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Home My Public Portal AboutLOVELL AV_1203.pdfu.a. utrRKIMCN"I of HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB N0, 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration hate: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE A1. Building Owner's Name Camille Ward Policy Number: A2, Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number: 1203 Lovell Avenue City Tybee Island State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) lot 63-A, ward 4, PIN 4-0007-08-011 A4, Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc_) Residential A5. Latitude/Longitude: Lat. N 31d 59'23" Long. W 80d 50'52" 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) n/a 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 in the attached garage or enclosure(s) within 1.0 foot above adjacent grade nla within 1.0 foot above adjacent grade n1a c) Total net area of flood openings in A8.b nla sq in c) Total net area of flood openings in A9.b n/a sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bi, NFIP Community Name & Community Number B2. County Name B3. State Tybee Island 135164 t Chatham GA B4, Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel 68. Flood B9. Base Flood Elevation(s) (Zone 13051CO326 F 717114 Effective/Revised Date Zone(s) AO, use base flood depth) _ 9126108 AE 11.0 I10. 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: 01. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: 312. 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) :1. Building elevations are based on: ❑ Construction Drawings" ❑ Building tinder Construction* ® Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. 2. Elevations -Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/Al-A30, ARIAH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized7 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) 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 chis certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation nformation. 1 certify that the infonnation on this Certificate represents my best efforts to interpret the data available. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1009. 0 ( j q Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Z 51 Check here if attachments. licensed land surveyor? ® Yes ❑ No * :ertifier's Name J. Whitley Reynolds License Number 2249 -itle Land Surveyor Company Name Sddress�S 6 ephenson Avenue City Savannah State GA ZIP Code 31405 lign ure IZI Date 9130/16 Telephone 912-352-0464 ,x,49 A (7112) See reverse side for continuation. Replaces all previous editions, Check the measurement used. 8.6 ® feet ❑ meters 9.0 ® feet ❑ meters n/a. ® feet ❑ meters n/a. N feet ❑ meters 8.3 ® feet ❑ meters 8.1 ® feet ❑ meters 8.6 ® feet ❑ meters n1a. ® feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION chis certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation nformation. 1 certify that the infonnation on this Certificate represents my best efforts to interpret the data available. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1009. 0 ( j q Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Z 51 Check here if attachments. licensed land surveyor? ® Yes ❑ No * :ertifier's Name J. Whitley Reynolds License Number 2249 -itle Land Surveyor Company Name Sddress�S 6 ephenson Avenue City Savannah State GA ZIP Code 31405 lign ure IZI Date 9130/16 Telephone 912-352-0464 ,x,49 A (7112) See reverse side for continuation. Replaces all previous editions, '_ELEVATION CERTIFICATE, page 2 IMPORTANT: In these spaces, copy the corresponding information from Seetion 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: 1203 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 agenVcompany, and (3) building owner. Comments C2.a) is storage. C2.b) is living area. C2.e) is AIC pad. Date 9/30/16 SECTIOn — BUILDING ELEVATION 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 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, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, 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 andlor 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 stab) 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 Che 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) >r Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. 3roperty Owner's or Owner's Authorized Representative's Name kddress City State ZIP Code signature Date Telephone ;omments Check here if attachments SECTION G — COMMUNITY INFORMATION (OPTIONAL) e 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 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. ❑ 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.) ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. ❑ The following information (items G4—G10) is provided for community floodplain management purposes. 14. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued This permit has been issued for: ❑ New Construction ❑ Substantial Improvement Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum 0. Community's design flood elevation: ❑ feet ❑ meters Datum ocal Official's Name ommunity Name ignature cmments Title Telephone Date Check here if attachments. MA Form 086-0-33 (7/12) 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: 1203 Lovell Avenue City Tybee Island State GA ZIP Code 31328 Company MAIC 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 A8. If submitting more photographs than will fit on this page, use the Continuation Page. :MA 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.O. Route and Box No. 1 1203 Lovell Avenue Policy Number: City Tybee Island State GA ZIP Code 31328 Company NAIL Number: )f submitting more photographs than will ft 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 September 2E ImIA EMA Farm 086-0-33 (7112) Replaces all previous editions.