . 8.5 r�n�r _ ' � /"> Date 6/4/10 SECTION E - BUILDfRG ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8 -9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this 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, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate, Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. Gt. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by 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 following information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: — _ ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: G10. Community's design flood elevation Local Official's Name Community Name Signature Date ❑ feet ❑ meters (PR) Datum _ ❑ feet ❑ meters (PR) Datum _ Issued Check here if attachments FEMA Form 81 -31, Mar 09 Replaces all previous editions U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660 -0008 Federal Emergency Management Agency I Expires March 31, 2012 National Florid lnsuran;e Program Important: Read the instructions on pages 1 -9. SECTION A - PROPERTY INFORMATION For Insuranee Company Use: Al. Building Owner's Name SAM Management Corp./Marilyn Klompus - Policy Nt#aber Q. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Company,NAIC Number 17985 Biscayne Blvd. (Olive Garden) City Aventura State FL ZIP Code 33160 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A portion of Northwest 1/4 of Sec. 10 -5242. Portion of Folio 28 -2210- 0000 -0090, Public Records of Miami -Dade County, Florida A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Non - Residential A5. Latitude /Longitude: Lat. 25 °56'30.9" Long. -80 °08'53.5" Horizontal Datum: ❑ NAD 1927 N NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1 A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 0 sq ft a) Square footage of attached garage 0 sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes E No d) Engineered flood openings? ❑ Yes E No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 82. County Name B3. State Aventura - 120676 Miami -Dade I FL B4. Map/Panel Number B5. Suffix dex 67. FIR M Panel B8. B9. Base Flood Elevations) (Zone 1208600134 L FB76. XFIRM Effective /Revised Date ZAO, use base flood depth) 9 -11 -09 8.0 B10. Indi cate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile N FIRM ❑ Community Determined ❑ Other (Describe) 811. Indicate elevation datum used for BFE in Item B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date NIA ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construction' N Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, ARlAH, AR/AD. Complete Items C2.a -h below according to the building diagram specified in Item AT Use the same datum as the BFE. Benchmark Utilized DCBM H400. Elev 6.28Vertical Datum NGVD 1929 Conversion /Comments None Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 9.1 E feet ❑ meters (Puerto Rico only) b) Top of the next higher floor NIA - ❑ feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) NIA._ ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) N /A. ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 9.6 N feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) I) Lowest adjacent (finished) grade next to building (LAG) 8.8 E feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 8.9 E feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including N /A._ E feet ❑ meters (Puerto Rico only) - structural support 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 on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. N Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? E Yes ❑ No Certifier's Name Daniel C. Fortin License Number LS2853 Title Address 1 City North GII8➢Yi ti,t)J -4496 33162 7 RLS #2853 State of Florida FEMA Form 81 -31, Mar"09 See reverse side for continuation. Replaces all previous editions Building Photographs See Instructions for Item A6. (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. I Policy Number 17985 Biscavne Blvd Aventura State FL ZIP Code 33160 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. Pictures shown hereon were taken on August 4, 2010 Rear View (East Side) Front View (West Side) 0wy. a x a.' Left Side View (North Side) Right Side View (South Side)