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HomeMy Public PortalAboutJones Av_11U.S. DEPARTMENT OF HOMELAND SECURRY ELEVATION CERTIFICATE Feared Eaa regency Me egament /regency Ndonal Flood Meraanoa Program Important Read the Instructions on pages 1-9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION Fainie■a ecomparhr Lisa- . Al. A2. t g -1 [' f2 PtNye(�'- Ba dir,p Address liededilli Unit. Apt., t. Si e. India Ma. No.) or P.O. Route and Sox No. R 4ES $ 5T Stale A3. Property Disc bon (Lot and Bloch Numbers, Tarr Parcel Number. impi Dee tplon. eta) 1. 07 °1 S W A-t2 e. t T''4 (. E c= S t-• P >J C. Code 3 t 3 7.8 A4. Badding Use (e.g.. Redderrtiet. Access xy alc) o IJ - f2 S I 0 c' lst i 1 true._ AS. t :aihu a.a onglalee Lat. N 3 2. °)p . C ' Long. W �6° o • S-G3 2' ii rizanlai Oaken: [] NAD 1927 (2 AD 1983 M. Attach at least 2 photographs Mete building dem CerlMcab is beeg used to obtain load insurance. A7. Building Diagram Number 6 A8. For a brlulrhg with a crawispece or endosure(sp 1t A9. Fora building with an attached garages a) Squaws footage of aawlepece or endoarre(s) y C) t 1 sq II a) Square footage of attached garage -_S2 -._ sq It b) No. of permanent flood openings to the oawlapacs or b) No. of pa nenartt+Food openings to the adstlre4 garage enamored') Merin 1.0 foot above adjeoent tirade to Malin 1.O toot above adjacent grade C1 c) Told not awe of flood oper*rge inftS.b J 7. TV aq in c) Total net arse of flood openings In A9.b o sq In d) Engineered load openings? &Yes 0 No d) Enoeheemd deed openings? 0 Yea 9-i - SECTION B4 FLOOD INSURANCE RATE MAP (FILM) INFORMATION B1. NFIP Name & Community Number 82. County Neva TY sezz r ! 35-1 GI- I G i- `±t-f-r+M 83. Stab $E -4R6IA 84. MaplPanel Number I osit0o-Zt4 BS. Suer • r- 88 FIRM Mtded Date 137. FIRM Panel EffectivaiRerised Dab 138. Flood A E M. Base Flood Eievalon(s) (Zone AO. use bedstead depth) !Z.o B10. Inricaie the source of =a Flood Elevation (BFE) deb or base flood depth mitered it item 89. 0 RS Pratte CAF Camsnu�:liy Determined D Ot er (Describe) 811. Indicate eieveton datum used for t3FE to Item 89: 0 N6100 1820 illerfAVD 1+188 0 Other (Describe) B12. Is the building located in a Coastal Bander Reso{rces System (CSRS) awe Protected Area (OPA)? Delon Date i 0 CORE CPA [3 Yes 1E1'110 SECTION C - BULI*IG ELEVATION INFORMATION (SURVEY ) Cl. Budding etevaalions am based crc 0 Canetnn an Drawings' 0 Building Under Construction' Winstead Conseudton A new Elevation Cerlicele will be required whertconseucfbn of the bulking is compte3a. C2. Elevations -Zones Ai -A30. AE. AH. A (wit EWE). VE, V1 - -V30, V tonic BFE). AR, AR/A, AR/AE. AR/A1 -A30, AR/AH, AR/AO. Complete Items C2 a-h below accenting to** beading diagram spedlstktn tern A7. Use the same datum as the iFE: Benchmark Utilized L. as G "L.,. Vertical Datum N rr-t ): I9gS /IN a) Top of bottom leer (Including basement: rraWtspece, or condoms Soar) b) Top of the next higher door c) Bottom of the lowest hodzoniel airmen* member (V Zones only) d) Attad+ad garage (top of stab) e) Lowest eleveion of machinery or equipmei'l servicehU Ilse baling (Describe type of equipment and location in ) f) Lowest adjacent (misted) grade next to (LAG) g) Highest adjacent (Bashed) grade next to b (HAG) h) t.oweet admen grade et lowest elevation of dedi or stales, inducting strual sinppat dta Check Are measurement used. � Q 8 mews (Puente Pico only) meters (Puerto Rion only) feet 0 meters (Puerto Rico only) 0 meters (Puerto him ordlr) 5-G 0 meters (Puerto Rico only) 0 meters (Puerto Rico any) 0 meters (Puerto Rico only) pesetas (Puede Rteo aft) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERT'IFICA'TION TNs Uon is to be signed and seated by a lent surveyor, engineer. or architect authorized by lewio certify eevadon bt omhatlan. I codify that the information on this COMM* represents my best efforts to inimpret the daia.avalleble. i understand that any taiga statement may be punish ble by One or Imprisonment under le US. Cod& Section 1001. [VrChedc here if comments are provided on back Mime. Wrens eel ode and kinglude InWaar ALtrovided by a Mewed lend suveycr? Yes U No Y/NCeNT j- 7ehM1.4el - ' I8S2 ' ( 4 " 1 0 SURV:yfl4. CCIlliginY Nanie \t ry ir-tEt.rs% ,...