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U. _ .•.TMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660 -0008
Feo4ral Emergency Management Agency I Expires March 31, 2012
National Flood Insurance Program Important: Read the instructions on pages 1 -9.
SECTION A - PROPERTY INFORMATION For Insurance Company Use:
Al. Building Owner's Name City of Aventura Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number
3385 NE 188 Street
City Aventura State FL ZIP Code 33180
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Portion of Folio #28 -2203- 047 -0010.
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Non - Residential
A5. Latitude /Longitude: Lat. 25 °56'59.4" Long. -80 °08'04.6" Horizontal Datum: ❑ NAD 1927 ® 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 _B
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 N/A 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 ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP Community Name & Community Number
B2. County Name
B3. State
Aventura -120676
1 Miami -Dade
FL
B4.MapJPaneINum-berJ
B5. Suffix
B6. FIRM Index
B7. FIRM Panel I B8. Flood
B9. Base Flood Elevation(s) (Zone
1208600134
L
Date
Effective /Revised Date Zone(s)
AO, use base flood depth)
N /A._
❑ feet
9 -11 -09
9 -11 -09 AE
9
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) _
B11. Indicate elevation datum used for BFE in Item B9: ® 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 ® 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' ® 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, Vi-V30, V (with BFE), AR, AR/A, AR/AE, AR/Al -A30, AR/AH, AR/AO. Complete Items C2.a -h
below according to the building diagram specified in Item AT Use the same datum as the BFE.
Benchmark Utilized MDCBM #N -460Vertical Datum NGVD 1929
Conversion /Comments None
Check the measurement used.
a)
Top of bottom floor (including basement, crawlspace, or enclosure floor) 10.5
® feet
❑ meters (Puerto Rico only)
b)
Top of the next higher floor
12.9
® 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)
N /A._
❑ feet
❑ meters (Puerto Rico only)
e)
Lowest elevation of machinery or equipment servicing the building
10.2
® feet
❑ meters (Puerto Rico only)
(Describe type of equipment and location in Comments)
f)
Lowest adjacent (finished) grade next to building (LAG)
8.8
® feet
❑ meters (Puerto Rico only)
g)
Highest adjacent (finished) grade next to building (HAG)
12.0
® feet
❑ meters (Puerto Rico only)
h)
Lowest adjacent grade at lowest elevation of deck or stairs, including
10.3
® 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 certuy elevam
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.
® Check here if comments are provided on back of forth. Were latitude and longitude in Section A provided by a
licensed land surveyor? ® Yes ❑ No
Fortin,
1/10
Daniel C. Fortin
RLS #2853
State of Florida
FEMA Form 81 -31, Mar 0 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Companr
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Pol Numb
3385 NE 188 Street es
City Aventura State FL ZIP Code 33190 Company NAIL 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: La & Longitude were established by LABINS survey data interactive map.
Crown of Roa evat n +8.6
C2E - Ge tqr pa at Elev. +10.2.
/Signature Date 6/11/10
® Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO ANn 7nntc a rwtruni m
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.
Et. 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 ZIPCode
.iyuawa Date
Telephone
❑ 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 A0.
G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes.
G4. Permit
G5. Date Permit Issued
Date
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: _ _ ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation _ _ ❑ feet ❑ meters (PR) Datum
Local Official's Name
Name
Telephone
Date
Issued
Check here if attachments
�lvv+ rurrn o i -si, mar ua Replaces all previous editions
Building Photographs
See Instructions for Item A6.
rot insurance i ompany use.
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
3385 NE 188 Street
City Aventura State FL ZIP Code 33180 1 Company NAJC Number
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 May 27, 2010
Rear View (South Side)
Left Side View (East Side)
Front View (North Side)
Right Side View (West Side)
i