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HomeMy Public PortalAboutLovell Av_1005FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Impoitut Reed rie i w4ons on pages 1.7. O.M.B. No. 3067 -0077 Expires December 31, 2005 SECTION A. PROPERTY OWNER INFORMATION BUILDING O MER'S NAME TIM FULLER BUILDING STREET ADDRESS (Including Apt, Uni Su%, adlor Bldg. No.) OR P.O. ROUTE AND BOX NO. 1005 LOVELLAVENUE For kensan sCompaq Use: Pak'y Number Comport NAIC Number CITY TYBEE ISLAND, STATE GA ZIP CODE 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, eta) LOT 38+4, WARD NO.3 BUILDING USE (e.g., Residential, Non-residential, Addition, Accessory, etc. Use a Camn� area, necessary.) RES LATrTUDEALONGITUAE (OPTIONAL) (U° -1N -A.t% or .intilA °) HORIZONTAL DATUM: 0 NAD1927 0 NAD1983 SOURCE ❑ GPS (Type). ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (F*) INFORMATION B1. SHP COMMUNITY NAME k COMMUNITY NUMBER TYBEE ISLAND 136164 Ea-COUNTY NAME CHATHAM 133. STATE GA B4. MAP AND PANG. B7. PRA PANEL B9. BASERDODELEVATION(s) NUMBER 95. SUFFIX B6 HRM INDEX DATE DATE B8. FLOODZONE(S) Rona AO, use depth aflooding) 1351640002 C 8/17186 611766 A8 12 B10. Indicate the source d the Base Flood Elevation (BFE`) data or basetood dept entered n 69 ❑ FISPidle ® FIRM 0 Cann, ity Determined ❑ Oaher(oesathe): B11. thcicste the elevation dabrn used forthe BFE n I3S: ® NGVD 1929 0 NAVD 1988 ❑ Other (Describe): 012 Is the bulling bcared in a Coastal Bads Renames System (MRS) area a CUierwise Protected Asa p )PA)? ❑ Yes ® No Desigralan Date SECTION C - BURDNG ELEVATION INFORMATION (SURVEY REQUIRED) C1. Buting elavaions as based are ❑ Conskudion D►a ag;' ❑ Bulling Under Consmrclon'` ® Fibbed Caalruction 'A new Elevation Cerlficale wrrT be required when canstucion tithe baidog is complete. C2 Building Diagram Number 5 (Select the btidng dagom most simiarbn the buid 1g for which this cedNIcate Is being completed - see pages 6 and 7. If no dcagam accurately represents the butting, provide a sketch or photograph.) C3. Elevation —Zane A1-A30, AE, AN A (wit BF) VE, V1 -V30, V (with BFE), AR, AR+A, ARIAE, ARIA1 -A3D, ARAN, AR/AO Complete kerns Ca-a+ below eccordrg loo the buidng diagram specified in Item C2 State the data used t the datum is difaertfrom the datum used faire BFE in Section B, convert the dekrmb that used for the BFE Show field measurements ad datum emersion calculation. Use Steepens pnxrided ate Cormherts area Section D or Secdxhn G, as appropriate, to document the datum conversion. Da4m NGVD 29 Elevation refers= mak used Does the elevalon reference mak used appear on the FIRM? ❑ Yes ® No o a) Top d bottom toe (nckrdng basement or enclosure) 12 8 t(m) o b) Top of rued higher floor ft(m) o c) Bottom d lastest horizontal structural member (V zones only) NA . _R(m) o d) Attached garage (lop dslab) Hes ft(m) o e) L m steueraion of machnery acts equipment sentig the bulking (Desathe in a Comments area) 12 . Wm) of) Lowest aliment (LAG) alt(n) o g) **et adjacent (Irish' add) grade (HAG) Q. 714m) o h) No. of permanent openings (flood vents) wihir 11L &we adjacent grade Q o j Tdat area d al permanent apenngs food %arils) in Cat sq tin (sq. am) A SECTION D - SURVEYOR, E NGINEHR, OR ARCHITECT CERTIHCAT ION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by haw b cot* elevation information. t certify that the iionnetion in Sections A, a and Con Ns certificate represents my best efforts to hJterpet the data available I understand that any false statement may be pur ishebie by fine or imprisonment under 18 U.S. Code, Section 1001. CERIFER'S NAPE