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06-0460 SOUTHLAND BUILDERS.pdf
CITY OF TYBEE ISLAND CERTIFICATE OF OCCUPANCY DATE COMPLETED: 01/09/08 This Certificate issued pursuant to the requirements of the Standard Building Code Certifying that at the time of issuance this structure was in compliance with the various ordinances of the Jurisdiction regulating building construction or use. PERMIT #: PROPOSED USE: OCCUPANCY TYPE: CONTACT NAME CONTACT ADDRESS CONTACT CITY STATE ZIP PROPERTY ADDRESS APPROVED BY: 1.1.1 NEW RESIDENTIAL BLDG - SF P NANCY MAINE 2 CONCORD CIR POOLER GA 00000 1405 SOLOMON AVENUE P. O. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786 -4573 - FAX (912) 786 -5737 www.cityoftybee.org ' 4A "# Inspection Report City of Tybee island 403 Butler Ave. P.O. Box 2749 Tybee Island, GA 31320 Phone: (912) 706-4573 next. 114 Fax: (912) 706 -9539 Permit No, 0 (4-(00 date Requested Owner's Name (1 Gate Needed ,� �-k, Cq rc� Gen. Contractor,, , ►tic)-s Subcontractor -'_ Contact Number ` 1 h n L ( /r o k r ej <9 ``t `T - -7 2- G Location QpSS Inspector (t'�� Date of Inspection Type of Inspection _ �' f V\ 1 e H O D S= "` r Pass Aqv VA 4 ' Fail L-LE VA-Ar (i C)&� P i' r 1 V,V „vi (� Ake A ",15 Dianne Otto From: Joe Wilson Sent: Wednesday, January 09, 2008 10:17 AM To: Brannyn G. Allen; davisenginc @bellsouth.net; Dianne Otto Subject: 1402 Solomon I've revisited John Lamour's site and am satisfied with the drainage. It looks like there are people living there already. 20© $� 1 Dianne Otto From: Joe Wilson Sent: Friday, December 07, 2007 10:31 AM To: davisenginc @bellsouth.net; Brannyn G. Allen Cc: Dianne Otto Subject: RE: The following sites were visited this a.m. with discrepencies or acceptance noted: 1405 Solomon Ave. - Appears to be a retention in the N.E. corner of lot. Need to review overall drainage plan. Brassrail Condos - Catch basins need cleaning, inverts, and pipes cut flush w /wall. Sump pump wiring needs to be incased. 1204 Second Ave. - Okay 1010 Hwy 80 - Pipes in catch basin need to be cut flush with wall. The Southside (Marshside) needs soil stabilization. I will recheck this p.m. for compliance. 1408 Fifth Ave. - Okay 403 Tenth St. - Soil needs to be stabilized next to marsh (Westside)_ Needs deliniation of swale on Eactr-i ,'- 1 - - - -- Original Message - - - -- From: davisenginc @bellsouth.net Sent: Fri 12/7/2007 7:44 AM To: Brannyn G. Allen 1 Cc: Joe Wilson; Dianne Otto Subject: J U ra •r\0-� Please print and call me upon receiF 695 -7262 Downer Page 1 of 1 Dianne Otto From: Dianne Otto Sent: Tuesday, December 04, 2007 3:43 PM To: Brannyn G. Allen; Joe Wilson Subject: site visit Brannyn and Joe: John L'Moure (844 -7265) of Southland Builders has asked for a final drainage review at 1405 Solomon Avenue. This is lot 1 of the Sanctuary, so Downer will not be involved. Thanks, Dianne K. Otto Administrative Assistant Building & Zoning dotto @cityoftybee.org Phone: (912) 786 -4573 ext. 114 Fax: (912) 786 -9539 12/04/2007 .1� • pill -�oufAd -- e -Pro po,,,6 Li//¢ 000 Sotn; per✓l'ws p oe/V 5 ti N ti /73�ffo ►�'� �47.59� ayzrs f 5o�owroti/ A ✓�. zo' IV PL. AAA O fo Q ZO 40 s0 ° RQ� aQ q No 1A t 3� ,S o t�� 3UR j� `� r IT Z-,:::l CA TIOV PZ fire': /F Z In[.OD Zone vJ 4�,-v 1,45, O Qs &ze;// Sllrv¢ y 14os soLoim T Avz _s a. Pinl400?