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Home My Public Portal AboutCampbell Av_145ENATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. O.M.B. No. 3067 -0077 Expires December 31, 2005 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME JIM TAYLOR Policy Number BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 4 4 s yYl -E SOUTH CAMPBELL AVENUE Company NAIC Number CITY TYBEE ISLAND, STATE ZIP CODE GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 3-A -2 OF A SUBDIVISION OF LOT 51-B, HORSE PEN HAMMOCK BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RES LATITUDE/LONGITUDE (OPTIONAL) ( ##° - ##' - ##.##" or ##.#t##W#°) HORIZONTAL DATUM: D NAD 1927 ❑ NAD 1983 SOURCE: D GPS (Type): D USGS Quad Map 0 Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER TYBEE ISLAND 135164 B2. COUNTY NAME CHATHAM B3. STATE GA B4. MAP AND PANEL NUMBER 1351640001 B5. SUFFIX C B6. FIRM INDEX DATE 6/17/86 B7. FIRM PANEL EFFECTIVE/REVISED DATE 6/17/86 B8. FLOOD ZONE(S) AE B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 13 B10. Indicate the source of the Base Float Elevation (BFE) data or base flood depth entered in B9. 0 RS Profile ® FIRM 0 Community Determined 0 Other (Describe): B11. Indicate the elevation datum used for the BFE in 89: ►5 NGVD 1929 0 NAVD 1988 0 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1, Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 7 (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, AR/A, AR/AE, AR/A1 A30, AR/AH, AR/AO Complete Items C3. -a4 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 Seddon G, as appropriate, to document the datum conversion. Datum NGVD 29 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 0 Yes ® No o a) Top of bottom floor (including basement or endosure) 7. 9 ft.(m) Ta o b) Top of next higher floor 17.2 ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft.(m) o d) Attached garage (top of slab) 7. 9 ft.(m) o o e) Lowest elevation of machinery and/or equipment w • servicing the building (Describe in a Comments area) 13.0 ft.(m) c o f) Lowest adjacent (finished) grade (LAG) 7.5 ft.(m) o g) Highest adjacent (finished) grade (HAG) 7. 9 ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 4 o i) Total area of all permanent openings (flood vents) in C3.h 416 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. 1 certify that the information in Sections A, B, and Con 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. CERTIFIER'S NAME J. WHITLEY REYNOLDS LICENSE NUMBER 2249 TITLE LAND SURVEYOR COMPANY NAME ADDRESS 636 STEPHENS SIGNATURE FEMA Form : ' -31, January 2003 CITY STATE SAVANNAH GA DATE TELEPHONE 10/14/05 912-352-0464 ZIP CODE 31405 See reverse side for continuation. Replaces all previous editions - - _ nuvnnauvn uv I Qecuon For fnsuranceCompany Use: BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and' - -Bldg. No.) OR P.O. ROUTE AND BOX NO. 147 -E SOUTH CAMPBELL AVENUE crrY STATE ZIP CODE TYBEE ISLAND, GA 31328 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. Policy Number Company NAIC Number COMMENTS C3.e) = NC PAD ❑ 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 El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be 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 (induding basement or endosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is ft.(m) _in.(an) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery andior equipment servicing the building is , ft.(m) __in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. 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 floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local offidal must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), 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, C, and E are coned to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES 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. G1. ❑ 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 loci law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community offidal 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 COMPUANCE/OCCUPANCY ISSUED G7. This permit has been issued for. ❑ New Construction Q Substantial Improvement G8. Elevation of as -built lowest floor (induding basement) of the building is: G9. BFE or (in Zone AO) depth of flooding at the building site is: ft(m) _ ft.(m) Datum: Datum: LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS TITLE TELEPHONE DATE ❑ Check here if attachments FEMA Form 81 -31, January 2003 Replaces all previous editions