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Home My Public Portal AboutCampbell Av_145D/� ' FEr' -RAL EMERGENCY MANAGEMENT AGENCY ,'ZONAL 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 Forinsurance Company Use: BUILDING OWNER'S NAME JIM TAYLOR Policy Number BUILDING STREET ADDRESS (Including Apt., tint Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. (�($ ,i41 D SOUTH CAMPBELL AVENUE CITY TYBEE ISLAND, STATE GA Company NAIC Number ZIP CODE 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 3-A -1 OF A SUBDIBISION OF LOT 51 -B, HORSE PEN HAMMOCK BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, RES if necessary.) LATrrUDEILONGrTUDE (OPTIONAL) ( ##° - ##' - ##.##" or ####### °) HORIZONTAL DATUM: ❑ NAD 1927 El NAD 1983 SOURCE: 0 GPS (Type): 0 USGS Quad Map 0 Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER TYBEE ISLAND 135164 82 COUNTY NAME CHATHAM B3. STATE GA B4. MAP AND PANEL NUMBER 135164 0001 B5. SUFFIX C B6. FIRM INDEX DATE 6117186 B7. FIRM PANEL EFFECTi IE/REVISED DATE 6/17186 B8. FLOOD ZONE(S) A8 B9. BASE FLOOD ELEVATION(S) (Zane AO, use depth of flooding) 13 810. indtate the source of the Base Rood Elevation (BFE) data or base flood depth entered in B9. 0 RS Profile ►l FIRM 0 Community Determined 0 Other (Describe): B11. indicate the elevation datum used forthe BFE in B9: NGVD 1929 0 NAVD 1988 0 Other (Describe): B12. is the budding located in a Coastal Barrier Resources System (CBRS) area cc Otherwise Protected Area (OPA)? 0 Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl . Buikting elevafions are based on: 0 Construction Drawings* 0 Building Under Construction` CI Finished Construction *A new Elevation Certificate wid be required when construction of the budding is complete. CZ Building Diagram Number 7 (Select the budding diagram most sinilar to the budding for which this certificate is being comp eted - see pages 6 and 7. If no diagram accurately represents the budding, provide a sketch or photograph.) C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (wih BFE), AR, AR/A, AR/AE, AR(A1 -A30, AR/AH, AR/AO Complete Items C3. -a-i below according to the balding diagram specified in Item C2. State the datum used. lithe dahan is dfferertfrom the datum used for the BFE in Section B, convert the datum to that used for the BFE. Shwa 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 NGVD 29 Cornresion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 0 Yes o a) Top of bottom floor (inducing basement or enclosure) 7. aft(n) o b) Top of text higher floor 17.2ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) NA . ft(m) o d) Attached garage (top of slab) 7. PO) o e) Lowest elevation of machinery and/or equipment servicing the budding (Describe in a Comments area) 13.0 fL(m) o f) Lowest adjacent (finished) grade (LAG) 7.5 ft(m) o g) Highest adjacent (finished) grade (HAG) 7. 9 t(m) o h) No. of permanent openings (flood vents) within 1 ft. above acijacent glade 4 o i) Total area of ad permanent openings (flood vents) in C3.h 416 sq. in. (sq. cm) No co E w CU d E c ZN g 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 inform I 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 maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME J. Whitley Reynolds LICENSE NUMBER 2249 ,ORGJ4 �� 6ZSTE4''4 NO. 2249 IMPORTANT: In these spaces, copy the corre f ng information from Section A. BUILDING STREET ADDRESS (Including Apt, Unit Suite, and/cr Bldg. No.) OR P.O. ROUTE AND BOX NO. 147 -D SOUTH CAMPBELL AVENUE CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 Forinsuarce Company Use Policy Number Company NAIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) communky official, (2) insurance agent/company, and (3) building owner. COMMENTS C3,e) =A/C PAD ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BEE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting infomnation for a LOMA or LOMB F, Section C must be completed. El . 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 bung, proms a sketch or photograph.) E2. The top of the bottom floor (inducting basement or endosure) of the baking is _ ft(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent made, (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.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on front of foram. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft(m) _in.(cm) 0 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 avalable, is the top of the bottom floor elevated in accordance with the community's floodgain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Sedan G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's 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 her Theatafemenfs in Sections A, B, C, and E are corm to the bust of my knowledge. PROPERLY OWNER'S OR OWNERS 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 f oodplain management ordinance can complete Sections A, B, C (or E), and Gel this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information in Section C was taken from other doannenta ion 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. ❑ A community official completed Section E fora 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 communitytloodplain 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 is G9. BFE or (in Zone AO) depth of flooring atthe building site is: f(m) — _ft(m) Datum: Dahxn: LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS TITLE TELEPHONE DATE ❑ Check here if attachments