4026 Island DRFEDERAL EMERGENCY MANAGEMENT AGENCY
O.M.B. No. 3067 -0077
NATIONAL FLOOD INSURANCE PROGRAM
Expires July 31, 2002
ELEVATION CERTIFICATE
FLORIDA.
B4. MAP AND PANEL
B5. SUFFIX
Important: Read the instructions on papies 1 - 7.
Q -
SECTION A - PROPERTY OWNER INFORMATION
For Insurance Company Use:
BUILDING OWNER'S NAME
Policy Number
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO.
Company NAIC Number
4026 Island Drive
(Zone AO, use depth of flooding)
CITY STATE
Aventura Florida
ZIP CODE
33160
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
7 -17 -1995
Tnt R- Rlcrk 2
9.00
BUILDING USE (e Residential, Residential, Non - residential, Addition, Accessory, etc. Use comments section s necessary.)
SINGLE FAMILY HOME.
LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 1_I GPS (Type):
or #tt.#tFp##`7 LINAD1927 1XINAD1983 1_1USGSOuadMap XI Other: AUTOMATIC LEVEL.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER
B2. COUNTY NAME
B3. STATE
120635
Miami -Dade
FLORIDA.
B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
89. BASE FLOOD ELEVATION(S)
NUMBER
DATE
EFFECTIVEIREVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
0014
J
3 -2 -1994
7 -17 -1995
AE
9.00
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 139.
1 -1 FIS Profile I XI FIRM 1_I Community Detemlined 1J Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: IX I NGVD 1929 1_1 NAVD 1988 1_1 Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? IJ Yes 1x1 No
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: IJConstruction Drawings' I— (Building Under Construction' XIFinished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. 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 C3a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum N . G . V . D . Conversion /Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 1J Yes iJ No
❑ a) Top of bottom floor (including basement or enclosure)
9 90 ft.(m)
El b) Top of next higher floor
—ft.(m)
a
• c) Bottom of lowest horizontal structural member (V zones only)
ft.(m)
o
• d) Attached garage (top of slab)
8 . 60 ft.(m)
w
❑ e) Lowest elevation of machinery and /or equipment
- 6
servicing the building
E] f) Lowest adjacent grade (LAG)
ft.(m)
S . 00 ft.(m)
E A
Z'ti
❑ g) Highest adjacent grade (HAG)
_ft.(m)
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
❑ i) Total area of all permanent openings (flood vents) in C3h
sq. in. (sq. cm)
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 in Sections A, B, and C 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.
Form 81 -31. AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS
IMPORTANT: In these spaces, copy the corresponding information from Section A. _ I For Insurance Company Use:
CITY
STATE
ZIP
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.
Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1 through E4. If the Elevation Certificate is intended for use as supporting
information for a LOMA orLOMR -F, Section C must he completed.
E1. Building Diagram Number _ (Select the building diagram most similar to the building for which this certificate is being completed –
see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is LL-1 ft.(m) LLlin.(cm) L.I above or L.I below
(check one) the highest adjacent grade.
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is
LI_I ft.(m) " lin.(cm) above the highest adjacent grade.
E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
flnn,rninin mnmmnoment nrrlinance? I I Yes I I No I I Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVt) ctrl IrR A I1UN
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.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
L� 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.
G1. 1 -1 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2. 1 -1 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. L1 The following information (Items G4 -G9) is provided for community floodplain management purposes.
G7. This permit has been issued for: LI New Construction L.1 Substantial Improvement
68. Elevation of as -built lowest floor (including basement) of the building is: —ft. (m) Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
Check here if attachments
FEMA Form 81 -31, AUG 99 REPLACES ALL PREVIOUS EDITIONS