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HomeMy Public PortalAboutLOVELL AV_912.pdfU.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 ,Vatfonal Flood lnsurar�ae Program Important: Read the instructions Ofl pages -9. Expiration Date:.iuly 3i, 2015 SECTION A -- PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name KC Cottage, Inc_ Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number: 912 Lovell Avenue City Tybee Island State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 6B, Ward 6 PIN 4-0006-07-002 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. N 32 00 06 Long. W 80 50 47 Horizontal Datum: ❑ NAD 1927 ® 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 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) Na sq it a) Square footage of attached garage nla 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 nca within 1.0 foot above adjacent grade nla c) Total net area of flood openings in A8.b nla sq in c) Total net area of flood openings in A9.b n1a sq in d) Engineered flood openings? ❑ Yes E No d) Engineered flood openings? ❑ Yes ® No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1, NFIP Community Name & Community Number 52. County Name B3. State Tybee Island 135164 Chatham I CA 64 Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood 89 Base Flood Elevation(s) (Zone Revised 13061CO213 F 711114 Effective/Dato Zone(s) AO, use base flood depth) 2b/08 91AE 11.0 P 1 VHIM aUU14C V1 Lim odSC FIuuu neva Liwi toFr-1 Pala or oase noOU aepTn entereo In Item bd. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: Bi 1. Indicate elevation datum used for BFE in Item 89: ❑ NGVD 1929 M NAVD 1988 ❑ OtherlSeurce: B12 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 elevations are based on: ❑ Construction Drawings' ❑ Building Linder Construction* ® 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, ARIA, ARIAS, AR/A1—A30, AR/AH, ARIAO. Complete Items C2.a_h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: local Vertical Datum- NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below_ ❑ NGVD 1929 ® NAVD 1988 © Other/Source: Datum used for building elevations must be the same as that used for the BFE. 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) Q 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 information. I Certify that the information on this Certificate represents roy 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.j� R� ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Ci��Ti ® Check here if attachments. licensed land surveyor? ® Yes [I No }r a Certifier's Name J. Whitley Reynolds License Number 2249 r4 Title Land Surveyor Company Name Address 636 Stephen""son I entre' City Savannah State GA ZIP Code 31405 Signature /` ' f Date 416116 Telephone 912-352-0464 FEMA Form 086-0-)53 (7112) See reverse side for continuation. Replaces all previous editions. Check the measurement used. 8.5 ® feet ❑ meters 16.6 ® feet ❑ meters fila. N feet ❑ meters n1a. R feet © meters 8.5 N feet ❑ meters 7.8 ® feet ❑ meters 8.4 R feet ❑ meters 7.8 E feet ❑ 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 information. I Certify that the information on this Certificate represents roy 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.j� R� ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Ci��Ti ® Check here if attachments. licensed land surveyor? ® Yes [I No }r a Certifier's Name J. Whitley Reynolds License Number 2249 r4 Title Land Surveyor Company Name Address 636 Stephen""son I entre' City Savannah State GA ZIP Code 31405 Signature /` ' f Date 416116 Telephone 912-352-0464 FEMA Form 086-0-)53 (7112) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding infonmation 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: 912 Lovell Avenue City Tybee Island State GA ZIP Code 31328 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 plumbing on lower floor. The A/C corepressors are elev 13.2. Signature Date 4/6116 SECTION E 41JILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT EIFE) For Zones AO and A (without BFI=), compiete Items El—E5, If the Certificate is intended to support a LOMA or LOMR-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 ❑ feet ❑ meters ❑ above or ❑ 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 Owners 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 --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 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 04—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued Ub. Date Certnccate Ot Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE cr (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 Comments Date Check here if attachments FEMA Form 086-0-33 (7112) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding 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: 912 Lovell Avenue City Tybee Island State GA QIP Code 31 328------ NA1C Number: 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"; 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 AS. If submitting more photographs than will fit on this page, use the Continuation Page. Front View FEMA Form 086-0--33 (7112) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.Q. Route and Box No. Policy Number: 912 Lovell Avenue City Tybee Island State GA ZIP Code 31328 Company MAIC Number. If submitting more photographs than will tit 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_ Rear View 1®ice t- LMA Form Udlj-U-33 (fllZ) Replaces all previous editions.