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Home My Public Portal AboutTS Chu Ter_10F,eh 25 04 12:17p o s-;1/4°9 3 �itley Rebnolds wurvArrl.t YKLA RAM ELEVATION CERTIFICATE Important Read the instructions on pages 1 • T. SECTION A - PROPERTY OWNER INFORMATION 912 52 7787 p.2 Expires December 31, 2005 For Insurance Company Use: BUILDING OWNER'S NAME HURTY GROUP BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 10T. S. CHU TERRACE Policy Number Company NAIL Number CITY TYBEE ISLAND STATE GA PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number. Legal Description, etc.) LOTS 6 & 7 OF A SUBDIVISION OF LOT 104, WARD 5, TYBEE ISLAND BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) ZIP CODE 313 RES LATITUDE/LONG /TUDE (OPTIONAL) ( toe -qtr - 44.44" or #4.10###°) HORIZONTAL DATUM: ❑ NAD 1927 ❑ NAO 1983 SOURCE: 0 GPS (Type):__,__, ❑ USGS Quad Map ❑ Other. SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFiP COMMUNITY NAME & COMMUNITY NUMBER TYBEE ISLAND 135164 B2 COUNTY NAME CHATHAM B3. STATE GA 84. MAP AND PANEL NUMBER 1351640002 35. SUFFIX c 96. FINN INDEX DATE 6117/86 • 87. FIRM PANEL EFFECTIVEIREVISED DATE x/17/86 B10. indicate the source of the Base Float Elevation (BFE) data or base flood depth entered in 89. 0 AS Profile ® ARM 0 Community Determined ❑ other (Describe): 911. Indicate the elevation datum used for the BFE in 89: ® NGVD 1929 0 NAVO 1988 0 Other (Describe): 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (CPA)? 0 Yes Q No Designation Date,___, SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based arc 0 Construction Drawings` ® Building Under Construction" ® Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2.8tirng Diagram Number 6 (Select the burking diagram most similar to the bufldng for which this certificate is being completed - see pages 6 and 7. If no diagram =Irately represents the building, prmdde a sketch or photograph.) . C3. Eleva ons — 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 Compete Items C3.-a; below according to the bullring diaorarn specified in Item C2. State the datum used. if the datum is dfferent from the datum used for the BFE in Section 8, Convert the datum to that used tar 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. Dattrm NGVD 29 ConversiorVComments Elevation refererre mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of button floor (indudng basement or enclosure) 8. 3 ft.(m) 17.f{m) m o b) Top of rpd higher floor o c) Bottom of lowest horizontal structural member (V zones only) NA . .ft.(m) '83 o d) Attadted garage (top of slab) 8. 311.(m) w 2 o e) Lowest elevation of machinery and/or equipment m servartg the bullring (Describe in a Comments area) NA . _1t.(m) it Iii o f) Lowest adjacent (Shushed) grade (LAG) 8.0 ft.(m) 2 °' o a) iigbest ad scent (finished) grade (HAG) 8. 3 fi(m) N o h) Nil of permanent openings (flood vents) within i ft above adjacent grade 4 i o i) Toter mad al permanent operrngs (flood vents) in C3.h 705 sq. in. (sq. cm) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by taw to certify elevation information. t 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 L.S. Code, Section 1001. CERTFIERS NAME J. Whitley Reynolds LICENSE NUMBER2249 88. FLOOD ZCNE(S) All 89. BASE FLOCO ELEVATION(S) (Zare AO, use depth of flooding) 14 O EIS TITLE Lard Surveyor COMPANY NAME ADDRESS 636 STEFi- :. * VEND ir SIGNATU N r� FEMA Fo 81 -31, January 2003 CITY STATE ZIP CODE Savannah, GA GA 31405 DATE TELEPHONE 1(21104 912-352-0464 See reverse side for continuation. Replaces all previous editioxis J �itle� Reynolds i 2 ; 16 p u . levo.T .O. R(kJTE ati0 90X Na er 25 04 ... ,__. ,st_ANO 912 32 7787 p.1 ror insurance Company Use: Pcticy Hunter STATE ZIP CODE GA 31328 Company y NAIL 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 ❑ Check here if attachments SECTION E • BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zane A0 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. Butting Diagram Number _(Select the bulking diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no dagram accurately represents the building, provide a sketch a photograph.) E2 The top of the bottom floor (mdudirg basement a enclosure) of the buiding is ft.(m) _in.(am) ❑ above a ❑ below (check one) the highest ac¢aent grade. (Use natural grade, if available). Ei. For Building Dagrams 6-6 with openings (see page 7), the next higher floor or elevated floor (elevator b) of the building is — ft.(m) __in.(cm) above the highest adjacent grade. Complete items C3.b and C3.i of front cf form. E4. The top of the platform of machinery ands equipment servicing the bulking is f(m) __in.(cm) ❑ above Of 0 below (check one) the highest ado: ant grade. (Use natural grade, if avalable). ano Zone A0 only: If no Rood depth number is available, is the top of the bottom Ronr elevated in accordance with the community's ttoodptan management ordnance? ❑ Yes ❑ No ❑ Unknown. The !mat official must artily this information in Section G. SECTION F - PROPERTY OWNER (OR OWNERS REPRESENTATIVE) CERTIFICATION The property owner a ovarer's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only). and E for Zone A (without a FEMAissued a community- issued BFE) or Zone A0 must ski here. The statements in Sections A 8, C, and E are cared (0 the best CAW knc ledge. PROPERTY OWNERS 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 offidat who is authorized by law or ordnance to actrinister the commurtitys Roaipian management ordnance can complete Sections A, B, C (a E), and G of this Elevation - Certkate. Complete the applicable item(s) and sign bebw, Gt. ❑ The irfixmation in Section C was taken from other doaur>entalion that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local taw to certiy elevation itdunlation. (Indicate the source and date of the a evalion data in the Comments area below.) G2 ❑ A co inanity off al completed Section E for a budding located in Zone A (without a FEMA - issued or community- issued BFE) or Zane AO. G3. 0 The following information (Items G4-G9) is provided for community Roodplain management purposes. G4. PERMtTNUMBEft 85. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CONPLUINCEIOCCUPANCY ISSt1ED G7. This permit has been issued for 0 New Cotstnldion ❑ Substantial Improvement G& aeration of as -butt lowest floor (including basement) of the ixikting is: 89. BFE a (tin Zane AO) depth of flooring at the building site is: _ft.(m) fl-(m) Datum: Datum LOCAL OFFlClAL`S NAME COMMUNSTY NAME SIGNATURE COMMENTS TITLE TELEPHONE DATE 0 Check here if attachments EMA Form 81 -31, January 2003 Replaces all previous editions