6835 SW 67 ST_GREEN FINAL ZONING L
f
` CITY OF SOUTH MIAMI
BUILDING DEPARTMENT
JOB LOCATION: 6835 SW 67 STREET PERMIT #: 09-0691
OWNER: CSM REAL ESTATE LLC
PHONE: PERMIT TYPE: BLDG-NEW CONSTRUCTION
CLASS OF WORK: NEW SINGLE FAMILY RESIDEN
CONTRACTOR: CUE CONSTRUCTION LLC
PH0RE:(305) 610-6651 PROPOSED USE: NA
WORK DESCRIPTION: new single family home
INSPECTION REQUIRED: OTHER INSPECTION INSPECTOR: ML
DATE REQUESTED: 11/04/11
DATE INSPECTED: _�0��S�1-0BY _ -Mv!!-____________________ APPROVED: REJECTED: ----
COMMENTS final zoning
Location of work on site; as approved on permit drawings; is the responsibility of the contractor or owner/builder.
y,wuc
CITY OF SOUTH MIAMI
BUILDING DEPARTMENT
JOB LOCATION: 6835 SW 67'STREET PERMIT : 09-0691
OWNER: CSH REAL ESTATE LLC
PHONE:
PERMIT TYPE: BLDG-NEW CONSTRUCTION
-. CLASS OF WORK: NEW SINGLE FAMILY RESIDER
CONTRACTOR: CUE CONSTRUCTION LLC
PHONE:(305)A'10-6651 PROPOSED USE: NA
WORK DESCRIPTION: new single familYAORe
INSPECTION REQUIRED: OTHER INSPECTION INSPECTOR: HL
DATE REQUESTED: 11104/11
DATE INSPECTED: -I1��S !-\ BY_...__M_"_?L.______._._._---_-____--
APPROVED'.'" REJECTED: -__-.--
COMMENTS final zoning } +` "3?al,F
Location of work on site; as approved on permit drawings; is the responsibilitY;of the contractor or owner/bni _r; ;.
BP 501UO2 CITY OF SOUTH MIAMI 1/10/12
Inspection Results Entry 10: 19: 12
Application number , type : 09 00000691 NEW SINGLE- FAMILY RESIDENCE—ATTATCH
Structure, permit . . . . : 000 000 BPN 00
Inspection type, sequence : B10 0010 OTHER INSPECTION
Property address . . . . : 6835 SW 67 STREET
Request date, time, by : 11/04/11 17:00 DM
Type information, press Enter.
Inspector ID (F4) . . . . ML
Results date 11012
Results status (F4) . . . . . AP'
Final insp — flag (F4) . . . . . N
Edit comments . . . . . . . Y Y=Yes
Display inspection penalties . . _ Y=Yes
Point value . . . . . . . . . .
F3=Exit F4--Prompt F7=Request comments F9=Standard comments F12=Cancel
BP006U01 CITY OF SOUTH MIAMI 1/10/12
Edit Narrative 10: 19:44
Application number , type 09 00000691 NEW SINGLE FAMILY RESIDENCE-
Property address . . . . 6835 SW 67 STREET
Type information, press Enter.
FINAL ZONING INSPECTION APPROVED. APPLICANT SIGNED
STORMWATER MAINTENANCE AGREEMENT. NO OTHER COMMENTS.
T/S: 01/10/2012 10: 19 AM MLIGHTFOOT --------------------
More. . .
F3=Exit F5=Copy F6=Insert F7=Delete F8--Time stamp
F12=Cancel F21=User defaults
'.Ughtfoot,_Marcus
Fran: Smilka Melgoza [smilka @sharekindness.org]
Seat: Thursday, November 17, 2011 10:20 AM
. To: Lightfoot, Marcus
Cc: Jose Cue; Frank Perez
Subject: Fwd: Patio columns
Hi Marcus
Find enclosed columns pictures.
