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2712 NE 184 TERRU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program Building Owner's Name ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -9. OMB No. 1660 -0008 EXDlres March 31. 2012 SECTION A - PROPERTY INFORMATION I 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 2712 N.E. 184th Terrace City State ZIP Code FL. Folio No.: 28- 2203-082 -0320 A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential A5. Latitude /longitude: Lat. 25 °56'44.7" Long. - 80°08' 37.5" Horizontal Datum: NAD 1927 D NAD 1983 17 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 1a 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 ft 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? D Yes 0 No d) Engineered flood openings? O Yes O No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & 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 68. Flood 69. Base Flood Elevation(s) (Zone Date Effective /Revised Date Zone(s) AO, use base flood depth) 1208600134 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. D FIS Profile O FIRM ❑ Community Determined D Other (Describe) B11. Indicate elevation datum used for BFE in Item 139: O NGVD 1929 D NAVD 1988 D Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? D Yes 0 No Designation Date WA D CBRS D OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: D Construction Drawings' D Building Under Construction` Z 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 Miami Dade BM No.: X -18 Elev.: 6.29 Vertical Datum N.G.V.D. 1929 Conversion /Comments NIA Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) 9.68 El feet D meters (Puerto Rico only) b) Top of the next higher floor 10.24 F] feel D meters (Puerto Rion only) c) Bottom of the lowest horizontal structural member (V Zones only) N/A l7 feet D meters (Puerto Rico only) d) Attached garage (top of slab) 9.28 0 feet D meters (Puerto Roo only) e) Lowest elevation of machinery or equipment servicing the building 9.04 0 feet D meters (Puerto Rion only) (Describe type of equipment in Comments) 0 Lowest adjacent (finished) grade (LAG) 8.8 O feet D meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 9.2 O feet D meters (Puerto Rion only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including NIA O feet ❑ meters (Puerto Roo 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 certify elevation - 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. _ 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes D -No_: - - _ Certifier's Name License Number - Edwin J Fernandez P.S.M. 5676 Title Company Name Professional Surveyor& Mapper Ford Armenteros & Manucv Inc. Address City State ZIP Code 1950 N.W. 94'" Avenue con oor Miami Florida 33172 - Signature Date Telephone 04 -07 -2010 (305) 477 -6472 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 2712 N.E. 184th Terrace 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. A/C Slab Amendment by Federal Emergency Management Agency (FEMA) ❑ Check here if attachments SECTION E - BUICMG ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El -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 Z 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 _.- 0 feet ❑ meters El above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment servicing the building is Z 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 ofmy knowledge. Property Owners 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) 'I 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 I G5. Date Permit Issued I 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: F1 feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑X feet ❑ meters (PR) Datum G10. Communitys design flood elevation 191 feet ❑ meters (PR) Datum _ Local Official's Name Title Community Name Telephone Date ❑ 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. I Policy Number 2712 N.E. 184th Terrace City State ZIP Code Company NAIC Number Avanfora 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. Front View — Taken 04 -07 -2010 Rear View — Taken 04 -07 -2010 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 2712 N.E. 184th Terrace .City State ZIP Code Company NAIC Number 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