2801 NE 187 ST (2)' FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Ira Rant Read the irlstrucUoPs on ptlges 1.7.
2801 NE 18r Street --
lI
Aventura
PROPER — rY DES nC
A portion of Tracts -B $ C,
=X&"
nft (PaddnO G.
Plat Book 113,
etc
ROUTE AND BOX NO.
STATE
FL
or #q.:)—r HORIZONTAL DATUM:
❑ NAD 1927 El NAD 1983
O.M.B. No. 3067 -0077
Expires December 31, 200:
33180
❑ � u. t —y uara Or Dase ffood dep
FIS Profile ®FIRM
nckale the elevation ❑ Gm
811. I datum used for the BFE in B9: ®NG p 92g
612 Is itw iv,a.c,,,,
C -
❑ Other (Descnbe):-
❑ NAVD 1988 ❑ Other(Da nbe): _
rlecledArea (OPA)? fl Yes ® No Dffi
C1. Build elevations �•^ rrVR101rurctwgTION (SURVEY REQUfRED) --
n9 a6ms ere based a : Construction Draairgs ®Bukirg UnderConslnx —
C2. Building new Elevation Cerfi i wil be required when construction of the building is corn pfete. ❑ Fudsl eel Cersfnrction
a=m* DWeseumherl(Snerdthede,asgdiag per ) tothebuildingforw*hthis eIsbeingcanpleled _scepages6and7.ifnodiagram
represonfs the holding, provide a sketch a
C1 ovations -Zones At AM, AE, AH, A (with Wq , VE, V1-V30, V (with BFE) AR, ARrA, ARIAE, APJA1 -A30, AR/AH, AR/AO
Conrplele Items C3.-a 1 belowacdng b the btul ing diagram sperafied in ftem C2 State flmdatum used. ttfhed�um is ditfemnt from the datum used for the WE in
Secha B converfthedalum(othafusedfa he BFE. Shavfieldpheasurerr"a,dd,lum=vw"calcuI . UsethespaceprovidedatheCommentsazead
Section D or Section G, as appropriate, to domain! the daum conversion.
Datum_ Conversionromments
Elevaton reference mark used _Does E" elevation reference mark used appear on the FIRM? ❑ Yes ®hb
o a) Top of bdbmffoa (indLKing baser wt or ndmn)
o b) Top of ned higher floor 5. 7ft(m)
WA.o c)Botnd lowest hor izontalsrcturalmernter (Vzonesonly)
o WA._ft(m) Ills
0 e LLoweste6vatonOfmmhna WA.
maddrtery arhd/a
sen' dng the building (Desalt in a Camhertstam) WA. 8 Q
of ) Lowest adjacenftGrpshedJ grade (LAG) f7t,s, Ls�Y�
0 9) Highest adacenf (finished) grade (HAG) 7.5 ft.(m)
z� 6Y '
o h) No. of permanent 8. 1 ft.(m) „ "' [l 0 S
o) Total area ofallpenrrarent ( floodvents )witnn1ft.aboveadl'cantgradeWA
ope ergs (food vents) n C3.h WA sq. in. (sq. am)
This ced fication is to be signed and sealed by a land surveyor, engineer, at archifact0a .. law to flCATION
le evroaf on inic
1 certify that the information in Sections A, B, and C on this certificate re I "Island end that any false statement may bar punishable by B a 0.; en best eon to interpret the data avaitahle.
WRTANT: In these spaces, copy the corresponding information from Section A.
:8tli INGSTREEfAbDRESSpnAft Apt, UASil0,anNaBtlg.NO)ORP.O.RanANDBOXNO.
2801 NE187n Street
My STATE ZIPCODE
AvenWia FL 33180
SECTION D • SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CON
Copy both sides of this Elevation Cedficate for (1) community official, (2) i swance agenticompany, and (3) building owner.
C3. a. TheboUanfloorhasarampwithacrossdrainat tlneh% vgpointoftheflcoraidthedwalicnwastakenat the
drain kx4on.
Check here 9 attachments
For Zone AO and Zane A (without BFE), complete Items E1 through E4. If the Elevation Certificate is infended foruse as supporting infamalion for a LOMA or LOMR -F,
Section C most be completed.
Et. Building Diagram Nurnber_(Selec he building diagram most similar to the building for which this cefificate is bang completed –see pages 6 and 7. If no dagran accurately
represents the buldng, provide a sketch or photograph)
E2. The top d the bof tom floor (including basernerdaen losure)of the building is _ff.(m)_in.(an) ❑above or❑ below (check one) the tnglemta4acentgrads.(Use
natural grade, N available).
E3. For Building Diagram 6-8 with openings (seepage 7), the next higherfloor or elevated floor (elevation b) of the building is _ t (m)_n.(an) above the highest adacent
grade. Complete flensC3 .h and C3.ionfrontof form.
E4. The top of the platform d machinery and foreopment servicing the building is _fL(m)_kr.(an)❑aboveor ❑ belay (dledkone)thehowstadacentgrade. (Use
natural grade, if wailable).
E5. Far Zone AO only: If no flood depth number is available, is the top tithe bdtomfloor elevated in acoadancewidn the cormuniyrs floodplain management ordnance?
Fl yes F l No F1 Unknown. The local dfidal mustcedfy this infamafiorn in Section G.
SECTION F
The property owner or owners authorized representativewtaamplates SedionsA, B, C (Items C3 h and C31 "),and Efor Zone (Without a FEMA4ssued or community-
issued BFE) orZoneAD must sign here ThestdemeMssinS9& wA, fl, GandEmecwedtofhebodofaVkCWedge.
PROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIPCODE
SIGNATURE DATE TELEPHONE
SECTION G • COMMUNITY INFORMATION (VF I tUNAL)
The loci offiaal who is authorized by law or ordnance m adrunista file community's tloodplain management ordnance can complete Sections A, B, C (or E7, and G dthis Elevation
Certificate. Complete the applicable kern(s) and sign below.
G1. ❑ The information in Section C was taken from of erdocorerntafion go has been signed and embossed by a licensed surveyor, engineer, or aditect who is authorized by state
orkxxl law toavtifydevationInformation. (Indicate the source and date of the devalian data in the Comments area below.)
G2 ❑ A commonly otteid completed Section Efora building locate in Zone A (wihouta FEMA4ssued acommmity4ssked BFE) or Zone AO.
G3. [:]The fotlowing inionnation (Items G4-G9) is provided foroommunily floodplan management purposes.
G7. This permit has been issued for ❑ New Consladion ❑ Substantial Improvement
G8. Elevation of a- buitt lowest kor (including basement) of the building is: _ _fl(m) Datum: _
G9. BFE or (in Zone AO) depth of flooding at the baking site is: — _ tL(m) Datum: _
LOCAL OFFICIAL'S NAME TITLE
fiIAM25 RI
M Check here if attachments