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Home My Public Portal AboutLewis Av_129SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME CYNTHIA M. CUPP BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 129 LEWIS AVENUE CITY TYBEE ISLAND FCC Insurance ConpnyUse: Policy Number Company NAIC Number STATE GA ZIP CODE 31328 PROPERTY DESCRIPTION (Lot and Biodc Numbers, Tax Parcel Number, Legal Description, etc.) LOT 22 & THE NORTHERN HALF OF LOT 21, PALM TERRACE BUILDING USE (e.g., Residential, Non - residential, Adddion, Accessory, etc. Use a Comments area, if necessary.) RES LATITUDE/LONGITUDE (OPTIONAL) ( itita-or -*kw or ##.#####°) HORIZONTAL DATUM: 0 NAD1927 0 NAD1983 SOURCE ❑ GPS (Type): ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. Imo' cower NAME & COMMUNITY NUM: ER TYBEE ISLAND 135164 82. COUNTY NAME CHATHAM a B3. STATE GA B4. MAP AND PANEL NUtVEER 1351640001 B5. SUFFIX C B& FIRM INDEX DATE 6/17/86 87. FIRM PANEL EFFECTIVE/REVISED DATE 6/17186 88. FLOOD ZONE(S) AS B9. BASE FLOOD ELEVATION(S) (ZoneAO, use depth ar tloodng) 12 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89. ❑ F1S Preile ® FIRM ❑ Community Determined ❑ Other (Describe): _ B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Desabe): 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. Build'ing elevations are based on: ❑ Construction Drawings' ❑ Bu /ding Under Construction* ® Finished Constnrdion *A new Bevadon Certificate will be required when construction of the building is complete. CZ Building Diagram Number 1 (Select the building diagram most similar to the budding 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, APJAE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3. -a-i below according to the building diagram specified in Item CZ State the datum used If the 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 Seddon D or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (inducing basement or enclosure) 7. 6 ft(m) r o b) Top of next higher floor NA . _&(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) E o e) Lowest elevation of madiinery and/or equipment u, m servicing the building (Describe in a Comments area) 7.7 ft(m) o f) Lowest adfjacent (finished) grade (LAG) 6.ail.(/11) m y o g) Highest adjacent (finished) grade (HAG) 7. 0 ft(m) o h) No. d permanent openings (flood vents) within 1 ft above adjacent grade 0 o i) Total aea d)f a l permanent openings (flood vents) in C3.h so. in. (sq. an) . 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 informatl I 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 U.S. Code, Section 1001. CERT1FE t'S NAME J. Wt iley Reynolds LICENSE NUMBER 2249 TITLE Land Surveyor COMPANY NAME ADDRESS FEMA F. ' 81 -31, January 2003 CITY STATE ZIP CODE SAVANNAH GA 31405 DATE TELEPHONE 919134 912-352-0464 See reverse side for continuation. Replaces all previous editions 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) bulking owner. COMMENTS C3.e) = A/C PAD ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO 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. El . Building Diagram Number _(Select the baking diagram most similar to the bulling for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the budding, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or endosure) of the building is _ ft(m) _in.(cm) ❑ above or 0 below (check one) the highest adacent grade. (Use natural grade, if available). E3. For Bulking Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _1(m) .(m) _in.(an) above the highest adjacent grade. Complete items C3.h and C3i on front of form. E4. The top of the plalf�orm of machinery ardor equipment servicing the budding is _ it(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). B. For 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, C (Items C3.h and C3J only), 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, G and E are correct to the best of my knowledge. PROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVES 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 ordnance to administer the community's floociplain management onfnarim can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The infatuation in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or ardulect who is authorized by state air loo law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community o ficia completed Section E fora bulking located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The fdbMng information (Items G4-09) is provided for community floodpiain management purposes. G4. ?ITT tu€et G5: DATE PERMIT ISSUED I Go. DATE CE.RTIFIGATE OF AN(Y ISSUED G7. This perml has been issued for: 0 New Construction ❑ Substantial knprovernent C-td. Bevtion of as -boil lowest floor ( mg basement) of the boiling is G9. BFE or (in Zone AO) depth of tioodng at the bulking site is: LOCAL OFFICIALS NAME COMMUNITY NAME SIGNATURE ft(m) Datum: Datum: TITLE TELEPHONE COMMENTS DATE FEMA Forth 81 -31, January 2003 ❑ Check here if attachments Replaces all previous editions