HomeMy Public PortalAboutSolomon Av_38-B_20100824U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICA7
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
S. Russell Akers
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
39 -B Solomon Avenue
Policy Number
Company NAIC Number
City State ZIP Code
Savannah (Tybee Island) Georgia 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lots 4, 20 & Part of Lots 3, 19, 21 & 22 Campbell Subdivision, Fort Ward, Tybee Island - P.I.N. 4- 0002 -16 -018
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory
A5. Latitude /Longitude: Lat. 32.01735 °N Long. 080.84699 °W
A6. Attach at least 2 photographs of the building if the Certificate is being
A7. Building Diagram Number 6
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 432 sq ft
b) No. of permanent flood openings in the crawlspace or
enclosure(s) within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A8.b 576 sq in
d) Engineered flood openings? N Yes ❑ No
, etc.) Residential
Horizontal Datum:
used to obtain flood insurance.
❑ NAD 1927 N NAD 1983
A9. For a building with an attached garage:
a) Square footage of attached garage 912 sq ft
b) No. of permanent flood openings in the attached garage
within 1.0 foot above adjacent grade 5
c) Total net area of flood openings in A9.b 1000 sq in
d) Engineered flood openings? N Yes ❑ No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
Tybee Island 135164
B2. County Name
Chatham
B3. State
Georgia
B4. Map /Panel Number
13051'C' - 0213
B5. Suffix
'F'
B6. FIRM Index
Date
9/26/08
B7. FIRM Panel
Effective /Revised Date
9/26/08
B8. Flood
Zone(s)
AE
B9. Base Flood Elevation(s) (Zone
AO, use base flood depth)
11.0'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile N FIRM ❑ Community Determined
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date ❑ CBRS ❑ OPA
® Other (Describe) GIS Mapping
N NAVD 1988 ❑ Other (Describe)
❑ Yes N No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* N 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/AO. Complete Items C2.a -h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized Site Vertical Datum 1988
Conversion /Comments
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 6.2
b) Top of the next higher floor 17.6
c) Bottom of the lowest horizontal structural member (V Zones only) N /A.
d) Attached garage (top of slab) 62
e) Lowest elevation of machinery or equipment servicing the building 14.6
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 5.4 Z feet
g) Highest adjacent (finished) grade next to building (HAG) 5.7 N feet
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N /A. N feet
structural support
Check the measurement used.
N feet
N feet
E feet
N feet
E 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. 1 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.
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? N Yes ❑ No
Certifier's Name
Carl R. Jackson
Title Company Name
Ga. Registered Land Surveyor Carl R. Jackson Land Surve or, Inc.
Address City
411 Pine Street /f Bloomingdale
Signature /J / / Date
Aj[// - 8/24/10
License Number
Ga.2555
State
Ga
Telephone
988 -3355 or 596 -2189
ZIP Code
31302
``, %0c7sORG /q
`� Qobs'rEf
SUBNI ° 50,
IMPORTANT: In these spaces, copy the c( ;ponding information from Section A.
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No.
38 -B Solomon Avenue
For Insurance Company Use:
Policy Number
City State ZIP Code
Savannah (Tybee Island) Ga 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 Elevated Single Story Frame Residence.
Service Machinery = Elevated NC Deck.
Venting in the walls of the Enclosure installed per Tybee Island City Planning & Zoning. Total Enclosure Size = 1344 Sq. Ft.
Total Vent Count = 7 @ 1576 Sq. In.
Signature
SECTION E - BUILDING ELEV
Dote
8/24/10 El Check here if attachments
N INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE)Gcpr(rplete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B,
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 ❑ 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 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. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owners or Owner's Authorized Representative's Name
Address
Signature
Comments
City
State
ZIP Code
Date
Telephone
❑ Check here if attachment
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 G8 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 building 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
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name jekA 15
Community Name
Signature
CITY of fy5t6 ZSLANA
Q Art-
Comments
Telephone
Date
qu02-472- 5x3.4
Oa / 5 /.1-oJ4t
A -02, &1 e6e7- ADDRE 5 6NoUcD .8 38,, 6 6oLotco4 1} 116,11116
❑ Check here if attachme
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.
38 -B Solomon Avenue
Policy Number
City
Savannah (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 on the
reverse.
i11116111111 iiiiiitimi1It
08 i9 2L
HEM MIS
y� �