HomeMy Public PortalAboutHWY 80_1010.pdfU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
Al. Building Owner's Name Carrie L. Efird
144AVIIET41101LIVOIA IT 4159211'1�
Important: Read the ins,tructions on, pages 1-8.
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For Insurance Company Use:
Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.Ca. Route and Box No. Company NANO plumber
11010 Highway 8,0
City Tybee Island, State GA ZIP Code 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, (Legal Description t
Portions, of lots 5, 6, 15 & 16, block 14, Garden ward
131. NFIP Community Name & Community Number
B2. County Name
B3. State
Tybee, Island 136164
Chatham
GA
B4. Map/Panel Number
B5. Suffix
B,6. FIRM Index
B7. FIRM Fanelli
B8. Flood
B9 Base F- lood (Zone
2 feet
❑ meters (Puerto Rico only)
Date
Effective/Revised Date
Zone(s)
�Elevation(s)
AO, use base flood depth)
1351164 0120
C
5119187
5/19/87
AE
12
B10. Indicate the source of the Base Flood Elevation, (BFE) data or base flood depth entered in Item B9.
El FITS Profile Z FIRM ❑ Community Determined n Other (Describe) _
611, Indicate elevation datum used for B,FE in Item B9: E NGVD 1929 ❑ NAVD 1988 [] Other (Describe)
B12. Is the building located in a Coastal, Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? E]Yes E]No
Designation Date _ [--] CBRS El OPA
a) Top of bottom floor (including basement, crawl space, or enclosure floor)_
i 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 in Comments)
f) Lowest adjacent (finished) grade (LAG)
g) Highest adjacent (finished) grade (HAG)
00,
Address 636 rphen On Avenu uite C City Savannah, State GA - ZIP Code 31405
Signatur�/
Date 121 b7 Telephone 912-352-0464
. ............
FEIVIA For 1 -31„ February 2006 See reverse side for continuation. Replaces all previous editions
Check the measurement used.
feet
❑ meters (Puerto Rico only)
17.6
2 feet
EJ meters (Puerto Rico only)
f /a. _
2 feet
E] meters (Puerto Rico only)
n/a._
2 feet
❑ meters (Puerto Rico only)
12. p
0 feet
El meters (Puerto Rico only)
9.5
Z feet
El meters (Puerto Rico only)
7-5
2 feet
171 meters (Puerto Rico only)
00,
Address 636 rphen On Avenu uite C City Savannah, State GA - ZIP Code 31405
Signatur�/
Date 121 b7 Telephone 912-352-0464
. ............
FEIVIA For 1 -31„ February 2006 See reverse side for continuation. Replaces all previous editions
IMPORTANT. In these spaces, copy the 'esponding 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. Policy Number
1010 highway 80
City Tybee Island, State GA ZIP Code 31328 Company NAIL 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.
Check here if
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 Et -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 is above or below the highest adjacent
grade (HAG) and the Ilowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawl space, or enclosure) is n feet E] meters [:1 above or E] below the HAG,
b) Top of bottom floor (including basement, crawl space, or enclosure) is [] feet El meters [J above or ❑ below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings, provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is -._ El feet El meters [1 above or ❑ below the HAG.
E3. Attached garage (top of slab) is 0 feet El meters ❑ above or EJ Wow the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _._ [_1 feet ❑ meters El 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 community's floodplain management
ordinance? 0 Yes FJ 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 con-ect 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)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, 7(or _E),
and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.
G1. E] 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 completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.
G3. 0 The following information (Items G4.-G9,) is provided for community floodplain management purposes.
Vil"W"MRIN =I-
G5. Date Permit Issued
G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: El New Construction El Substantial Improvement
G8. Elevation of as-built lowest floor (including basement) of the building: _F1 feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: El feet El meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
......... . .. . ....... . ....... ...... . ... ............. -
Comments
Qjheck,hgre if attachments
FEMA Form 811-31, February 20,06 Replaces all previous editions
��- D r - z t o 1 . 1 I t R I M I M W u M M M 0
F o r f t u r a n c e C o m p a n y
B u i l d i n g S t r e e t A d d r e s s ( i n c l u d i n g A p t . , U n i t , S u i t e , a n d / o r B l d g . N o . ) o r P . O . R o u t e a n d B o x N o . P ' o l i c y N u i m - b e r
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C i t y T Y b e e W a n d S t a t e G A Z I P C o d e 3 1 3 2 8
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I f u s i n g t h e E l e v a t i o n C e r t i f i c a t e t o o b t a i n N F I P f l o o d i n s u r a n c e , a f f i x a t l e a s t t w o b u i l d i n g p h o t o g r a p h s b e l o w a c c o r d i n g t o
t h e i n s t r u c t i o n s f o r I t e m A 6 . I d e n t i f y a l l p h o t o g r a p h s w i t h : d a t e t a k e n ; " F r o n t V i e w " a n d " R e a r V i e w " ; a n d , i f r e q u i r e d , " R i g h t
S i d e V i e w " a n d " L e f t S i d e V i e w . " I f s u b m i t t i n g m o r e p h o t o g r a p h s t h a n w i l l f i t o n t h i s p a g e , u s e t h e C o n t i n u a t i o n P a g e ,
f o l l o w i n g .
For Insurance Compa-nvUse.-
Building Street Addre g Apt., Unit, Suite, and/or Bldg. No or P.O. R• e and Box No.
1010 Highway 80
City Tybee IS12nd, State GA ZIP Code 31328 1 Company NAIC
If submitting more photograp • 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-"