�or3 6j; ,C.K RLS / 8 �X Z�36 T 6e2 786 -4� o Z4 , � 53 LeYe & o Qk (p Enf► -ar�c2 ----- -_ -_ -. rte, !O V I/zLevels �+ of deck --,7 , • pill -�oufAd -- e -Pro po,,,6 Li//¢ 000 Sotn; per✓l'ws p oe/V 5 ti N ti /73�ffo ►�'� �47.59� ayzrs f 5o�owroti/ A ✓�. zo' IV PL. AAA O fo Q ZO 40 s0 ° RQ� aQ q No 1A t 3� ,S o t�� 3UR j� `� r IT Z-,:::l CA TIOV PZ fire': /F Z In[.OD Zone vJ 4�,-v 1,45, O Qs &ze;// Sllrv¢ y 14os soLoim T Avz _s a. Pinl400?�or3 6j; ,C.K RLS / 8 �X Z�36 T 6e2 786 -4� U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660 -0008 Federal Emergency Management Agency I Expires February 28, 2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Build'ngQ Hers Name Policy Number VICZ4 i f1 17, A2. Buil ing Street r ss (including Apt. nit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Company NAIC Number C) f_n C iq � CL. City T— f State ZIP Code 3 r A3..� fro pesc 'ption (Lot an Block Numbers, Tax Parcel PIu a �Lepal De ription, ttc.) el �11 r'i� �' �f 7� Go� � (` l /12 �Q hc�TU 4ry gG v ua►z� -- A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) /� ��f d �� fjQf A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photograph f the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number A8. For a building with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within 1.0 foot above adjacent grade ® walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Comm .yj# N me & gommunity Number B2. Coin Nam B3. State S toad /3 516 ¢ c� , Map /Panel Number 1-3s /� B5. Suffix B6. FIRM Index D B7. FIRM Panel Eff�i i d Date GTO B8. Flood Zxj1i ) B9. Base Flood Elevation(s) (Zone AO, u aseood depth) s B10. Indicate the source of the Base Flood Elevation (fiFE) data or base flood depth entered in Item B9. ❑ FIS Profile [DO IRM ❑ Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in Item 139: ❑ 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 EP No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' I Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, AR/AE, AR/Al -A30, ARIAH, AR/AO. Complete Items C2.a -g below according to the building diagram specified in Item AT Benchmark Utilized Q r 15 Vertical Datum Conversion /Comments ICheck the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) 91 ' lC i hefeet 11 meters (Puerto Rico only) b) Top of the next higher floor ID feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) Z afeet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) ❑ feet E] meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building _.1 _ feet ❑ meters (Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) .d 2-feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) T 9 i feet ❑ meters (Puerto Rico only) 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 ele information. I certify that the information on this Certificate represents my best efforts to interpret the data available. I�u-ndderstand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001 L`7 Check here if comments are provided on back of form. 7,. ,[�01 15$la r-tMA corm 61 -61, feoruary 2006 See reverse side for continuation. Replaces all previous editions MPORTANT: In these spaces, 3UILDING STREET ADDRESS (Incli D IC`s ✓h(:D'� y the cc ;ponding information from Section A. Apt., 4it Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 1 J[.� Lim For Insurance Company Use: Policy Number "TY ! 6 ! 