Kind Regards,
Smilka Melgoza
Begin forwarded message:
From: "Frank Perez" <frankkentekconstruction.com>
To: "Smilka Melgoza" <smilkagsharekindness.org>
Subject: Patio columns
For Marcus
1
Regards,
Frank C. Perez, P. E.
frankL entekconstruction.com
Phone: 305-662-1920
Fax: 305-662-1925
3
I��III I�III I��I��IIII VIII I�L��lIII��II�I I�lI
c- - - - - -
31 IRC-17613962-
OR $k 278?0 :P9s 4813 - 4816; t4a.9s#
RECORDED 11/101201.1 14"02:01
HARVEY RUVIN? CLERK.OF .COURT
MIAMI-GLADE COUNTY? FLORIDA
(Space Reserved for Clerk of Court)
STORMWATER.MAINTENANCE AGREEMENT
This Stormwater Maintenance Agreement made and executed this day of
.20.11, by CSM Real Estate,`LLC and the City of"South Miami,6130 Sunset Drive, So :Miami
Florida 33143.
WHEREAS,the undersigned is the Owner of that property described as:
Address:-6835 SW 67 Street, South Miami, Florida 33143
Folio No.: 09-4026-008=0060
Legal Description: 26 54 40 1.125 AC NELSON HOMESITES PB 39-57 W1161FT OF TR 6
PER W/P#20818 OR 18579-1365 04992 COC 25990-2088 10-2007 2 OR 25990-2088 1007 02
as_recorded Public Records of Miami-Dade County,Florida
WHEREAS, in accordance:with the City of South Miami Land Development Code; the
Minimum Housing Standards Section 20-4.7(C)(4) states that stormwater tcausig recurrent or
excessive ponding shall be eliminated through proper filling or grading. The ground shall be
graded .away from.the building and foundation, but not so as to cause water to drain onto
adj oining property or public.rights-of-way.
WHEREAS, Upon the final inspection performed.by the City of South Miami's Planning
& Zoning and Public Works Department for the aforementioned property, it was noted that the
property was elevated; which would ultimately foster drainage of excess stormwater onto the
adjoining properties and public right-of-way. Because:of the inability to predict the flow of
stormwater r-runoff and ponding in the public right-of-way and/or adjacent properties due to the
addition of the newly constructed property, in addition to the existing.drainage system installed
by the. Owner, Public Works has decided to require the installation of a drainage system
including catch basins and exfiltration trenches..(supported by plans and calculations from a.
registered Florida Professional Engineer)in,the event that ponding within the public right=of-quay
and/or adjacent properties occurs due to runoff in association with the above referehced'property.
NOW, THEREFORE, this Agreement is entered into by and between.the City of*South
Miami,Florida, a Florida municipal corporation, and CSM Real'Estate, LLC for itself and for its
successors,.assigns and heirs,._in and for the consideration of ten.dollars($10..00)and the mutual
covenants' contained. in this Agreernentj the receipt and legal sufficiency. of
whi ch is
acknowledged by both parties:.
pp co�N
Page 1 of4 J\�A CLcaK r
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A. In the event that the City's Operations, Engineering, & Construction Manager
determines that excess stormwater runoff generated by the newly constructed property creates
ponding within the public right-of-way and/or adjacent properties; the Owner shall construct and
install a drainage system including catch basins and ex-filtration trenches(supported by plans and
calculations from a registered Florida Professional Engineer) -to assist in the consumption and
absorption -of'stormwater runoff. After installation of the -system, the City's Public Works
Department shall inspection the site before.issuing a Certificate-of Occupancy.for the property..
During installation the.Owner shall satisfy all state, county and City plan-reviews, and comply
with permitting and construction standards, including, but not limited to, limiting the.location
where drainage trenches .can. be installed and specifying the standards for drainage system
construction.
B. The Owner shall maintain the drainage improvements in-good repair at all times;
at its sole expense, and prevent the drainage improvements from becoming traffic and pedestrian
hazards. The Owner shall be entitled to enter the right-of-way as necessary to perform necessary
maintenance, subject to standard permit requirements. The City shall have the right,but not the
obligation,to repair the drainage improvements upon giving the Owner 30-days written notice of
any necessary repairs, and Owner's failure to perform the repair within-an additional 30-day
period,-_The cost of the repairs shall be charged to and shall be reimbursed by the Owner within
30 days of receipt of the invoice from the City.
C. Owner shall have .the right to. enter the right-of-way for the purpose of
constructing and maintaining the drainage improvements. Owner shall secure necessary permits
from the!City to perform the work and shall notify the Public Works Department of its.work
schedule and work plans.
D. This agreement will be recorded at the applicant's expense.in the.official records
of Miami-Dade County and binding on any subsequent purchaser. A copy of which shall be
filed in the records of the City of South Miami's Planning & Zoning Department. ,The rights,
powers and obligations.under this Agreement shall run with the property into perpetuity and shall
bind the successors, assigns and heirs of the Owner and the City. This Agreement shall be
recorded and the property shall,be encumbered by this Agreement.
