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1518 Island BLVD (2)U.S, DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1 -8. SECTION A - PROPERTY INFORMATION Al. Building Owners Name Daniel Shift & wife Jacqueline D. Shift "'� Building Street Address (including Apt.. Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. .8 Island Boulevard City Aventura State FL ZIP Code 33160 -5016 OMB No. 1660 -0008 Expires February 28. 2009 For Insurance Company Use: A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 10, VILLA FLORA at Williams Island; Portion of'WILLIAMS ISLAND THIRD AMENDED ", P.B. 143, PG. 24; Miami -Dade Records Number A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential A5. Latitude /Longitude: Lat. 25 °56'25.0" N Long. 080 °08'19.1" W Horizontal Datum: ❑ NAD 1927 ® MAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. 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 enclosure(s) _ sq ft a) Square footage of attached garage 486 sq ft 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 4 c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b 1491 sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number 62. County Name 9.3 B3. State City of Aventura & 120676 Miami -Dade ® feet Florida N /A. ❑ feet ❑ meters (Puerto Rico only) 7.5 B4. Map /Panel Number B5. Suffix B6. FIRM Index ® feet B7. FIRM Panel 68. Flood B9. Base Flood Elevation(s) (Zone ❑ meters (Puerto Rico only) 8.9 Date ❑ meters (Puerto Rico only) Effective /Revised Date Zones) AO, use base flood depth) 12025CO084 J 7/17/1995 3/2/1994 AE 8 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) _ B11. indicate elevation datum used for BFE in Item 69: ® 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 _ ❑ CBRS ❑ OPA If , SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 61. 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 (w(rth BFE), VE, VI 430, V (with BFE), AR, ARIA, AR/AE, AR/A1 -A30, AR/AH, AR/AO. 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) 9 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 eler 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 form. Certifiers Name Darryl J. Hauser License Number LS6277 Title Project Surveyor Company Name CONSUL TECH SURVEYING & MAPPING, INC. -as 3141 Commerce Parkway City Miramar State FL ZIP Code 33025 taoal asa-nsuu Check the measurement used. 9.3 ® feet ❑ meters (Puerto Rico only) 23.3 ® feet ❑ meters (Puerto Rico only) N /A. ❑ feet ❑ meters (Puerto Rico only) 7.5 ® feet ❑ meters (Puerto Rico only) 8.8 ® feet ❑ meters (Puerto Rico only) 7.4 ® feet ❑ meters (Puerto Rico only) 8.9 ® 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 eler 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 form. Certifiers Name Darryl J. Hauser License Number LS6277 Title Project Surveyor Company Name CONSUL TECH SURVEYING & MAPPING, INC. -as 3141 Commerce Parkway City Miramar State FL ZIP Code 33025 taoal asa-nsuu IMPORTANT: In these spaces, copy the corresponding Information from Section A. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and /or Blda. No.) or P.O. Route and Box No. Policy Number 1518 Island Boulevard City Aventura State FL ZIP Code 33160 -5016 ARCHITECT CERTIFICATION Company NAIC Number �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 183m 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 N /A. (Field Book 329D, Pages 14 -15, 37, 43, 49 -50, 63) Signature Date 11/13/2008 ❑ Check here it attachments 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 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, 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 ❑ 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 +ress CRY 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. Permit Number 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: _❑ 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 -nments 1-1 Check here if attachments Building Photographs See Instructions for Item A6. "Iding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. I Policy Number _ .8 Island Boulevard City Aventura State FL ZIP Code 33160 -5016 I Company NAlC 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, following. Building Photographs Continuation Paae Iding Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 8 Island Boulevard �,.ry Aventura State FL ZIP Code 33160 -5016 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 05/03/2007)