6 11 STATE/gr 3t 3zl CODE 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/cgmpapy, and (3) building owner. -OMMENTS ha `� J t)1` y�4F Gl `''� 6 �/�i ��✓i i �'1 �% �i `L CU 1%,k Ae? CoA. 1_1 Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) or Zone AO and Zone A (without BFE), complete Items E1. through E5. If the Elevation Certificate is intended for use as supporting (formation for a LOMA or LOMR -F, Section C must be completed. A. Building Diagram Number (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.) :2. The top of the bottom floor (including basement or enclosure) of the building is 1 -1 -1 ft. (m) 1_1_1 in. (cm) I-1 above or 1_1 below (check one) the highest adjacent grade. (Use natural grade, if available.) :3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1_1_1 ft. (m) "_tin. (cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. :4. The top of the platform of machinery and /or equipment servicing the building is 1 -1_I ft. (m) 1_1_1 in. (cm) 1_1 above or 1J below (check one) the highest adjacent grade. (Use natural grade, if available.) :5. 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? 1_1 Yes 1_1 No 1_1 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, C, 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 1_1 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 ections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign beiow. i1. 1_1 The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) 2. 1 1 A community official completed Section E for a building located in Zone A (without a FEMA - issued or community- issued BFE) or Zone AO. 6. 1 1 The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED Go. DATE CERTIFICATE OF COMPLIANCEiOCCUPANCY ISSUED i7. This permit has been issued for 1 -1 New Construction 1J Substantial Improvement i8. Elevation of as -built lowest floor (including basement) of the building is: G. BFE or (in Zone AO) depth of flooding at the building site is: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS —ft. (m) Datum: ft. (m) Datum: 1 Check here if attachments ENIA Form 81 -31. Januari 2003 . =olacas all crw;ous _�diticns Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, nd/or Bldg. No.) or P.O. Route and Box No. Policy Number v(o� ►� U City Tom` . State ZIP Code 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. Z_FFTV &Q��✓� n �d ,T7 v f�cr'c`'"%rU tt5{Y `• ir.T -rA yr •� tit [ e v e Lj Inspection RepoF t City of Tybee Island 403 Butler Ave. P.O. Box 2749 Tybee Island, GA 31328 Phone: (912) 786 - 4573 ext. 114 Fax: (912) 786 -9539 Permit Nn. 0(o " c) 4 (K,)C) Efate Requested — i'2 • Lf - owner's Name -/Y\ 1 0 , �j Date Needed Sow- �kcarCTI— -- Gen. Contractor — 91`i rr s .. I Subcontractor Contact Number - -- V � 1-� r^, — � Lf L4 1-7 2- Location Date of Inspection Type of i nsperhon pgs Pass - -- __ // QpSs S `t �1 �C,0� 61 d& epSs rm"Mn Fail Lj Vii Inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2749 Tybee Island, GA. 31328 Phone: (917) 785 -4573 extension 114 Fax. (912) 785 -9539 Perliot Nii_ \ ll�i — l� �G� mate R#*gi,4-.ctd-cl Owner's Name _J r t n� � fate �+ieeded i � " � - � -7 Gen. Contractor _ j IA I' S . S ibCointrartor Contact Number �) o ►� O �'-t ' 2 Location H S 60 1 C') err O r -s tT �ns,pector �� hate of Inspection Pe o't Inspection -- n Q1 ��c f %ha A 4wel+)- I. 0.4 S,df i��c,� k -lam S4r4R AIL vn. r�eeJs t (��v Coll" - k Aw, Re-\3-,VS ^err) C- F Z <cSS 4, TYrp��p� tr,,, cal