J. VN l y Iielrokh LICENSE NUMBER 2249 TRLE Land Surveyor COMPANY NAME ADDRESS CITY STATE ZP CODE B36 i C Saraneh, GA GA 31405 SIGNA► DATE HC E 06 912P4 MPORrANT: In these spaces, copy be corresponang infomtaion from Section BUS 1,3i4G STREET ADDRESS Qrnhudig Apt. Urt, Sub, soft Bldg. No.) OR P.O. ROUTE AND BOX NO. 1005 LOVELL AVENUE CRY STATE ZIP CODE TYBEE ISLAND, GA 31328 For he saneConvey Use Poky Wilber Consery NAIL Ntsnber SECTION D - SURVEYOR, ENGINEER, t, OR ARCHITECT CERTIFICATION (CONTINUED) Copy loot sides dths Be va nn Centifical , for (1) camanby litchi, (2) insurance age aco any, and (3) buicirtg owner. COMMENTS C3.e) =NC PAD 0 Check here f a aliments SECTION E - BULDNG ELEVATION INFORMATION (SURVEY NOT REQUIBD) FOR ZONE AO ANDZONEA (IMTHOUT BFE) For Zone AO and Zane A (wihoutBFE), complete liens E1 though Et he Sevalton Cerlilcalle is intended for use as suppling iiama`on fora LOW or LOMZ -F, Section C must be completed El. Boiling Diagram Minter _(Select the bullring diagram most sinter to the buidrg for Mich this certitude is being coned —see pages 6 and 7. If no cram accuracy cy represents the boiling, prudide a sketch or photograph.) EZ The lop lithe bottom floor (inducing basement or endosue) of the boiling is _1(m) __i(cm) 0 above or 0 below (check one) the highest adlaoatt grade. (Use nabral grade, t amiable). Ea ForBtidng Diagrams 68w U openings (see page 7), the next higher floor elevated tour ( elevation b) lithe buidirg is ^ t(m) _n.(an) abode the highest adjacent grade. Complete bans C3.h and Cat on front din). E 4 . The top lithe * T a n n d mac finery a don egriprrrert serviang the bolding is _ ft(m) _n.(an) 0 stave or 0 be (check one) the highest adjacent grade. (Use natural grade, I amiable). B. For Zone AO ork If no flood depth numbers aysiable, is the by d the bosom floorefevaed in aooadance vat the oarxnunilys Ioodplain ma>agemert adnatce? 0 Yes 0 No 0 Urinate). The Coal official must cagy tics iifomtation in Section G. SECTION F - PROPERTY OWNER pR OWNER'S REPRESENTATiVE) CERTIFICATION The properly wrier or owners authorized reixesentatim who completes SecSas A, B, C (Berns CD and C3i arty), and E for Zone A (about a FEAiA- issued =manly- issued BFE) or Zone AO must sign here. The statements » Sec6ionsA B, G end E a►ecorrect toll* best dmylvuar/edtia. PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE CONSENTS 0 Check here if attachments SECTION G - COMMUNITY gr1FORMATlON (OPTIONAL) The local Acid who s alliatsd bylaw or ordinate in admiisiarlhecamxnly'sioodplan management ordnance cat complete Secias A, B, C (or E), and G stiffs Elpxaion Cer6icaie. Complete the typical* lam(s) and sign below. G1.0 The infamaiat it Secbn C was taken iron otter doamtenktion that has been signed and embossed by a ieensed surveyor, engiieer, or adiledwho s authorized try stale car local lay b certify elevation iiomtaion. (Inicale the scum and dale d fie elevation data n the Comments area below.) G2. 0 A connwtby oiids completed Section E fora burg located in Zone A (witrout a FEMP issued or community-issued BFE) or Zone AO. G3.0 Thefolowig iionndon (Name G449) is provided for cam* floodptan rna ugernert purposes. G4. PEWIT NUM3Bt G5. BATE PIT ISSUED G6. DATE CERTFICATE OF COM'LUNCESOCCUPPNCYiSSUE G7. 1Y63 punt hes been issued fo: 0 New C alneion 0 Substatiet Improvement G8. Bevdon d as•btrit lowest.00r (rdudrg basement) dtte bulling is GO.8FE or (n Zone AO) depth d tooling at the buuldrg cabs is: Jun) __i(m) Dek1 Dakar LOCAL OFFICALS NAME COMMUNITY NAME SIGNATURE COMBOS TITLE TELEPHONE ATE 0 Check here I a t eats