HomeMy Public PortalAboutVan Horn_10IS, DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL. EMERGENCY it AGENCY
vwrwwa FIood Insun"elf v lly'o'q'l xxxt Important: Read the Instructions on pages i—q,
SECTION A -- PROPERTY INFORMATION
Al, Ruilding Owners Marne Friends uf the Tybee Theater
A2. Building Street Address (anrhidtnq Apt- (.1nit, Suftc,,, and/or Bldg. No ) or P.O. Route and Box W),
10 Van Horn Street
...... .... .
C ty I ybee island State GA ZW1 Code 31'328
Expiration Date: JUIY 31, 20150
RWoticy INSURANCE COMP,�Ny
—G r ri be —, —
parry NAIL Number-,
forferty Description (I.of and Block Nuarbeis, Tax Parcel Numbef, Legal Description, e1c
lot 5, block 12, Fort Screven Ward
A4, Building Use (e q, Residential, is Residential, AdrRion, Accessory, 00
A5. Latilude/Longttude: Lat N 32 f
l-0119 ANIIQee�'J Min hforizrifrtaV Datum: E-1 NAD 19 27 NAD 1983
A6, Attach at least 2 photographs of the building if the Certifioate is being used to obtain flood insurance.
AT BtAlding, Diagram Number 3
A8, For a building with a orawlspace or enctosur&(s): A9. For a building with an attached garage.
a) Square footage of crawlspace or endosute(s) nAA Sr) ft a) Square, friatage of attached garage n1 sq ft
b) Number of permanent flood opining.- in the maw space; b) Number of permanent flood openings in the athiched garagL
or enclosure,(s) within 1,0 foot above adjacent grade. 11.6a- within 1.0 foot above adjacent grade n
c) 10tal not area of flood openings inA8,b n151 so in c) Total not area of flood openings in A9. b L)LLi sq in
0) Engineered flood openings? 1:1 "has No d) Engineered flood openings? yes No
SECTIOI T iD 'TN LI# A N CL:, I A F1
A RM) INFORMATION
...... ....
F31 NFlP Community Name Cornrnurijiy Number - Jr
.1 10 1 ill
Tybele lsl,nd 135164 Chatham GA
...... ..... ... .. . ... .... ......... - - - ------
134, Map/Panel Number 8,51 Suffix B6, FIRM Index Date B7 FIRM Panel Bg Flood B9 Base Flood C-levation(s) Zone
13051G0214 F 711/14 Effective/Revisod Date zones) A04 use twase florid d
9126/0 AE
-1-1---l- r r, Ir '- 11.11 1 - - __- ' -- -' I"rl""r,--'9 �'.....r,,...-... -_1-- ----'-"' I ' 2
B10, Indicate the sout-co, of t1he Base Flood Elevation (B t..) data or base flood depth entered in llern 139,
HS Profile M - t),eleltyriqed
FIRM El COMI'TIUnity 0 otherlsource:
6 1. Indicate elevation datuni used for 8FE fn: ltern Bg: [] NGVD 1929 El NAV0 1988 LJ otheTiSojifoe:
B12r Is the ie build in q located i it a Coa sta 1 B,,r rr ier R eso rces 'ystern ((.1 B W�) area far Otherwise Protected Area (OPA)? 1-1 yes M No
DesigrMtion Date, C13RS -'A
EJ 0 V
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations cite based on: C(,wislruction DrawirTs' E-1 Gullding Under Coirstructiorr* 12A RnWied Construction
'A new Elevation Certificate vviit be required when CoJrStririctfou cif buildinq
is cornplete.
C2. Elevations - 2ories Al -A d, AE, AH. A (with WE), VE, V1 � V30, V (with BFE), AP. AR/A, ARJAE, ATAI --A30, AR/AH, AWAO Complete C2 a-il
below according to the building diagrarn specified in Itern A7- li-i Puerto Rice, only, enter meters,
Benchmark UtHized: iocai
Vertical Daturm
lndicate elevation daturn used for the elevations it) itenns a) through h) below, 0 NGVO 192q 0 NAVD 1988 11 OtheriSource-,
Dattim used for building elevations must be the since as that used for the SSE.
