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Flood Control - Elevation Certificate - 2094 N Vizacya Way - Vizcaya - 6/7/2011U.S, DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION For".I Ur$nce Campany.Use!. '..._ Al. Building Owner's Nam `� Policy Number GOIKPoov4�� .. _. . A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 2(1.91 xl. V/Z,_cdv.4 wife City £4 L.6( / M// State ZIP Code A3. Property Description (Lot and Block Nurnbers, Tax Parcel Number, Legal Description, etc.) ..&7 /e• 3e.o4il t . Jizt_44,)4 A4. A5. A6. A7. AB. $34/Co Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Z$.5111w-A/fi.41-- Latitude/Longitude: Lat. 43.4257 /V Long. //G. ZO z-7 itI Horizontal Datum: ❑ NAD 1927 Attach at least 2 photographs gf the building if the Certificate is being used to obtain flood insurance. Building Diagram Number/ For a building with a craw space or enclosure(s): a) Square footage of crawlspace or enclosure(s) /VO/U(3, sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade NOA)& c) Total net area of flood openings in A8.b NOW' sq in d) Engineered flood openings? ❑ Yes X No NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage /44t't, sq ft b) No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade dIJOIL)g` c) Total net area of flood openings in A9.b AANti 1 sq in d) Engineered flood openings? ❑ Yes No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFtP Community Nance & Community Number 4Azi:p /Ab 4 e01.4Aire I 3 82. County Name B3. State /b4//e, 84. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) )II e3 /G a 1S4 to Z//9/2o05 2//9/zoes3 AfE Z GAO B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. [] FIS Profile X FIRM Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 to NAVD 1988 ❑ Other (Describe) AU COa '3c Ilp A/a Gd1. 5E44 B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes kr No Designation Date ,(/a4-• ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. 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 A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete hems C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized Sid Cog . -T-RilAtirdrotatele ?ADD 47) LOTS Vertical Datum_Wilill) fire? Conversion/Comments IS 4' AA. !%LO'- 1 47..C21 = 247/6) Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) Z • 1 Kfeet b) Top of the next higher floor feet c) Bottom of the lowest horizontal structural member (V Zones only) „0 feet d) Attached garage (top of slab) 2Lr /7 . le I_"J feet e) Lowest elevation of machinery or equipment servicing the building Zip 1 7 .V [ eet (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) Z ` /4 ..Q�feet g) Highest adjacent (finished) grade next to building (HAG) 2 is /GI .,.„, _Pfeet h) Lowest adjacent grade at lowest elevation of deck or stairs, including N// . ❑ feet structural support meters (Puerto Rico only) meters (Puerto Rico only) ❑ meters (Puerto Rico only) 0 meters (Puerto Rico only) ❑ meters (Puerto Rico only) meters (Puerto Rico only) meters (Puerto Rico only) ❑ 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 elevation information. / 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. Were latitude and longitude in Section A provided by a licensed land surveyor? V Yes 0 No Certifier s License Number srh-6WAJ YZ SA,ullooT �Mlh 5t[QlJeVet/cv ?LS /42.Z/ Title Company Name 207 it). , 4i#i 4T. z nmL7T 1D /I+D 1?' loii �[�(/� Address '.i _-7+-- City li/7/2 0// State 2DR-3' -1/AsiZIP de Signature ' 7N'L�-' Date Telephone Name € L. Ye RT6-4. e FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For insurenceCOMpany.Use:.,:. Building Street Address (including Apl., Unit, Suite and/or Bldg. No.) or P.O. Route and Box No. Policy Number.,- _ Z094 .AJ . 11/2Cb'V/4 tc-4W City State ZIP Code Compariy NAIC Number '" 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 Signature L 03 6 14I) /A STII ,LL6Tt) A/9/7.o/� Date L!J'"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. El. 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, crawlspace, or enclosure) is feet ❑meters ❑above or ❑below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section Items 8 and/or 9 (see a es 8-9 of Instructions), the next higher floor (elevation C2.6 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 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. G4. Permit Number G5. Date Permit Issued 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 G9, BFE or (in Zone AO) depth of flooding at the building site G10. Community's design flood elevation Local Official's Name Title Community Name Telephone Signature Date Comments 0 feet ❑ feet ❑ feet ❑ meters (PR) Datum ❑ meters (PR) Datum ❑ meters (PR) Datum 0 Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. 1 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 2094 /Af 444,/i Gc.)neri City State ZIP Code CompanyNA)CNumber " - E"4G (—a— /DA lie) g34/60 For Insurance Company llse: Policy 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 on the reverse. Building Photographs Continuation Page Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. City State ZIP Code For Insurance Gortl Use: Policy Number • Company NAIC Number 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."