St��w� � T:7p r� PASN M i 11 !1^ ✓ 1 J 1n'� J '" t cwm u- A rtrPs a� C u 4 Ik 4c, IJ5 PV IAJ- 5+011 f �i 5 p.l L C OLAf ke KI -J�,5411 Pass Fail �1FC��,ca1 L-G�17c��tlr"��< CcJnnec�p( W,llr, n� C \.?wAv%,e . a4 f} +k,c G(en�AV (_ ujlr,wny) I � �M/7l���j �� Un t UOI <�rl ✓f�,� 0- 2-(o -o-7 VA q:ai venn� --J—e;-Cu-s / A In, e- c--\--r'. c Sq7- oco5Z (L� o 3 -o l o s— Ave. p(o- oS'�o a d -, (c l QTS k/ MM + a � � , s 4,w p zrV-^--4:s. o DATE ISSUED: 08 -24 -2006 WORK DESCRIPTION: WORK LOCATION: OWNER NAME ADDRESS CITY, ST, ZIP CONTRACTOR NAME ADDRESS CITY STATE ZIP FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE OCCUPANCY TYPE TOTAL FEE'S CHARGED PROPERTY IDENTIFICATION # PROJECT VALUATION I 1 ,.n�� CITY OF TYBEE ISLAND WATER METER PICKUP NEW RESIDENTIAL BLDG - SF 1405 SOLOMON AVENUE NANCY MAINE 2 CONCORD CIR POOLER GA 00000 SOUTHLAND BUILDERS PO BOX 2945 TYBEE ISLAND GA 31328 P $7,595.00 $200,000.00 PERMIT #: 060460 WATER METER PICKUP TOTAL BALANCE DUE: $ 0.00 ONE METER (3/4 -INCH) It is understood that if this permit is granted the builder will at all times comply with the zoning, subdivision, flood control, building, fire, soil and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether local, state or federal, including all environmental laws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction covered by this permit. This permit must be posted in a conspicuous location in the front of building and protected from the weather. if this permit is not posted work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided unless work has begun within six months of the date of issuance. Signature of Building Inspector or Authorized Agent: P. O. Box 2749 - 403 Butler Avenue, Tybee Ishnd, Georgia 31328 (912) 7864573 - FAX (912) 786 -5737 www.cityoftybee.org Inspection Report City of Tybee IsIdnd 403 Butler Avenue P.O. Box 2749 Ty bee Island, GA 31328 Phone: (912) 186-4573 extension 114 Fax: (912) 786-9539 Permit Nn- - o4 �o c-) Owner's Name ► � 0, • (Q-) Gen, Contractor .�'-)-4)I0,1r1: Contact Number Date Requested Date Needed 0.2 c), Subcontractor Location � Date of Inspection 7 Time Inspector Type of Inspection r\ 0 (-Jj PGA <�` /6P ti Inspection Report City of Tybee IsIdnd 403 Butler Avenue P.O. Box 2749 Ty bee Island, GA 31328 Phone: (912) 186-4573 extension 114 Fax: (912) 786-9539 Permit Nn- - o4 �o c-) Owner's Name ► � 0, • (Q-) Gen, Contractor .�'-)-4)I0,1r1: Contact Number Date Requested Date Needed 0.2 c), Subcontractor Location � Date of Inspection 7 Time Inspector Type of Inspection r\ 0 (-Jj PGA <�` /6P * * * * * * * * * * * * * ** -Comm. 2NAL- * * * * * * * * * * * * * * * * * ** DATE FEB- 01 -20' * * ** TIME 08 44 * *** **** MODE = MEMORY TRANSMISSION START = FEB -01 08:44 END = FEB -01 08:44 FILE N0. =163 STN COMM. ONE- TOUCH/ STATION NAME /EMAIL ADDRESS /TELEPHONE NO. PAGES DURATION No. ABBR NO. 001 OK a 4435073 001/001 00:00:19 -CITY OF TYBEE ISL. - ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** -CITY OF TYBEE - * * * ** - 912 786 9539- * * * *** *** RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND FOR SAVANNAH ELECTRIC. FAX TO: Lynn Brennan 9*2=0*1407 Phone 912443 -5063 4W 3 -1r PT S'0173 p �, 0 441,00 Location Address: 1405 '54orn a n Ave.. Lot #- Release Date: +e,, Type of Release: Temporary Permanent Subd Name: Electrician: Arru_r , e_ a. , 0 t a . Electrician Phone