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Home My Public Portal AboutLaurel Av_1104_2015U,S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY Naoonal Flood insurance, Pmgroin Important: Read the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION Al. Building Owner's Name DIANE CORNELIUS OMB No. 1660-0008 Expiration Date: JUly 31, 2015 FOR INSURANCE COMPANY USE Policy Number: A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No,) or P.0, Route .and Box No Company NAIL Number: 1104 LAUREL AVENUE I ti State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 8, BLOCK 10, GARDEN WARD, TYBEE TAX PARCEL 4-0026-0'3-019 A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Let. 32--01-11,50 Long. Horizontal Datum: ❑ NAD 1927 M NAD 1983 A6, Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance, A7. Building Diagram Number 6 A8. For a building with a crawispace or enclosure(s): A9 For a building with an attached garage: a) Square footage of crawl:space or enclosures) 312 sq It a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings an the attached garage or enclosures) within 1.10 foot above adjacent grade 2 within 1,0 foot above adjacent grade N/A c) Total net area of flood openings in A8,b 242 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 0 No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number B2. County Name B3. State CITY OF TYBEE ISLAND 135164 CHATHAM � GEORGIA B4. Map/Panel Number B5. Suffix 86. FIRM Index Dale 137, FIRM Panel B8. Flood 89, Base, Flood Elevation(s) (Zone 13051C 0213 F 912612008 EffectiveiRevised Date Zone(s) AO, use base flood depth) 1 912612008 1 AE 110' 610. Indicate the source, of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89. FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: B11, Indicate elevation datum used for BFE in Item B9: F-1 NGVD 1929 2 NAVID 1988 ❑ Other/Source: B12. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes 0 No Designation Date: _ [:] CSRS ❑ OPA a) Top Of bottom floor (inClUdingi 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) 0 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 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 I information. / certify that the inforination or? this Ceilificate represents my best efforts to interpret t J1 (4a e , to available. I onderstand that any false statement [nay be punishable by fine or- imprisooment under 18 U, S. Code, Section 1001. QZ, d Pv Check here if comments are provided on back of form, Were latitude and longitude in Section A provided by a E] Check here if attachiments. licensed land surveyor? M Yes ❑ No Certifier's Name, MICHAEL J. GARDNER License Number GA. RLS 2285 Title LAND SURVEYOR Company Namp MICHAEL J GAFRONIPP, LAND 9UFZVEYOR ... . . ..... . —A d —dr e s s1 2 1� V A R N E EN, E City GARDEN CITY State GA ZiP Code 31408 .. . ......... . . Signature Date 0912812015 Telephone 912-661-0479(CELL) i. .......... J * 1166 Z "7__ FEMA Form 086-0-33 (7/12) See reverse side for continUatior). Replaces all previous editions. Check the measurement used. 7.1 R feet ❑ meters _15 1 a__ ED feet El meters N/A. ❑ feet [:1 meter-, NIA.® ❑ feet ❑ meters __p3.8 0 feet ❑ meters &5 Z feet ❑ meters G.8 ❑ feel ❑ meters X6.5, -._ Z feet 0 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 I information. / certify that the inforination or? this Ceilificate represents my best efforts to interpret t J1 (4a e , to available. I onderstand that any false statement [nay be punishable by fine or- imprisooment under 18 U, S. Code, Section 1001. QZ, d Pv Check here if comments are provided on back of form, Were latitude and longitude in Section A provided by a E] Check here if attachiments. licensed land surveyor? M Yes ❑ No Certifier's Name, MICHAEL J. GARDNER License Number GA. RLS 2285 Title LAND SURVEYOR Company Namp MICHAEL J GAFRONIPP, LAND 9UFZVEYOR ... . . ..... . —A d —dr e s s1 2 1� V A R N E EN, E City GARDEN CITY State GA ZiP Code 31408 .. . ......... . . Signature Date 0912812015 Telephone 912-661-0479(CELL) i. .......... J * 1166 Z "7__ FEMA Form 086-0-33 (7/12) See reverse side for continUatior). Replaces all previous editions. Signature Date 09128/20,15 �ZC ForZonesaDmodA(without BFE). complete Items F'1-E5. IfthrCertificate is intended m support auDMAmL0MR-r request, oump,lete Sections A.s. and C, For Items E I-E4. use natvra/ grade, x available, Check the measurement used, |n Puerto Rico only, enter meters. El Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (MaG) and the lowest adjacent grade (L*S) o) Top uf bottom floor (including basement, cravWopaoe`oir enclosure) ia 0 El meters [] above ur[] below the HAG. u) Top or bottom floor (including basement, o,awiamouo.or enclosure) io� []feet [] meters [Jabove v,[]below the LAG, 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), tile next higher floor (elevation Cobm the d)agmma), uf the building ia ____,___. []fe=* []meters [] above or[] below the *AG E3 Attached garage (top uf slab) ix � []feet [I meters above or [] below the HAG. E4 Top o/ platform uv machinery and/or equipment servicing the building |e El feet [] meters [] above n,[] 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 community's floodplain, managernent ordinance? [] Yes [] No [] Unknown. The local official must certify this information in Section G SECTION PROPERTY OWNER OR OWNER'S, REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-isSUed or community-issued BFE) o/ Zone AO must sign here. The statements inSections A.B. and E are correct tu the best u/myknowledge. Property Owner's ur Owners Authorized Representative's Name Address City State ZIP Code Signature, Date Telephone ----- Comments O �aheck here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) The iocal official who is authorized by law or ordinance to administer the commun,ity's floodplarn management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate, Complete the applicable item(s) and sign bOow, Check the measurement used in Items G8-G1G. In Puerto Rico Only, enter meters, G/[] The information m Section C was taiken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architectwho is authorized by law to certify elevation information, (Indicate the source and date of the elevation dataiuoheCommentsaeabelnm) G2. LJ A Community official completed Section E for a building located in Zone A (without a FEMA-issued Or COMMUnity-issued BFE) or Zone AO, G3, [] The following infonnatipi (items G4,-818)|s provided for community Amndp|m|n management purposes. -64. Permit Number 5. Date Permit Issued G6. Date Certificate Of ComplianicelOocupancy Issued G7r This permlt has been issued for� New Construction Substantial Improvement G8r Elevation of*v-bUilx lowest floor (including basement) uy the building: El feet []meters Datum___ 89 8FEor (in Zone AO) depth of flooding at the building rite: []fec^ El meters Datum___ G1 0. Community's design flood elevation � [] feet [] maters Datum Local Official's Name Title _ - Community Name Telephone Signature Date Comments Check here if attachmej:qs =EMA Form O88~D33(7712) �� Replaces all prevoummdTtionw, If using the Elevation Cerfificate 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 Viiew"; and, if required, " "Bight 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 AB, If submitting more photographs than will fit on this page, use the Continuation Page. MOT• Z Fd N ra in IN im�z LEFT VIEW RIGHT VIEW FEMA Form 086-0-33 (7/12) Replaces all previous editions.