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Home My Public Portal AboutLovell Av_1501U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program Important: Read the instructions on pages 1 -9. ELEVATION CERTIFICATE SECTION A - PROPERTY INFORMATION OMB No. 1660 -0008 Expiration Date: July 31, 2015 Al. Building Owner's Name THOMAS AND LISA W. BUTLER FOR INSURANCE COMPANY USE Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1501 LOVELL AVENUE Company NAIC Number: City TYBEE ISLAND State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 40 -A, WARD NO. 4, TYBEE ISLAND A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) A5. Latitude /Longitude: Lat. N 31 °59'38.4" Long. W 80 °50'58.6" A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 590 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 5 c) Total net area of flood openings in A8.b 1020 sq in d) Engineered flood openings? ❑ Yes ® No RESIDENTIAL Horizontal Datum: ❑ NAD 1927 El to obtain flood insurance. NAD 1983 A9. For a building with an attached garage: a) Square footage of attached garage 672 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 4 c) Total net area of flood openings in A9.b 816 sq in d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number CITY OF TYBEE ISLAND 135164 B2. County Name CHATHAM B3. State GEORGIA B4. Map/Panel Number 13051C0326 B5. Suffix F B6. FIRM Index Date 08 -05 -13 B7. FIRM Panel Effective /Revised Date 09 -26 -08 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 12 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other /Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date: ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® 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. In Puerto Rico only, enter meters. Benchmark Utilized: GA DOT BV 025 4 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 El NAVD 1988 ❑ Other /Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support Check the measurement used. 9.8 ® feet ❑ meters 19.2 ® feet ❑ meters 17.8 ® feet ❑ meters 9.8 ® feet ❑ meters 13.9 ® feet ❑ meters 8.0 ® feet ❑ meters 9.4 ® feet ❑ meters 8.6 ® feet ❑ meters 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. /certify that the infommation 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. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifier's Name JAMES M. KEATON, RLS License Number GA #2743 Title LAND SURVEYOR Company Name CHATHAM SURVEYING SERVICES, INC Address PO BOX 61649 City SAVANNAH State GA ZIP Code 31420 Signature ite4 _17-L5 Date JUNE 18, 2014 Telephone 912 - 303 -0302 FEMA Form 086 -0 -33 (7/12) See reverse side for continuation. Replaces all previous editions. MPORTANT: In these spaces, copy the corresponding information from Section A. luilding Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 501 LOVELL AVENUE ;sty TYBEE ISLAND State GA ZIP Code 31328 FOR INSURANCE COMPANY USE Policy Number. Company NAIC Number. SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) ;opy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. ;omments ITEM C2a IS ENCLOSED STORAGE AND AN ACCESS STAIRWELL TO THE HABITABLE FLOOR. THERE IS A 28 S.F. ELEVATOR SHAFT ELEVATOR NOT INSTALLED) WITH THE BOTTOM AT ELEVATION 9.3'. ITEM C2b IS THE LOWEST HABITABLE FLOOR. ITEM C2c IS THE BOTTOM )F THE LOWEST HORIZONTAL SUPPORT BEAM. ITEM C2d IS A WALLED OFF GARAGE UNDER THE HABITABLE FLOOR. ITEM C2e IS WATER -EATERS ON A PLATFORM IN THE GROUND FLOOR STORAGE. ITEM C2h IS GRADE AT THE RIGHT SIDE OF THE HOUSE ADJACENT TO THE 3ORCH. signature Date JUNE 18, 2014 S ciii N E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete 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. E1. 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 b) Top of bottom floor (including basement, crawlspace, or enclosure) is 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. 41E1 E4. Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below a -r• G. 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. ❑ feet ❑ meters ❑ above or ❑ below the HAG. ❑ feet ❑ meters ❑ above or ❑ below the LAG. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners 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 Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. SECTION G — COMMUNITY INFORMATION (OPTIONAL) he 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 If this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. 31. ❑ 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.) 32. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. 33. ❑ The following information (Items G4 —G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance /Occupancy Issued 37. This permit has been issued for: ❑ New Construction 0 Substantial Improvement 38. Elevation of as -built lowest floor (including basement) of the building: 39. BFE or (in Zone AO) depth of flooding at the building site: 310. Community's design flood elevation: ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments. FEMA Form 086 -0 -33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.Q. Route and Box No. 1501 LOVELLAVENUE Policy Number. City TYBEE ISLAND State GA ZIP Code 31328 Company NAIC Number. If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 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." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. PHOTOGRAPHS TAKEN JUNE 12, 2014 FRONT VIEW LEFT SIDE VIEW =EMA Form 086 -0 -33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 1501 LOVELL AVENUE Policy Number. City TYBEE ISLAND State GA ZIP Code 31328 Company NAIC Number: If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. REAR VIEW RIGHT SIDE VIEW FEMA Form 086 -0-33 (7/12) Replaces all previous editions.