1500 Island BLVD (2)U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
Al. Building Owner's Name
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -8.
OMB No. 1660 -DD08
Exoires February 28. 2009
SECTION A - PROPERTY INFORMATION ) For Insurance Company Use: )
11110
'Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and
-ad Island Boulevard
City Aventura State FL ZIP Code 33160 -5016
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 1, VILLA FLORA at Williams Island; Portion of'WILLIAMS ISLAND THIRD AMENDED ", P.B. 143, PG. 24; Miami -Dade Records
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 25 °56'22.0" N Long. 080 *08'16.7" W 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 1
A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide:
a) Square footage of crawl space or enclosures) sq ft a) Square footage of attached garage sq it
b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage
enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP Community Name & Community Number
B2. County Name
B3. State
City of Aventura & 120676
Miami -Dade
Florida
B4. Map /Panel Number
B5. Suffix
B6. FIRM Index
67. FIRM Panel
B8. Flood
B9. Base Flood Elevabon(s) (Zone
(Puerto
Rico only)
Date
Effective /Revised Date
Zone(s)
AO, use base flood depth)
12025CO084
J
7/17/1995
3/2/1994
AE
8
610. 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 139: 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 ENo
Designation Date _ ❑ 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, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 -A30, AR/AH, AR/AD. Complete Items C2.a -g
below according to the building diagram specified in Item AT
Benchmark Utilized X 18 Vertical Datum NGVD 1929
Conversion /Comments
a) Top of bottom floor (including basement, crawl space, or enclosure floor)_
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG)
g) Highest adjacent (finished) grade (HAG)
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 elei
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.
Certifiers Name Darryl J. Hauser License Number LS6277
Title Project Surveyor Company Name CONSUL TECH SURVEYING & MAPPING, INC.
"ess 3141 Commerce Parkway City Miramar State FL ZIP Code 33025
Check the
measurement used.
9.1
E feet
❑ meters
(Puerto
Rico only)
23.1
E feet
❑ meters
(Puerto
Rico only)
❑ feet
❑ meters
(Puerto
Rico only)
8.0
E feet
❑ meters
(Puerto
Rico only)
8.4
E feet
❑ meters
(Puerto
Rico only)
7.9
E feet
❑ meters
(Puerto
Rico only)
8.8
E feet
❑ meters
(Puerto
Rico only)
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 elei
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.
Certifiers Name Darryl J. Hauser License Number LS6277
Title Project Surveyor Company Name CONSUL TECH SURVEYING & MAPPING, INC.
"ess 3141 Commerce Parkway City Miramar State FL ZIP Code 33025
IMP(MTANT; In these spaces, copy the corresponding information from Section A. ( For Insurance Company Use: I
1500 Island Boulevard
City Aventura State FL ZIP Code 33160 -5016
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
.y both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments C2. The benchmark utilitzed is National Geodetic Survey, (NGS), Station Designation X 18; PID: AC2373 and is located along NE 183 Street,
2' North of the centerline of West Dixie Highway and 44.1' West of the Railroad Tracks. Elevation: 6.29'.
C2-e) The Lowest elevation of machinery or equipment servicing the building is an Air - Conditioner Pad. This residence contains an elevator pit with a bottom
elevation of 6.5'.
(Field Book 329D, Pages 34.35, 55, 57)
Date 07/08/2008
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items Et -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, crawl space, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawl space, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6 -8 with permanent flood openings provided in Section A Items 8 and /or 9 (see page 8 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 E] above or E] 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
Tess City State ZIP Code
Signature Date Telephone
Comments
❑ 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.
G1. ❑ 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 G6. Date Certificate Of Compliance /Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: E] feet ❑ meters (PR) Datum _
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
F1 Check here if attachments
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
ding Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number
,..JO Island Boulevard
City Aventura State Fl ZIP Code 331605016 Company NAlC Number
If using the Elevation Certificate to obtain NAP 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,
following.
Front of House: (Picture Taken on 07/09/2008)
A
Building Photographs
Continuation Page
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number
/`1�0 Island Boulevard
City Aventura State FL ZIP Code 33160 -5016 Company NAIC Number
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."
Rear of House: (Picture Taken on 07/09/2008)
A