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Home My Public Portal AboutMILLER AV_1310.pdfU.S. DEPARTMENT OF HOMELAND SECURITY LEVATIION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY "Voormal Flood Insurance Program Important: Read the instructions on pages 11-9. Owner's Name James Stevens A2. Bu0ding Street Address (including Apt., Unit, Suite, and/or Bldg No,) or P.O. Route and Box No. 1310 MiVer Avenue City Tybee Island State GA ZIP Code 31328 -K3-.— Property --D,escriptiori (Lot and Mock Numbers, "rax Parcel Number, Legal (Description, etc.) lot 146, Ward 4 0-000. Expiration Date: July 31, 2 j15 [a A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential A5. t-atitudie/Longitude: Lat. all do_q 59.8q Min Long. 18L!Qdeg 51 ;CD400 min Horizontal Datum: ❑ NAD 1927 Z NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 5 AS. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage. a) Square footage of crawlspace or enclosure(s) n/a sq ft a) Square footage of attached garage n1a sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade n1a within 1.0 foot above adjacent grade n1a c) Total net area of flood openings in A8.b n/a sq in c) Total net area of flood openings in A9.b n/a sq in d) Engineered flood openings? ❑ Yes Z No d) Engineered flood openings? ❑ Yes M No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION NFIP�Cornmunity N� me & Community Number B2. County Name B3. State Tybee Island 135164 Chatham GA Island LFy b e I'l. . .... ... ...... I . . .. ..... B4. Map/Panel Number B5. Suffix ] B6. FIRM Date B7. FIRM Panel B8. A lood M 13051C0326 /aF V 1 4 Effectivised Date Zoe(s) 9126108 E . . ............ B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered [11 Item B9, -.11 FIS Profile rA FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BEE in Item 89: ❑ NGVID 1929 VA NAVD 1988 0 Other /Source:. B12. Is the building located in a Coastal Barrier Resources 'System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: __ ❑ CBRS [:1 OPA B9 Base Flood Elevation(s) (Zone AQ use base flood depth) ❑ Yes 121 No a) 'rap of bottom floor (including : basement, crawlspace, or enclosure, floor) b) Top of the next higher floor c) 'Bottom of the lowest horizontal structural mernber (V Tones only) d) Attached garage (top of slab) a) 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) Flighest adjacent (finished) grade next to building (HAG) fi) Lowest adjacent grade, at lowest elevation of deck or stairs, incWding structural support SECTION D -- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be ssgned and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate repnesents my best efforts to interpret the data available. I understand ther any false Statement may be punishabie 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 att@chments, licensed land surveyor? Yes ❑ No - .-, - ..... .... r I CertiEer's Name J. Whitley Reynolds License Number 2249 Title I-and Surveyor Company Name . ....... . ........ . ... . .. .... Address nature D 636 Stephenson Avenue, City Savannah . .... .. . ..... -ate 7/16115 Sig State GA Z9P Code 31405 Telephone 912-352-0464 FEMA Form 086..0-33 (7712) See reverse side for continuation. Replaces al'l previous edffions. Check the measurement used. 15.5 N feet ❑ meters 1112— Z feet El meters n1a. — ❑ feet ❑ meters n1a, ........ ...... ... Z feet El meters 13.4 N feet ❑ meters 6.0 0 feet EI rneters 6.4 0 feet F-I meters 6,D 0 feet F.1 meters SECTION D -- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be ssgned and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate repnesents my best efforts to interpret the data available. I understand ther any false Statement may be punishabie 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 att@chments, licensed land surveyor? Yes ❑ No - .-, - ..... .... r I CertiEer's Name J. Whitley Reynolds License Number 2249 Title I-and Surveyor Company Name . ....... . ........ . ... . .. .... Address nature D 636 Stephenson Avenue, City Savannah . .... .. . ..... -ate 7/16115 Sig State GA Z9P Code 31405 Telephone 912-352-0464 FEMA Form 086..0-33 (7712) See reverse side for continuation. Replaces al'l previous edffions. ELEVATION' CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information frorn Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and! Box No, 1310 MilIer Avenue City Tybee Island State GA ZIP Code 31328 FOR INSURANCE COMPANY I Policy Number: Company NAIC Number: 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) building owner. Comments C2.e) Is A/C pad Signature M Mtqoft-10011 ljjjjj !11 !!111 IiIIII 11 1111111111111 !�! 11111 1!! 11101INKRIFICZ "IT W&I211401 i 111�111qjlii For Tones AOl and A (without BFE), complete Items E1 —E5. If the Certificate is intended to support a LOMAorLOMR-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. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation ns above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters, ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is E feet ❑ mete rs _above or ❑ below the LAG;. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 andlor 9 (see pages 8--9 of Instructions),, the next higher floor (elevation C2.b in the diagrams) of the building is _._ [:1 feet [I meters ❑ above or ❑ below the HAG, II Attached garage (top of slab) is ❑ feet ❑ E meters E above or E] below the HAG, E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the communfty'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 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 Signature Comments City State ZIP Code . . ......... Date Telephone Lj Check here if attachments. SECTION G – COMMUNITY INFORMATION (OPTIONAL) The 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 of this Elevation Certificate. Complete the appilicable item(s) and sign below. Check the measurement used in Items G8 --G10. In Puerto Rico only, enter meters. G1. ❑ '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 bylaw to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section I for a building located in Zone A (without a FEMA.-issued or cornmunity-issued BFI or Zone AO, G3. ❑ The following information (Items G4 —G10) is provided for community floodplain management purposes. G4. Permit Number G5 Date Permit Issued 6. Date Certificate Of Compliance/Occupancy Issued ...... . ........ GT TNs permit has been issued for: ❑ New Construction ❑ SubstanfiaI Improvement G8. Elevation of as -built lowest floor (including basement) of the buflding: ❑ feet meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: feet meters Datum G10. Community's design food elevation: ❑ feet ❑ meters Datum Local Official's Name — .......... Community Name Signature Comments ........... FEMA Form 086-0-33 (7112) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 B rig d'ing Photographs See Instructions foritern A6 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"; arid, 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. FEMA Form 086-0-33 (7112) Replaces all prevjouse�di _mns, ELIEVATION CERTIFICATE, page Building Photographs Continuation Page IMPORTANT: In these spaces, copy the cor� ding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No 1310 Miller Avenue City 'Tybee Island State GA ZIP Code 31328 FOR INSURANCE COMPANY USE Policy plumber: Company NAlC 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, ----------- FEMA Form 086-0-33 (7112) RepIaces all previous editions.