E_ Any cost incurred by,.the City to install, maintain or repair the drainage system
required by this agreement, either incident to an emergency. action or upon the failure of the
Owner to install, maintain or repair the system as required:under:this agreement after receipt of
written notice by the City, or to correct a dangerous or unsafe condition, or any cost incurred by
the City to defend or pay any claim, ,investigation, settlement,judgment or expense, including
reasonable attorney's fees and costs necessarily incurred,arising out of or relating to any claim
for death or bodily injury,property damage, including damage to the right-of-way; or personal
injury.that is allegedly caused in whole or in part by the construction and/or maintenance, or the
failure to maintain the drainage improvements shall constitute a lien against the Property. The
lien shall have the status and priority of a special assessment lien. The City shall have the right
and the power to record.the lien if the cost is not paid by the Owner to the City within 30 days of
Page 2 of 4
:issuing-the invoice for costs and to thereafter enforce the lien by foreclosure:and by any other
lawful means.
F. Owner shall indemnify, defend and hold the City harmless for any -claim,
investigation, settlement, judgrnent or expense,. including reasonable attorney's fees and costs
necessarily incurred,arising out of or relating to any claim for death or bodily injury, property
damage, including damage.to the right-of-way, or personal injury that is caused in whole or in
part by the construction and/or maintenance, or the failure to maintain the drainage
improvements.
G. The drainage improvements shall be maintained in a safe condition at all times by
Owner.,in-the event the City determines that an unsafe or dangerous condition exists in the right-
of way which is caused.in whole or in part by the Owner's.failure to maintain.or to restore the
improvements.as required under this agreement, the City has the right, after giving the Owner
30-days written notice,to cure, repair, correct or modify.the drainage improvements and the
affected right-of-way at the Owner's expense.
H. If the City determines that the unsafe or dangerous condition is of an emergency .
-nature, which threatens public safety or damage to property, it may take immediate action to
remedrthe situation. The City shall give notice of the emergency condition and the corrective
action to the Owner as;soon as ispracticable, at the Owner's expense..
I. The City reserves the right to. enter upon the property at any time for any
municipal purpose; including,but not limited to,.clearing accidents, maintaining the stormwater
'infrastructure installed on the property,,, or placement of telecommunication cables and.
equipment, The City, or its agents and licensees, and independent contractors, shall disturb the
drainage improvements as little as possible to accomplish the municipal purpose; and the City
shall be responsible for repairing any damage to the drainage improvements caused by the City,
its agents, licensees and independent-contractors.
Je For the purposes of this Agreement, Florida law shall govern the terms of this
Agreement. Venue shall be in Miami-Dade County,Florida:
K. The City does not waive sovereign immunity, and shall not be liable for the
payment of attorney's fees or prejudgment interest.
..L. The officials executing this Agreement warrant and represent that they are
authorized byl their respective agency . to: enter into a binding Stormwater Maintenance
Agreement:
Page.3,of 4
CSR Bpi � a�89A� PG � v16
AST PAGE
-CSM Real Estate, LLC ector M'rrabile,PhD
City Manager
IN WITNESS WHEREOF,this Agreement is accepted and delivered on the date stated
above by the following signatories.
STATE OF FLORIDA )
ss:
COUNTY OF MIAMI-DADE)
ACKNOWLEDGEMENT OF PROPERTY OWNER
The foregoing instrument was acknowledged before me this _day of
2011 by <= Mj ad - 1Z of CSM Real Estate,LLC as
on behalf of the Property Owner,who is personally known to me or has
u h s identification.1e9 � 'b
Notary Public,State.of Florida
E-I-4 ry Public State of Flori da ck.Dulao ommission DD960180 Prmt name: )u o
res 02/101.2014
Commission No:
STATE OF FLORIDA )
SS:
COUNTY OF MI A.M-DARE)
ACKNOWLEDGEMENT OF CITY.OF SOUTH MIAMI
The foregoing instrument was acknowledged before me this day of
201.1 by Hector Mirabile PhD, City Manager, and the City of South Miami on behalf of th Ci,
tY � � �Y � ty,
who are personally known to me:
STATE OF FLORIDA,COUNTY OF;DADS
I HEREBY CERTIFY that this is a true copy of the co
,� cicaa �0
oiig,n.a1 flied m this once on�__�day of �+ �
NOV 1 0 20 , a a 20 U y
--- Notary Pu tate of Florida
WITNESS has re. eai,. 7 �
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BP50IU02 CITY OF SOUTH MIAMI 9/16/11
Inspection Results Entry 10 : 54 : 56
.Application number, type 11 00000432 * FENCES AND WALLS
Structure, permit . . . 000 000 BDF 00
Inspection type, sequence : B10 0001 OTHER INSPECTION
Property address . . . . . 6835 SW 67 STREET
Request date, time, by . . 8/12/11 17 : 00 DM
Type information, press Enter.
