HomeMy Public PortalAboutLaurel Av_1012FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE.
Important: Read the instructions on pages 1.7.
O.M.B. No. 3067 -0077
Expires December 31, 2005
SECTION A - PROPERTY OWNER INFORMATION
For Insurance Company Use:
BUILDING OWNERS NAME
CATSKILL BUILDERS, INC.
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO.
1012 LAUREL AVENUE
Policy Number
Company NAIC Number
CITY
TYBEE ISLAND,
STATE
GA
ZIP CODE
31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 3 BLOCK 11, GARDEN WARD
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RES
LATITUDE/LONGITUDE (OPTIONAL)
( ##° - ##' - ##.##" or ##.#####°)
HORIZONTAL DATUM:
❑ NAD 1927 ❑ NAD 1983
SOURCE: ❑ GPS (Type):
❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP COMMUNITY NAME & COMMUNITY NUMBER
TYBEE ISLAND 135164
82. COUNTY NAME
CHATHAM
B3. STATE
GA
B4. MAP AND PANEL
NUMBER
L^ 135164 0001
65, SUFFIX
C
66. FIRM INDEX DATE
6/17/86
B7. FIRM PANEL
EFFECTIVE/REVISED DATE
6/17/86
88. FLOOD ZONE(S)
A8
B9. BASE FLOOD ELEVATION(S)
(Zone AO, use depth of flooding)
13
B10. Indicate the source of the Base Flood Elevat on (BFE) data or base flood depth entered in 69.
❑ FIS Profile ® FIRM ❑Community Determined ❑Other (Describe):
811. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations 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 5 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram
accurately represents the building, provide a sketch or photograph.)
C3. 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 C3. a-i below according to the building diagram specked in Item C2. State the datum used. lithe datum is different from the datum used for the BFE in
Section B, convert the datum to that used for 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.
Datum NGVD 29 Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No
o a) Top of bottom floor (including basement or enclosure) 18.3 ft.(m) To
o b) Top of next higher floor NA . _ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft.(m) o 0
o d) Attached garage (top of slab) NA, _ft.(m) w 2
o e) Lowest elevation of machinery and/or equipment IL
servicing the building (Describe in a Comments area) NA . _ft.(m) E
o 0 Lowest adjacent (finished) grade (LAG) 8.7 ft.(m) z
o g) Highest adjacent (finished) grade (HAG) 9. 2 ft.(m)
o h) No. of permanent openings (flood vents) within 1 ft, above adjacent grade 0
o i) Total area of all permanent openings (flood vents) in C3.h 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 law to certify elevation information.
I certify /hat the information in Sections A, B, and C 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.
CERTIFIER'S NAME J. WHITLEY REYNOLDS LICENSE NUMBER 2249
TITLE LAND SURVEYOR
COMPANY NAME
ADDRESS
636 STEPHENSA NUE, S
SIGNATU'
CITY
SAVANNAH
DATE
6/22/06
STATE
GA
TELEPHONE
912 - 352 -0464
ZIP CODE
31405
FEMA Fo 81 -31, Jan 2003 See reverse side for continuation.
Replaces all previous editions