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912 898 9947
EDERPL, EMERGENCY MANAGEMENT AGE
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CER.TiFICATE
im ort*nt: Read the Instructions on a es 1 - 7.
SECTION A -PROPERTY OWNER INFORMATION
P 8 1
O.M. .B No 3067 -0077
Expires July 31, 2002
For Insurance Company Use
D N...DiNG OWNER'S NAVE
ROBERT CHU
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg, No,) OR P.O. ROUTE AND BOX 140
fl1413T3•i LANE
CITY STATE ZIP cobE
TYBEE ISLAND GA 31328 •
PROPERTY DESCRIPTION (Lot and Birk Himbers, Tax Parcei Number, Legal Description, etc.)
PARCEL 3-1 OF A SUSDIVISION OF BEACH LOT 82, WARD 4,TYEEE ISLAND
BUILDING USE (e.g., Residenliet, Non - residential, Addition, Accessory, etc Use Comrnenls section if necessary.)
RESIDENTIAL _._„_„
LATITUDE/LONGITUDE (OPTIONAL) . NORiZONT'AL DATUM: SOURCE; ❑ GP5 (Type);___
( #° - ##' - 41#1##' or ##, ,y°) iJ NAD 1927 ❑ NAD 1993 ❑ USGS Quad Map 0 Other: __
Pettey Number
Company NAIC Number
SECTION 19 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. Nr X 1EJ JITY NAW CoiviAQFETTFITTFA m is ifr
TYBEE ISLAND, GEORGIA - 135184 CHATHAM
83. SLATE
GA
r 94. MAP AND FAt1EL 85. SUFFIX I Bra. FIRM INDEX B7. FIRM PANEL I 98. FLOOD
NUMBER DATE EFFECTIVEiftt Vi9ED DATE L ZONE (6)
135164 -0302 G 6!17 6 6/17 6 A8
89. BASE FLOOD ELEVAi'ION(S)
(Zone AO, use depth or hooding) I
13
610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In 69.
❑ FIS Profile E) FIRM ❑ Community Determined 0 Other (Describe): __
911 Indicate the elevation datum used for the BFE in B9: g NGVD 1020 0 NAVD 1998 fl Other (Describe):
612. 1s the building located in a Coastal Barrier ResourcEs System (CBRS) area or Otherwise Protected Area (OPA) ?0 Yes E No
Designation DateN/A
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building etevations 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 1 (Select the building diagram most similar to the building for which this certificate is being cornp:eted - see
papas 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
03. Elevations — Zones Ai. -A30, AE, AH, A (with BFE), VE, V1 -VD, V (with BFE), AR, ARIA, AR /A1r_, AR/A1-A30, AR /AH, ARiAO
Complete items C3a 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 E3FE in Section 9, convert the datum to that used for the BFE. Show field measurements and daturn convorrion
calculation. Use the space provided or the Comments area of Section D or Section 0, as appropriate, to document the datum conversion.
Datum NGVD 1929 Conversion /Comments NONE
Elevation reference mark used LOCAL Does the elevation reference mark used appear on the FIRM? Li Yes
a) Top of bottom floor (including basement or enclosure) 15. ,ft (m)
CI b) Top of next higher floor 24,. 84 ft.(m)
❑ c) Bottom of lowest horizontal structural member (V zones only)N!A . tt.(r )
i d) Attached garage (top of stab) 15.34osfL(m)
e) Lowest elevation of machinery and /or equipment
servicing the building 15. 1 ft,(m)
C1 1) Lowest adjacent grade (LAG) 14 - Zft.(m)
J g) Highest adjacent grade (HAG) 15 Qft.(m)
G h) No, of permanent openings (flood vents) within 1 ft, above adjacent grade NfA
CI I) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq, cm)
E4
w�
3
C
No
SECTION D • SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION _
This certification is to be signed and sealed by a and surveyor, engineer, or architect autnorized by law to certify elevation information.
I certify that the information in Sections A, 8, and 0 on this certificate represents my best efforts to interpret the date available
I understand Ma! en,y false statement maybe punishable Mile ori,nprisonment under' 19 U.S. Code, Section 1001.
CERTttiER'S WANE BERT 8. BARRETT, JR. �~ LICENSE NUMBER 2228
TITLE PRESIDENT
COMPANY NAME BERT BARRETT. JR. LAIVO SURVEYING, F.G.
ADDRESS r CITY STATE z0 1615-t
-.1 z.Ealt.FR I'OtAQ . - r \ - 59VANjllat( (.A 3t410 __
SIGNATURE � DATE TELEPHONE
_9111 L02 412-139:( i1