Inspector ID (F4) . . . . . . . ML
Results date . . . . . . . . 91611
Results status (F4) . . . . . . AP
Final insp - flag (F4) . . . . . N
Edit comments . . . . . . . . . Y Y=Yes
Display inspection penalties . . _ Y=Yes
Point value . . . . . . . . . .
F3=Exit F4=Prompt F7=Request comments F9=Standard comments F12=Cancel
BPO06UO1 CITY OF SOUTH MIAMI 9/16/11
Edit Narrative 10 : 55 : 10
Application number, type 11 00000432 * FENCES AND WALLS
Property address . . . . . . . 6835 SW 67 STREET
Type information, press Enter.
FINAL ZONING INSPECTION APPROVED. NO COMMENTS .
T S: 09/16/2011 10 : 55 AM MLIGHTFOOT --------------------
More. . .
F3=Exit F5=Copy F6=Insert F7=Delete F8=Time stamp
F12=Cancel F21=User defaults
CITY OF SOUTH MIAMI
BUILDING DEPARTMENT
JOB LOCATION: 6835 SW 67 STREET PERMIT #: 11-0432
OWNER: CSM REAL ESTATE LLC
PHONE:
PERMIT TYPE: BLDG-FENCES/WALLS
CLASS OF WORK: t FENCES AND WALLS
CONTRACTOR: CUE CONSTRUCTION LLC
PH0NE:1.305) 610-6651 PROPOSED USE: NA
WORK DESCRIPTION: exterior fence and gates
INSPECTION REQUIRED: OTHER INSPECTION INSPECTOR: ML ~
DATE REQUESTED: 81112/11
DATE INSPECTED: qj-j(9I_'(---BY___--BMW►- _ --__ -- APPROVED: REJECTED: __--
No C "
rb
Location of work on site; as approved on permit drawings; is the responsibility of the contractor or owner/builder.
ti 01 youTy t, South Miami
City of South Miami
Planning and Zoning Department ;Anwricac'i
• INCORPORATED • 6130 Sunset Drive, South Miami, Florida 33143 -
192]
0 1 Phone: 305-663-6326 Fax: 305-668-7356 e
2001
Memo of Review for Correctness and Completion
In accordance with participation in the NFIP/CRS program,all elevation certificates are required to be reviewed for correctness and
completion prior to acceptance by the community. This completed form shall be attached to all elevation certificates maintained on file
and provided with requested copies of elevation certificates.
The attached elevation certificate requires corrections by the surveyor of section(s) prior to
acceptance by the community.
X The attached elevation certificated is complete and correct.
Minor corrections have been made in the below marked sections by the authorized Community Official.
SECTION A-PROPERTY INFORMATION For.Insurance,CompanyUse
Al. Building Owner's Name Policy Number
A2. Building Street Address mcludin Apt.,Unit,Suite,and/or Bldg.:No.)or P.O.Route and Box No. Company NAIC Number
tots 3 5 S (o S4yeef
City . S.M1Q.111nt State �L ZIP Code 331+3.
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)
A5. Latitude/Longitude:Lat. Long. Horizontal.Datum: ❑NAD 1927 ❑ NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance..
AT Building Diagram Number
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) sq ft a) Square footage of attached garage sq ft
b) No.of permanentflood 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 walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c). Total net area of flood openings in A9.b sq in
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number. B2.County Name B3.State
B4.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)
1310. Indicate the source of the Base Flood Elevation(BFE)-data or base flood depth entered in item B9.
❑FIS Profile ❑FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item B9:.❑ NGVD 1929 ❑NAVD 1988 ❑Other(Describe)'
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑ No
Designation Date ❑CBRS ❑OPA
COMMENTS: N-e%-� Ctslskc�,tN, S'1ytR�t Frtyv�tl� Qe��dc,,,ce
Date of Review: (I ]°$ 1 20 rl Community Official: IZW
All elevation certificates shall be maintained by the community and copies with the attached memo made ailab upon request.