-, Adm.. 9 Ft $y^:ort Rower S %V?.rer.aert Stale 4F*• 31405 S nanre U i. -- I I 0 "j 1-12,1- 1.41 °12.5° 3523 ��. FEMA Form 81 1, Mar 09 , See reverse side for continuation. Replaces al previous editions IMPORTANT: in these spaces, copy the corresponding Information hum Section A. BulBrp wept Address (i cturRg Apt. Unit. Suite, anther Bldg. No,) or P.O_ Route and Box No. . g .J o 1.4 S S7 vt r Day Slate 21P %/ S ..1—S Ps-r..1-5:. Gec r.. rA 313 Z� SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATiON (CONTINUED) Copy bath sides of this Eiavaion Cwiieale for (1) communtly ofl d, (2) insurance agandcompany, and (3) building owner. For insurance Company Use: Policy Number Company NAIL Number Comments (� r`t� — 71t-c^42 r A-2s S S nn Pr cL.T V Fr'''rS C C rv-6 r A.) rr- cwt R (i-p 1 (IS/aa rr`fi- c°14'-i- C Z ce) = Arty Getz, • t.) r•-/ r p e--3— R- r-/N, Signature t SECTION E - BUILDING ELEVATION °"0e ^ L l — 12... c hedr wawa itaeadrmmas (SURVEY NOT MOWED) FOR ZONE AO AIR) ZONE A (WITHOUT BFE) For Zones AO and A (wiinet 8FE), complete liens EI-E5. lithe Certificate is intended to support a LOMA or LOMR -F request complete Sections A, 8. and C. For Item E1 -E4, use naer.l grade. We-e able. Check the mess used In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the boa9eFto show whether the elevation is above or below the highest adjacent grade (tiAG) and the SOMA adjacent grads (LAG). a) Top of bottom loon (including b.aernehl. aawrtspaoe, or - ..; , ) is Chest Omelets Dabove or Chubs, the VIAL_ b) Top of bottom Jour (irdndbg aewIspace • 4 e [3eet Omete s ()above or ©below the LAG. E2. Far Building Diagrams 8-9 will permanent Mood , . -. _ , . -. a Seep I 8 ptar 9 (see s 8-9 of instructions). the next higher Moor (elevation C 2.6 in the diagrams) of the building is fir feat U.metars Li above or L f below the HAG. E3. Modred garage (lop of gab) is 0 []meters 0 above or 0 below the HAG. E4. Tap of platform of mmchirery sndfor equipment samisen; rise building is r_ 0 feet 0 meters 0 above or 0 below the HAG. E5. Zone AO only: lino flood depth number is ayslebie, is the top afore bottom 'Boor elevated in accordance with the community's foodpMn management ordinance? 0 Yes 0 No 0 Unknown. The local oThcW must array file information in Section G. SECTION F - PROPERTY CANNER (OR OIUINER'S REPRESERTATIVE) CERTIFICATION The property owner er owners aditorized ran ellee who compotes Sedlons A. B. and E AhrZone A (without a FEW - issued or comawrtey -blued BFE) or Zane AO must sign here. The statements it Sections A. S. and E are correct lo the best afmyimowtedye. Property Owner's or Owner's Authorized Repmaerdalve s Name Address S Comments State ZIP Code Telephone E Check here if aftaclrrher SECTION G - COIMltilY INFORMATION (OPTIONAL) The local Otidaiwho Is anrlhaized by last or ordnance to adadniderlre community's #oodplaih management ordinance can couplets Sections A. B. C (or q, and G of this aevelion Carlisle. Complete the applicable Sends) and sips below. Check the amerces t used in Items G8 and G9. G1. 0 The intonation in Section C was .meant her other documentation that has been stand and sealed by a licensed surveyor, engineer, or architect who is a=Mhodred by bur to certify elmadio s idea ninon. (indicate the source and dale of the elevation dale In the Comments ar a below.) Ga 0 A community °eked completed Section E for a budding loaded In Zone A (WMout a tE7AA-issued or conhmestiy ued BEE) or Zone AO. G3.0 The follower, information (teens G4-G9) is provided for oammandty Aaodpiaih tmawpekmen* purposes. G4. Pewit Number G5. Dale Perrin: issued t Ge. Derr Cedta*. tX issued GT. This permit has been issued Sr 0 New ConseurBon 0 Sub:d ntet Improvement GB. Elevation of es -bait lowest Moor (nririg basemen() of the bulldog ❑ feet 0 meters (PR) Datum 69. SEEor( in Zone AO) depth cftbodfgat the WHIM sae abet meters (PR) Cabin G10. Community's design Mood elavai n 1 _,__.._ Oast 0 motors (PR) Datum Local °Wars Name Comae* Name Signature Commits Telephone Date 0 Check here if attachments FEMA Form 61 -31, Maas Replaces aN Previous a dltons r Building Photographs See Instructions for Item A6. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 11 JONES STREET City TYBEE ISALAND State GA ZIP Code 31328 For Insurance Company Use: Policy Number 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 10 -11 -12