Check the measurement used
a) Top of bottom floor (including basernent, crawlspace, w enclosure flool)
�, -2
r"] feet
0 meter's
b) Top of the rtext higher floor
10.2
C;J feet
L-I meters
C) Bottom of the lowest horizontal structuiat inember (V Zones only)
Z feel
0 rneters
d) Attached garage (top of slab)
rda.
"'D feet
F raietee s
D
e) Lowest elevation of rnachinery of Priuipment servicing the bwlding
0 f e e t
rneters
(Describe type of equipment and 10ration in Comments)
I) Lowest adjacent (finshed) glade next to buflding (LAG)
feet
meters
9 Highest adjar-,erd (finished) grade, next to buil6ng (HAG)
feel
F1 rmters
h) Lowest adjacent grade al lowest elovition of deck or stain, iricluding slructurai support
feet
0 metur-
SECTION D -- SURVEYOR, ENGINEER, OR ARCHITECTCERTIFICATION
This certification is to bo signed and seak.,,d by a land surVeYOT', et'9111eef, Virchitect authorlzed by law to cod�fy elevation
infourfation, I (;edify that Me or" thts corifficatr reprvsents cry tai efforts h) intofprei ths" data ovagabtc.
I understand that any hgse staten ?enl Iva b e puf iishable, by rh w ot 6 U, S Godo", suc&ofa 100-"
y
1/1, j�� (') R
Check hers if cornm(:ntsafe proyided on bar of form. Wr4ro ialJtU(l(1 aild 1011qftUde, in SeCtion A provided by
Check here ifattachnnent licensed land surveyor? 01 Yes El No
N
/* A", *,"N
C ertifier's Name Jr Whifley Reynolds
Title Land Surveyor
Address 636
Signature
FEMA orfFl
Avenue,
(1d'[ /-)
Ucertsc Number 2249
Cumpany Marne
City Savannah St alp GA ZIP Code 31405
bate 9/22115 J52
Teiephorre 912, -0464
r„o
"raJ
ad V
V
See reverse side for contillWition. Replaces all pte -- -
VIOUS editions.
LEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces, copy Vie corresponding inn -ormiation from SectJon A, FOR INSURANCE COMPAN USE
iTj—i4hg et Address (including Apt., Unit, Suite, and/or Sidg. No,) or P.O. Route and Box No Policy Number:
10 Van Horn Street
City Tybee Isiand State GA ZiP God '31328 Company NAIL Nurrfbor:
SECTION D - SURVEYOR, ENGINEER, OR ARC HITEc-r CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community offi�Ja1, (2) insuMirice aT,,,nt/company and (3) buriding owner,
omroents, This building is a theater. Enhance
10,2, Fligh point Inside is -ir1g. J-Ovy Point a 5 9
New HVAC equipment on the outside of the building is elevaitien 13,0, 13 8 &14-7
j /
— ----------
Sig tasre Date 9122115
SEEC.T� E -- BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT
For ion AO and A (without BIFE), complete Items El--E5 if the Certificate is intended to support a LOMA or LOMR-F request complete Sections A, B,
ana 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 foflowing and check the appropriate boxes to show whether the ofevation is above or below tile highest adjacent
grade (HAG) and the lowest adjacent grade (L.A%
a) Top of bottom floor (including basement, crawispace, or enclosure) is feet 0 rneters [-I above of C1 below the HAG
b!) Top of befforn floor (Including basement, crawlspace, or enclosure) is ------- Ll feet [I meters El above or 0 below the LAG�,
E2 For Building Diagrarris G-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 bLdiding is - -, e t F -,rs [ above or 0 be HAG,
[-] ff .] rriete -j - low the I
E3. Attached garage (top of slab) is El meters F-1 above or below the HAG3.
