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Home My Public Portal AboutTeresa Ln_17nFEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE mportant: Read the instructions on pages 1 - 7. O.M.B. No. 3067 -0077 Expires July 31, 2002 SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME HALLMARK HOMES Policy Number BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. 17 TERESA LANE Company NAIC Number CITY STATE ZIP CODE TYBEE ISLAND GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 17, NORTHWAVE SUBDIVISION, PHASE 1 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE /LONGITUDE (OPTIONAL) HORIZONTAL DATUM: ( ##° - ##' - ##.##' or ##.##### °) ❑ NAD 1927 ❑ NAD 1983 SOURCE: ❑ GPS (Type): ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER CHATHAM COUNTY 130030 B2. COUNTY NAME CHATHAM 83. STATE GA B4. MAP AND PANEL NUMBER 135164 — 01 B5. SUFFIX C B6. FIRM INDEX DATE 9/20/95 B7. FIRM PANEL EFFECTIVE /REVISED DATE 5/19/87 B8. FLOOD ZONE(S) V9 B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 14.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 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 SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Z Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 6 (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 A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/A0 Complete Items C3a -i 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 Section G, as appropriate, to document the datum conversion. Datum NGVD\29 Conversion /Comments Elevation reference mark used TBM Does the elevation reference mark used appear on the FIRM? ❑ Yes o a) Top of bottom floor (including basement or enclosure) o b) Top of next higher floor 17. 93 ft.(m) 27 . 95 ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) 16 . 59ft.(m) o d) Attached garage (top of slab) 8. 16ft.(m) o e) Lowest elevation of machinery and/or equipment servicing the building NSA . _ft.(m) o f) Lowest adjacent grade (LAG) 6 . 12ft.(m) o g) Highest adjacent grade (HAG) 6. 54ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N\A o i) Total area of all permanent openings (flood vents) in C3h MA sq. in. (sq. cm) To N 0 0 w E Z ® No rovce,(-3 co % Fo\ 5 �9 2486 �I 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. I certify that the information in Sections A, B, and C 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. CERTIFIER'S NAME TERRY MACK COLEMAN LICENSE NUMBER GA RLS # 2486 TITLE R4istered Land Surveyo, iIADDRESS % GNA UR� , FEMA = orm 81 31, A COMPANY NAME KERN - COLEMAN & COMPANY CITY Savannah A STATE GA TELEPHONE 912 -354 -8400 ZIP CODE 31406 G 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 17 TERESA LANE CITY TYBEE ISLAND STATE ZIP CODE GA 31322 Policy Number Company 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 El 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 (including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. 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. E4. 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 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. 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. 31. ❑ 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 local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) 32. ❑ A community-official dompleted Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. 33. ❑ 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 37. This permit has been issued for ❑ New Construction ❑ Substantial Improvement 38. Elevation of as -built lowest floor (including basement) of the building is: 39. BFE or (in Zone AO) depth of flooding at the building site is: . _ft.(m) _ ft.(m) Datum: Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check.here if attachments =EMA Form 81 -31, AUG 99 REPLACES ALL PREVIOUS EDITIONS