Number:- Owner/Builder: nQJ Phone Number: :33o-9(,o3 Location Address: Lot # Release Date: Type of Release: Temporary _ Permanent Subd Name: Electrician: Owner/Builder: Electrician Phone Number: Phone Number: Location Address: Lot # Release Date: Type of Release: Temporary _ Permanent Subd Name: Electrician: Electrician Phone Number: Owner/Builder: Phone Number: 4 r RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND FOR SAVANNAH ELECTRIC. FAX TO: Lynn Brennan 9-37 Phone 912 - 443 -5063 4y 3- So '73 0(,,-off(oo Location Address: 1405 --,� (orn o n ke . Lot #- Release Date: 1-(- 0 -7 of Release: Temporary Z+e,F,So,-o4u- Type Permane Subd Name: Electrician: �� � c . Electrician Phone Number:-pcoS Z- Owner/Builder: Q h / r \Ct , ruy Phone Number: 3:30-9(00-2> Location Address: Type of Release: Temporary Electrician: Owner/Builder: Location Address: Type of Release: Temporary Electrician: Owner/Builder: Lot # Release Date: Permanent Subd Name: Electrician Phone Number: Phone Number: Lot # Permanent Release Date: Subd Name: Electrician Phone Number: Phone Number: Inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2749 Tybee Island, GA 31328 Phone: (912) 786-4573 extension 114 Fax: (912) 786-9539 Permit No. (0 - �0 0 Date Requested _6 � - Owner's Name—, Vol r Date Needed Gen, Contractor Subcontractor Contact Number 0 o Le Location Date of Inspection Type of Inspection '? Time 5)_�,J' Fes Inspector IV' lkf. V Inspection Repoil City of Tybee Island 403 Butler Avenue P.O. Box 2749 Tybee Island, GA 31328 n j Phone: (912) 786-4573 exte. ':�� 114 ns' n Fax: (912) 786-9539 Permit No, 3 L4 - Date -quested (.,:Q Dale Owner's Name G. o) Da Needed -T� Geri. Contractor bcontractor Contact Number Location ZA- A j 3% z-- Date of Inspection Time Inspector Type of Inspection IL �� Q1) o� 0 �o t `i? �.a J y, ; Inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2 749 Tybee Island, GA 31328 Phone: (912) 186 -4573 extension 114 Fdx: (912) 786 -3539 Permit No d- i- _- OY.+00 -- Date Requested Owner' Man+' �_� Date Needed - - -- - -- Gen. Co `U nCi Subcontractor C'ontart lip ilmher - -- -��st _- J -, V Location - �{_J D., .04%.,V —). Date of t o --pectin rt - �)�/ u6 Time 7 n- -pecto r v Type of 1nsperhon _ (� P C L ft� : ; ; r vq. A., '. f Inspection Report City of Tybee Island 403 Butler Avenue P.C. Box 7749 Tybee Island, GA 31328 Phone: (912) 786 -4573 extension 114 Fax: (912%] 785 -9539 Permit No. Ina- L�(o O Owner's Name 5, Gen. Co ntracto r � �D J Contact Number Location ! 0 -�, Date Requested __����u Date Needed 101 Subcontractor n Date of Inspection Time Inspector I-) Type of Inspection 4 1 /n/s4 ;!4TP t F%►�l Inspection Report City of Tybee Island 403 Butler Avenue P.O. Box 2749 Tybee Island, GA 31328 Phone: (91'2.) 786-4573 extension 114 Fax: (912) 786-9539 Permit No. L) 4 kp Owner's Name 2La 0 , \-rj Gen. Co ntracto r. S� 04 Contact Number Location. Date of Inspection Date Requested 2 L) S 0 Date Needed C) Subcontractor - 7 2, (v r LTime — Inspector I I Type of Inspection ? -5 4V'e -�'v a C. QPSS ��w j - - , I n s p e c t i o n R e p o r t C i t y o f T y b e e I s l a n d 4 0 3 B u t l e r A v e n u e P . O . B o x 2 7 4 9 �� d T y b e e I s l a n d , G A 3 1 3 2 0 ( - / P h o n e : ( 9 1 2 ) 7 8 6 - 4 5 1 3 e x t e n s i o n 1 1 4 F a x : ( 9 1 2 ) 7 8 6 - 9 5 3 9 P e r m i t N o . D a t e R e q u e s t e d O w n e r '