6050 SW 63 ST_GREEN ELEVATION � :TY OF SOUTH FLAM= Z ��
® Building & Zoning Department
6130 Sunset Drive, 2nd Floor Fax #: ( 305) 666-4591
South Miami, Florida 33143 Phone: (305) 663-6325
ELEVAT=ON CERT=F=CATE
(To be completed and submitted before final building inspection)
PROPERTY INFORMATION
ED NEW SUBSTANTIAL Improvement
construction (ADDITION or REMODELING)
Permit # to Date 01105/7—
Owner's Name /✓sue/ T.6r" 740/2
Address .5,Z,61
Description: 11T
(Lot, Block, Plat Book, etc.)
. rOR''INSURANCE`:COMPANY
' -
... ,. ..
Policy., Number : :Company: NAZC.:.Number
FLOOD INSURANCE RATE MAP INFORMATION
Community # Panel #:Suffix FIRM Date FIRM Zone Base Flood
120658 ? Rev 1-20-93 ")("&uT-s iac
125098 F I1-4-1987 $0C,_ 7� , NJA NGVD
If a Variance has been obtained from DERM, provide number
ELEVATION CERTIFICATE
Indicate the diagram number that best /
describes the subject building's reference level:
THE TOP OF THE REFERENCE LEVEL FLOOR FROM
THE SELECTED DIAGRAM IS AT AN ELEVATION OF FT. NGVD
THE ELEVATION OF THE LOWEST GRADE
IMMEDIATELY ADJACENT TO THE BUILDING IS ,��� FT. NGVD
CERTIFICATION
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 under is O.S. Code, Section 1001.
Certifier
Name /�/✓,Ol�1S ��[��.0/L /�1.5. �6aS Title: �,�cSi/lrifiT
Certificate: Company Name
� plr,yt
Address/Phone:-Z�v�D !��/�J�G�_,,_.�,o/� .G�idL .G'dGcS �L•� � �/o�
Sic���ature _ Date z "7-6 - 5
COMMENTS:
�.Q7'l0/t/A-C_
3e/277, le 47 mss -
Copies should be made of this Certificate for community official, insurance agent/company, and building owner.
Rev 1/4/93