2000 E Country Club Dr05 -2479 2002 -007
"G" Site Limited Pari
BUILDING STREET ADDRE
24071 Country Club Drive
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Read the instructions on pages 1 -7.
SECTION A -
ip - Building #1 - North Tower
(Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
O.M.B. No. 3067 -0077
Expires December 31, 2005
CITY STATE ZIP CODE
Aventura FL 33180
PROPERTY DESCRIPTION (Lot and Black Numbers, Tax Parcel Number, Legal Desmodon, etc.)
See Attached Exhibit "A°
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, B necessary.)
Residential
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type):_
or ##.###?f) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. _
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Aventura -- 120676...... Miami-0ade L FL _.
NUMBER - B5. SUFFIX I B5. FIRM INDEX DATE EFFECTIVEREVISED DATE 68. FLOOD ZONE(S) (Lone AO, use depth of flooding)
120250082 J 3294 7!1795 AE IS 7)
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe):
611. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12 Is the building located in a Coastal Bamer Resources System (CBRS) area or Otherwise Protected Area (OPA)? []Yes ®No Designation Date_
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. 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.
C2.3uilding 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, V1 430, V (with BFE), AR, ARIA, APIAE, ARIA1 -A30, AR/AH, ARIAO
Complete Items C3. -aa below according to the building diagram spedfied in Item C2. Stale 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_ Conversion/Comments Elev. + 4.44
Elevation reference mark used DCBM 4oes the elevation reference mark used appear on the FIRM? ❑Yes ®No
• a) Top of bottom floor. (including basement orenclosure) 10. OR
A
�
• b) Top of next higher floor 22.6 ft.
v
o c) Bottom of lowest horizontal structural member (V zones only) WA. _ft
o 0
o d) Attached garage (top of slab) 6. 0 ft,
w
o e) Lowest elevation of machinery andlor equipment
m
servicing the building (Describe ina Comments area) 110. ?ft
;
Daniel%. Fortin, PSM
o 0 Lowest adjacent (finished) grade (LAG) 9.4ft.
v N
LS 2853
o g) Highest adjacent (finished) grade (HAG) 9.8ft.
g
January 6, 2006
o h) No, of permanent openings (flood vents) within 1 ft. above adjacent grade 0
o i) Total area of all permanent openings (flood vents) in C3.h 0 sq. in.
SECTION D • SURVEYOR, ENGINEER, OR ARCHITECT CtKI INUAI IUN
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, Q 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.
TITLEO Pros COMPANY NAME Fortin, Leavy, Skiles, Inc
AD ESS CJy STATE ZIP CODE
0 NE 1
"tree, North, Miami Beach FL 33162
SIG, ��� DATE TELEPHONE
T 106106 AS) 653 4493
IMPORTANT: In these spaces, copy the corre, ding information from Section A
CITY STATE ZIP CODE ( 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.
f attachments
SECTION E- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F,
Section C must be completed.
E1. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed –see pages 6 and r'. If no diagram accurately
represents the building, provide a sketch or photograph.)
EZ The top of the bottom floor (including basement or enclosure) of the building Is _ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6$ with openings (see page T, the next higher floor or elevated floor (elevation b) of the building is _ ft(m) _in.(an) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of the plattorm of machinery and/or equipment serviang the building is _ft.(m) —n-(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, f available).
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in acrardance with the communit/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) ULKI IrfcAt tun
The property owner or owners 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 cemmunity -
issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best ofmy knowledge.
PROPERTY OWNER'S OROWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZJP CODE
SIGNATURE DATE TELEPHONE
Check here if
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The b al official who is authorized by law or ordinance to administer the communiVs 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.
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 is authorized by state
or loci law to cermy elevation information. (Indicate he source and date of the elevation data in the Comments area below.)
G2 ❑ A community, ofiidai completed Section E fora building located in Zone A (without a FEMA- issued or ccmmunityassued BFE) or Zone A0.
G3. ❑ The foiioYing Information Qtems G4-G91 is provided foroommucity floodplain management purposes.
G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G3. Elevation of as- buiit lowest floor rinduding basement) of the building is: _. _ft.(m) Datum:
G9. BFE or (in Zone AO) depth of Pwding at the building site is: _ _ft.(m) Daum:
-XALOFFICIAC'S NAME TITLE
COMMUNITY NAME TELEPHONE
Check here if