HomeMy Public PortalAboutRiver Oak Lane_6_20131107U.S. DEPARTMENT OF HOMELAND SECURITY
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -9.
OMB No. 1660 -0008
Expiration Date: July 31, 2015
SECTION A - PROPERTY INFORMATION
Al. Building Owner's Name DIANE BELITKUS
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
6 RIVER OAK LANE
FOR INSURANCE COMPANY USE
Policy Number.
City TYBEE ISLAND State GA ZIP Code 31328
Company NAIC Number.
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT K OF A SUBDIVISION OF LOTS 8 & 9 HORSE PEN HAMMOCK
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude /Longitude: Lat. N 32 °00'46.2" Long. W 80 °51'00.2" 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 6
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) 1276 sq ft a) Square footage of attached garage NA sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade 18 within 1.0 foot above adjacent grade NA
c) Total net area of flood openings in A8.b 14340 sq in c) Total net area of flood openings in A9.b NA 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
CITY OF TYBEE ISLAND 135164
B2. County Name
CHATHAM
B3. State
GEORGIA
B4. Map /Panel Number
13051CO213
B5. Suffix
F
B6. FIRM Index Date
09 -26 -08
B7. FIRM Panel
Effective /Revised Date
09 -26-08
B8. Flood
Zone(s)
AE
B9. Base Flood Elevation(s) (Zone
AO, use base flood depth)
11
B10. Indicate the source of he Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other /Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other /Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. 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 A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a -h
below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters.
Benchmark Utilized: USGS TIDAL NO. 6 Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other /Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 7.8 ® feet ❑ meters
b) Top of the next higher floor 17.6 ® feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) 16.3 ® feet ❑ meters
d) Attached garage (top of slab) NA. ❑ feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 14.0 ® feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 6.6 ® feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 8.1 ® feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 5.8 ® feet ❑ meters
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. /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 a
❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No
Certifier's Name JAMES M. KEATON, RLS License Number GA #2743
Title LAND SURVEYOR Company Name CHATHAM SURVEYING SERVICES, INC
Address PO BOX 61649
City SAVANNAH State GA ZIP Code 31411
Signature
m.
Date NOVEMBER 07, 2013
Telephone 912 - 303 -0302
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FEMA Form 086 -0 -33 (7/12)
See reverse side for continuation. Replaces all previous editions.
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a n d C . F o r I t e m s E 1 E 4 , u s e n a t u r a l g r a d e , i f a v a i l a b l e . C h e c k t h e m e a s u r e m e n t u s e d . I n P u e r t o R i c o o n l y , e n t e r m e t e r s .
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g r a d e ( H A G ) a n d t h e l o w e s t a d j a c e n t g r a d e ( L A G ) .
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( e l e v a t i o n C 2 . b i n t h e d i a g r a m s ) o f t h e b u i l d i n g i s Q' f e e t Q' m e t e r s Q' a b o v e o r Q' b e l o w t h e H A
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E 5 . Z o n e A O o n l y : I f n o f l o o d d e p t h n u m b e r i s a v a i l a b l e , i s t h e t o p o f t h e b o t t o m f l o o r e l e v a t e d i n a c c o r d a n c e w i t h t h e c o m m u n i t y ' s f l o o d p l a i n m a n a g e m e n t
o r d i n a n c e ? Q' Y e s Q' N o Q' U n k n o w n . T h e l o c a l o f f i c i a l m u s t c e r t i f y t h i s i n f o r m a t i o n i n S e c t i o n G .
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t h e l o c a l o f f i c i a l w h o i s a u t h o r i z e d b y l a w o r o r d i n a n c e t o a d m i n i s t e r t h e c o m m u n i t y ' s f l o o d p l a i n m a n a g e m e n t o r d i n a n c e c a n c o m p l e t e S e c t i o n s A , B , C ( o r E ) , a n d G
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i s a u t h o r i z e d b y l a w t o c e r t i f y e l e v a t i o n i n f o r m a t i o n . ( I n d i c a t e t h e s o u r c e a n d d a t e o f t h e e l e v a t i o n d a t a i n t h e C o m m e n t s a r e a b e l o w . )
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G 4 . P e r m i t N u m b e r
G 5 . D a t e P e r m i t I s s u e d
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3 9 . B F E o r ( i n Z o n e A O ) d e p t h o f f l o o d i n g a t t h e b u i l d i n g s i t e :
3 1 0 . C o m m u n i t y ' s d e s i g n f l o o d e l e v a t i o n :
Q' f e e t Q' m e t e r s D a t u m
Q' f e e t Q' m e t e r s D a t u m
Q' f e e t Q' m e t e r s D a t u m
L o c a l O f f i c i a l ' s N a m e
T i t l e
C o m m u n i t y N a m e
T e l e p h o n e
S i g n a t u r e
D a t e
C o m m e n t s
Q' C h e c k h e r e i f a t t a c h m e n t s .
= E M A F o r m 0 8 6 - 0 - 3 3 ( 7 / 1 2 )
R e p l a c e s a l l p r e v i o u s e d i t i o n s .
ELEVATION CERTIFICATE, page 3
Building Photographs
See Instructions for Item A6.
IMPORTANT: In these spaces, copy the corresponding information from Section A.
LFOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
6 RIVER OAK LANE
Policy Number.
City TYBEE ISLAND
State GA ZIP Code 31328
Company NAIC Number.
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
FEMA Form 086 -0-33 (7/12)
Replaces all previous editions.
ELEVATION CERTIFICATE, page 4
Building Photographs
Continuation Page
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.
6 RIVER OAK LANE
Policy Number.
City TYBEE ISLAND
State GA ZIP Code 31328
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." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
FEMA Form 086 -0-33 (7/12)
Replaces all previous editions.