2755 NE 184 WAYU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -9.
OMB No. 1660 -0008
Expires March 31. 2012
SECTION A - PROPERTY INFORMATION ) For Insurance Company Use: (
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number
2755 N.E. 180 Way
City State ZIP Code
Aventum Florida 33160
Lot 3, Block 1, "MERCO AT AVENTURA ", P.B. 166, Pg. 58, Miami -Dade County, FL. Folio No.: 28 -2203- 082 -0030
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential
A5. Latitude /Longitude: Lat. 25.56'47.7 Long. - 80 °08' 37.6" Horizontal Datum: NAD 1927 ❑ NAD 1983 E
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number to
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) N/A sq It a) Square footage of attached garage 324 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 N/A walls within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? O Yes O No d) Engineered flood openings? O Yes E No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name R Community Number
B2. County Name
B3. State
Aventura, City of
I Miami -Dade
FL
B4. Map /Panel Number
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevations) (Zone
E feet
❑ meters (Puerto Rico only)
Date
Effective /Revised Date
Zones)
AO, use base flood depth)
12086CO134
L
09 -11 -09
09 -11 -09
AE
8
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM E) Community Determined ❑ Other (Describe) _
BI 1. Indicate elevation datum used for BFE in Item B9: O 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 WA ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. 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/AO. Complete Items C2.a -g
below according to the building diagram specified in Item AT
Benchmark Utilized MiamkDade BM No.: X -18 Elev.: 6.29' Vertical Datum N.G.V.D. 1929
Conversion /Comments WA
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)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
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.
/understand that any false statement maybe 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
Name
a licensed land surveyor? E Yes ❑ No
License Number &7'1e,
Address ._�_ City State ZIP Code
04-07 -2010 (305) 477 -6472
FEMA Form 81 -31, January 2003 See reverse side for continuation. Replaces all previous editions
Check the measurement used.
9.61
E feet
❑ meters (Puerto Porn only)
10.22
E feet
❑ meters (Puerto Rico only)
NIA
E feet
❑ meters (Puerto Rico only)
8.80
E feet
❑ meters (Puerto Rico only)
9.05
E feet
❑ meters (Puerto Rico only)
8.6
E feet
❑ meters (Puerto Rim only)
9.0
E feet
❑ meters (Puerto Rim only)
NA
E feet
❑ meters (Puerto Rim only)
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.
/understand that any false statement maybe 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
Name
a licensed land surveyor? E Yes ❑ No
License Number &7'1e,
Address ._�_ City State ZIP Code
04-07 -2010 (305) 477 -6472
FEMA Form 81 -31, January 2003 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number
2755 N.E. 184th Way
City State ZIP Code Company NAIC Number
Aventura Florida 33160
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
Highest Crown of Road Elev.: ( N.E. 185 STREET) 6.65 ft. (m)
Project Number 028170 A/C Slab Elev.: 9.05 R (m)
Letter of Map Amenc1men1_JLQL&ALLLor Letter of Map Revision (LOMR -F) ❑ issued by Federal Emergency Management Agency (FEMA)
Letter Date: icabk:
Signature Date
04-07 -2010 ❑ Check here if 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.
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 ❑x feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawl space, or enclosure) is 0 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 _ ❑x feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑x feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _ ❑x 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, 8, 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 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.
Number
G5. Date Permit Issued
G6. Date
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -buik lowest floor (including basement) of the building: _ _ ❑x feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: 0 feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑X feet ❑ meters (PR) Datum _
Local Official's Name Title
Name Telephone
Signature Date
Comments
Issued
❑ Check here if attachments
FEMA Form 81 -31, February 2006 Replaces all previous editions
Building Photographs
See Instructions for Item A6.
Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
2755 N.E. 184th Wav
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.
Front View — Taken 04 -07 -2010
x�
Rear View — Taken 04 -07 -2010
Building Photographs
GOntmuanon raye
For Insurance Company Use:
Building Street EAddresS (i ncluding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 2755 N.E. 184th W ZIP Code Company NAIC Number
City State
Aventura Florida 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, following.
Side 1 View — Taken 04 -07 -2010
Side 2 View —Taken 04 -07 -2010