HomeMy Public PortalAboutTaylor St_3Apr 19 10 08:15a J Whitley Reynolds
912 352 7787 p•1
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
Federal Emergency Management Agency
National Flood Insurance Program
Important: Read the instructions on pages 1 -9.
OMB No. 1660 -0008
Expires March 31, 2012
SECTION A - PROPERTY INFORMATION
For Insurance Company Use:
Al. Building Owner's Name Bill Robinson
Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
3 Taylor Street
Company NAIC Number
City Tybee Island State GA ZIP Code 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.
Lot 5-A of a recombination of lots 3, 4 & 5, block 32, Fort Screven Ward
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. N 32 deo 01.4080 min Long. W 80 dee 50.8940 min
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood in
A7. Building Diagram Number 5
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawispace or enclosure(s) n/a sq ft
b) No. of permanent flood openings in the crawlspace or
enclosure(s) within 1.0 foot above adjacent grade n/a
c) Total net area of flood openings in A8.b n/a sq in
d) Engineered flood openings? ❑ Yes ® No
A9. For
a)
b)
c)
d)
Horizontal Datum: ❑ NAD 1927 IS NAD 1983
surance.
a building with an attached garage:
Square footage of attached garage n/a sq ft
No. of permanent flood openings in the attached garage
within 1.0 foot above adjacent grade n/a
Total net area of flood openings in A9.b nla sq in
Engineered flood openings? ❑ Yes )H No
SECTION B - FL000 INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
Tybee Island 135164
Chatham
GA
B4. Map/Panel Number
B5. Suffix
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevation(s) (Zone
13051 CO213F
F
Date
Effective/Revised Date
Zone(s)
AO, use base flood depth)
9126/08
9/26/08
AE
12
810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe)
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Describe)
812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes
Designation Date ❑ CBRS ❑ OPA
® No
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, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/A0. Complete Items C2.a -h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized IocalVertical Datum NAVD 1988
Conversion/Comments
a)
b)
c)
d)
e)
f)
9)
h)
Top of bottom floor (including basement, crawlspace, or enclosure floor) 16.8
nia.
o1.
nom.
15.1
Top of the next higher floor
Bottom of the lowest horizontal structural member (V Zones only)
Attached garage (top of slab)
Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
Lowest adjacent (finished) grade next to building (LAG)
Highest adjacent (finished) grade next to building (HAG)
Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support
6.4
7.0
6.8
Check the measurement used.
® feet
® feet
® feet
® feet
® feet
® feet
® feet
® feet
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
❑ meters (Puerto Rico only)
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. t certify that the information on this Certificate represents my best efforts to interpret the data available.1
understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? ® Yes ❑ No
Certifier's Name J. Whitley Reynolds License Number 2249
Title Company Name J. Whitley Reynolds, Land Surveyor
Address 636 St- ' n •n Avenue, Suite C City Savannah, State GA ZIP Code 31405
Signature
ate 4/19/10 Telephone 912 - 352 -0464
FEMA Fo :1 -31, Mar 09
ee reverse side for continuation. Replaces all previous editions
Apr 19 10 08:16a J Whitley Reynolds
912 352 7787
p.2
IMPORTANT: In these spaces, copy the corresponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
3 Taylor Street
For Insurance Company Use:
Policy Number
City Tybee IslandState GA ZIP Code 31328
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 C2.e) =NC pad
Sign = re
Date 4/19/10
❑ Check here if attachments
SECT, E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For es AO and A (without BFE), complete Items E1-E5. lithe Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, 8,
and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or 0 below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. 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 owners 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. The statements in Sections A, 8, and E ere correct to the best of my knowledge.
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. Check the measurement used in Items 08 and G9.
01. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by 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 for a budding 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 community floodplain 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
08. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum
09. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet 0 meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments
FEMA Form 81 -31, Mar 09 Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
3 Taylor Street
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 two 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." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
Front View April 18, 2010
•
Building Photographs
Continuation Page
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
3 Taylor Street
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."
Rear View April 18, 2010
r