Y:\Flood\EC Correction Form Template.doc
,SS A
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency Management Agency I Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION For Insurance Company Use,
Al. Building Owners Name CUE CONSTRUCTION LLC 10-14111 Policy Number i
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No,)or P.O.Route and Box No. "Compan NAIC I�fumber
X '
�y 3 r•
6835 S.W.67TH STREET ^
City SOUTH MIAMI State FL ZIP Code 33143
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
26 54 40 1.125 AC NELSON HOMESITES PB 39-57 W161 FT OF TR 6 PER W/P
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longitude:Lat.25D42'31.09"N Long.80D18'16.36'W Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6: Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1 B
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 0 sq ft a) Square footage of attached garage 832 sq ft
b) No.of permanent flood openings in the crawlspace or b) No.of permanent flood openings in the attached garage
enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 1
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b 168 sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name B3.State
CITY OF SOUTH MIAMI 120658 1 MIAMI-DADE FL
B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12086C 0458 L Date Effective/Revised Date Zone(s) AO,use base flood depth)
09/11/09 09/11/09 X + N/A N.G.V.D.
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other(Describe)_
Bl 1. Indicate elevation datum used for BFE in Item 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe)_
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date N/A ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. 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 Al-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 Items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized #P-4025(Miami-Dade)Vertical Datum N.G.V.D. 1929
Conversion/Comments N/A
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor)14.80 ®feet ❑meters(Puerto Rico only)
b) Top of the next higher floor N/A._ ®feet ❑meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) N/A._ ®feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) 14.00 ®feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 14.30 ®feet ❑meters(Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 13.0 ®feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 13.1 ®feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A._ ®feet ❑meters(Puerto Rico 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 r
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 ,
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by arF � LASE jr
licensed land surveyor? ® Yes [I No
y E�
Certifier's Name RENE AIGUESVIVES License Number 4327 �z
Titl ROFESSION LAND SURVEYOR AND MAPPER Company Name ALVAREZ,AIGUESVIVS: `A
AN ASSOCIATES C. X
Ad ess 5 01 107 AVENUE# City MIAMI State FL ZIP Code 33173
Sign atur Date 09/22/11 Telephone 305-220-2424 k
FEMyForm 81---'-31,,
/ r 09 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. :aForinsuranceCompany,U� „ v�hY.
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. '�"_ .#
6835 S.W.67TH STREET 10-14111
City SOUTH MIAMI State FL ZIP Code 33143 I'm m3ny NANumber�
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 CROW OF RO LEVATION=13.66 FEET(N.G.V.D.)
C2.e)MACHII�ERY EVATION REFERS TO A/C UNIT PAD.ELEVATION=14.30 FT(N.G.V.D.)
GENERATOR S ELEVATION=14. 3 F��(N`G.V.D.)
aTITUDE/L/0 ITUDE OBTAINED 1NG A GPS MAGELLAN MAESTRO 4210.
BENCHM USED=#P-4025 afiii-Dade),€LEVATION=10.1 FT(N.G.V.D)
i
Signature /' Date 09/22/11
,_ ❑ Check here if attachments
SECTION,E-BUILDING ELOATjefi INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE), mplete 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 nat al 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,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 A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b 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? C3 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 A0.
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:—_ ❑feet ❑meters(PR)Datum _
G9. BFE or(in Zone AO)depth of flooding at the building site: __ ❑feet ❑meters(PR)Datum _
G10.Community's design flood elevation __ ❑feet ❑meters(PR)Datum _
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments
FEMA Form 81-31, Mar 09 Replaces all previous editions
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Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number
6835 S.W.67TH STREET 11-14111
City SOUTH MIAMI State FL ZIP Code 33143 Company NAIC 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,
following.
FRONT VIEW 09/22/11
gill i �
REAR VIEW 09/22/11
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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
6835 S.W.67T"STREET 11-14111
City SOUTH MIAMI State FL ZIP Code 33143 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."
LEFT SIDE VIEW 09122/11 RIGHT SIDE VIEW 09/22/11
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