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Home My Public Portal AboutNINTH ST_ 105.pdfJ.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE EDERAL EMERGENCY MANAGEMENT AGENCY OMB No, 1660-0008 Vatronal Flood liasurance Program important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name SHIRLEY G. WHATLEY Policy Number: A2. Building Street Address (including Apt„ Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number. 1059 TH STREET City TYBEE ISLAND State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) PARCEL X AKA THE WESTERN 50 FT OF LOT l B & PT OF 2B WARD 3, TYBEE TAX PARCEL 4-0006-07-001 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude&ongitude: Lat. 32--00-08.62 Long. 080-50-45.12 Horizontal Datum: ❑ NAD 1927 N 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 1A A8. 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) NIA sq ft 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 in the attached garage or enclosure(s) within 1.0 foot above adjacent grade NIA within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? ❑ Yes R No d) Engineered flood openings? ❑ Yes ® No SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bl. NFIP Community Name & Community Number B2. County Name B3. State CITY OF•TYBEE ISLAND 135164 CHATHAM I GEORGIA B4. Map/Panel Number 85. Suffix B6, FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 13051C 0213 F 7/07/2014 Effective/Revised Date Zone(s) AO, use base flood depth) 9/26/2008 AE B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 N NAVD 1988 ❑ Other/Source: 512. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date: ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building eievations are based on: ❑ Construction Drawings" ❑ Building Under Construction' R 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, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2 a -h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: GPS ESTABLISHED Vertical Datum,- NAVO 1988 Indicate elevation datum used for the elevations in items a) through h) below. 17 NGVD 1929 ® NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including 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 �.g R feet ❑ meters NIA._ ❑ feet ❑ meters NIA. ❑ feet ❑ meters 8.5 N feet ❑ meters 8.3 ® feet ❑ meters g.1 ® feet ❑ meters 8.2 R feet ❑ meters 8.1 ® feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION `j This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. N Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 110 ❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifier's Name MICHAEL J. GARDNER License Number GA. RLS 2285 Title LAND SURVEYOR Company Name MICHAEL S. GARDNER, LAND SURVEYOR Address 120 VARNEDO A U C GARDEN CITY State GA ZIP Code 31408 Signature ate 04/09/2016 Telephone 912-661-0479 (CELL) FEMA Form 086-0-3 (7/12) See reverse side for continuation. V v�o J. Replaces all previous editions. .EVATION GERTIFICATE., page 2 APORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE uilding Street Address (including Apt„ Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: D5 9 STREET :ity TYBEE ISLAND State GA ZIP Code 31328 Company NAIC Number: SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) :opy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. :omments C2 (e)- Elevation of AC Pedestal = 8.3'. AC Pedestal located at Left Side of Structure.. NOTE: This Residence was Built in 1940 prior to any EMA REGULATIONS FOR HOMES IN THIS AREA! PROJECT NO: SHIRLEYgr.,W!�igl_EYA4109/201), FB, MJG, 2016, "A", PG 33 3ignaturef Date 04/09/20116 SECTION E -/6UII #NG ELEVATIOC INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMB -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. E1. 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 lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is El feet El meters ❑above or C1 below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ 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), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ 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 community'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 owner's 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 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, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8-GiO. 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 by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ 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 information (Items G4 -G10) is provided for community floodplain management purposes. G4. Permit Number G7. This permit has been issued for: G5. Date Permit Issued ❑ New Construction G6. Date Certificate Of Compliance/Occupancy Issued ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. 1EVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. HPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Iuiidin�q Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 0505 9 STREET 9 ST ISLANDState GA ZIP Code 31328 Company NAIC Number: f using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions or Item A6. 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. If submitting more photographs than will fit on this page, use the Continuation Page. FRONT VIEW f 5%- • 4W. IMMSEL , LEFT VIEW i VIII �1�. L 1 1 REAR VIEW X" , RIGHT VIEW Replaces all previous editions. FEMA Form 0136-0-33 (7112)