El feet
E4. Top of platform of machinery and/or equipment servicing the b0ding is feet meters above or [] below the HAG
E5. Zone AO only: If no flood dopth num0ci is available, is the top of the bottom floor eievated in accordance with the comr,nunity's floodplarn manaqOrriera
ordinance? C] Yes 0 No r-1 Unknown The local official must certify this infDrmation in Section G,
SECTION F -- PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's aulhonzed representative who cornpleles Sections A, 8, and E for Zone A lwithout a FEMA-issued or corrunifflihi-issued BFI:;)
or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowIed9(-,-
Property Owner's or Owner's Authorized Representative's Narne,
Address City State ZIP Code
signature Orate Telephone
Comments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local officiat who is authorized by law or ordinance le administer the community'5 nnodplaO rnanagement ordinance can —romple—te Sea —ions TBI —(7r ETand G
of this Elevation Certificate. Complete the applicable, 4,erri(s) and sign below. Check the measurement used in Iterns G8--G 10. In Puerto Rico only, enter ureters.
f �, 1 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.)
G2, 0 A community official corripieted Section E for a building touted in Zone A (wilhout a FE - issued or conirnunity-issued BEE) or Zone A0.
G3. The following information ()term G4 - -G1 D) is provided for community floodplain management PL9POSes,
GA, Permit Nurnbvr Date Peirnit l%sued 6:�io 'C.od`tolaz,atc Cif rarrapisanseJE ?e,cuparrcy Issued
dc-
GT This prannit bas been issued for: Ej New Construction [1 61,11)5tandA irnpiovement
G8, Elevation of as -built lowest floor (including basement) of the building: ffae,t rrieters Datum
G9. 6FE or (in Zone AO) depth: of flooding at the building site: reet ureters Datuni
G IQ, Community's design flood e kvation: El feet 0 merefs, Dalurn
Locai Officiai�s Name
Community Name
Signature
Comments
T5,11A Fd'r'rn 086-0-33 (7/12)
Tiff
....... . ...
Telephone
Date
puts.
Replaces alit F)revricius ediliciii-9,
ELEVATION CER'rlFlGA'rE, page 3 Building Photographs
Se,e, lrtstnrlf-'Jior!S T'C" Item A6.
IMPORTANT: Iri these slpace$, Copy One coa,esporiding mfot-mabon ftom Soction k FOR INSURANCE COMPANY OSE
Apt, Unit, Poky NUMber!
0
10 Van Horn SN,,,(.-,t
C'4y I Ybee fs1Ind SMI(� GA zif"'Cade M328 D)mpiiny NAIC Number:
. . . ....... . . ... ..
If using 1.110 [E]e'vatiorl ("erlificate, 10 obta6l NFIP flood inswance, affix at least 2 budding pfwto� yaphs below accor(fing to ifie instrucAmns
Fria - Rem A6, Identify '.'0 photographs with date takeri, "Front Vievi" and "Rear Vi(.,vv"-, arid, if i'equif'ed, "Right 1)ide V e),v" an('i 'T.uft 'Sidc
View" When '.ipplicablc, phOtoOiaphS MUSt $11OW thO (OUndation with mpi,esentafive eXafflpie ; of the flood f.)perungs Ov veiils, ass
indicated in Section A8. If o ajbmftljng mofe photographs than will fit t)ri this, page, rise the Continuation Pag.
Fr -cant View September 21 2015
M�TMMTMM
f:[:MA Form 036.0-33 (7112) RepWces all preViOLIS e(Jitions.
FOR INSURANCE COMPANY USE
Palmy Number.
Company Nl.aK, Number
It submitting rnore photogr' ,Ph,,, thall WiH fit or) thr pscc,r.lrpiratp page, ajfix ttje, photoqi, q)hs beiovi, Wentify MI photc),9raTh,
vvift date taken-, "Front View" and "Plf, ar- View", and, if "Hight Side View" iind "Left Side View'" When ar)pficaUe,
photographs must show the fOLIndation with fepq,ast�njafive exampleg ()f II)e fjo(yj opej iif)U s of vr,-rsjs, as indicated 6n Se( tion A8.
Rppiack.,�s all previous edilionti,
__7 -61
rm -.33(7/12)
V�_