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Home My Public Portal AboutHODGES ST_6.pdfJ.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE -EDERAL EMERGENCY MANAGEMENT AGENCY Vational Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION Al. Building Owner's Name SUSAN LEONARD A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 6 HODGES STREET City CITY OF TYBEE ISLAND State GA ZIP Code 31328 OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE Policy Number: ny NAIC Number: A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 55 PAMELA TERRACE SUBDIVISION • . A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. N 32000'50.8" Long. W 80050'57.8" 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 6 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) 1219 sq ft a) Square footage of attached garage NIA 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 13 within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in A8.b 5083 sq in c) Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered Hood openings? ❑ Yes -Z No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Community Number B2. County Name B3_ State CITY OF TYBEE ISLAND 135164 CHATHAM „ GEORGIA B4, Map/Panel Number B5.Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 13051 CO213 F 07-07-14 Effective/Revised Date Zone(s) AO, use base flood depth) 09-26-08 AE 11.0 H0. 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: 111. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: 112. 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 Under 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, ARIA1-A30, ARIAH, ARIAO. Complete Items C2.a-h below according to the building diagram specified in Item A7_ In Puerto Rico only, enter meters. Benchmark Utilized: USGS TIDAL NO. 6 Vertical Datum: NAVD 1988 Indicate elevation datum used for the elevations in items a) through h) below. Il 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) f) 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. t certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by One or imprisonment under 18 U. S. Code, Section 1009. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments, licensed land surveyor? ® Yes ❑ No Certifier's Name JAMES M. KEATON, RLS License Number GA #2743 Title LAND SURVEYOR Company Name CHATHAM SURVEYING SERVICES, INC Address PO BOX 61649 City SAVANNAH State GA ZIP Code 31420 Signature !ZL S Date OCTOBER 01, 2015 Telephone 912-303-0302 EMA Form 086-0-33 (7112) See reverse side for continuation. OR N4 3 S U �o OZ Replaces all previous editions. Check the measurement used. 8.6 ® feet ❑ meters 17.8 ® feet ❑ meters 16.7 ® feet ❑ meters NIA. ❑ feet ❑ meters 17.4 ® feet ❑ meters 7.4 ® feet ❑ meters 7.8 ® feet ❑ meters 7.5 ® 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. t certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by One or imprisonment under 18 U. S. Code, Section 1009. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments, licensed land surveyor? ® Yes ❑ No Certifier's Name JAMES M. KEATON, RLS License Number GA #2743 Title LAND SURVEYOR Company Name CHATHAM SURVEYING SERVICES, INC Address PO BOX 61649 City SAVANNAH State GA ZIP Code 31420 Signature !ZL S Date OCTOBER 01, 2015 Telephone 912-303-0302 EMA Form 086-0-33 (7112) See reverse side for continuation. OR N4 3 S U �o OZ Replaces all previous editions. LVL- V P% 11%JIV VLr% f Ir llq"{ IQ, Fa{JC G 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 6 HODGES STREET City CITY OF 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 This house is constructed on columns with a partial enclosure beneath for parking and storage. Item A8a is this enclosure. Items A815 8 A8c are openings in the lath wall panels between the columns below the BFE. Item C2a is the ground floor enclosure slab. Item C211b is the habitable floor. Item C2e is exterior HVAC on a platform on the left side of the house. Item C2h is the lowest adjacent grade at the left side steps. Signature `W 41-;Ez 2 Date OCTOBER 01, 2015 SZ'&MN E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without SFE), 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, 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, 13, 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) he 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 F this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items GB—G10. In Puerto Rico only, enter meters. i1. ❑ 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.) 2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. .3. ❑ The following information (Items G4—G110) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement 8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum 9_ BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum 10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments. EMA 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, andlor Bldg. No.) or P.O. Route and Box No. Policy Number: 6 HODGES STREET City CITY OF 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 ft on this page, use the Continuation Page, PHOTOGRAPHS TAKEN OCTOBER 01, 2015 FRONT VIEW LEFT SIDE VIEW -EMA 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. Policy Number: 6 HODGES STREET . City CITY OF TYBEE ISLAND State GA ZIP Code 31328 Company MAIC Number. If submitting more photographs than will fit 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 RIGHT SIDE VIEW -IrMA Form 086-0-33 (7112) Replaces all previous editions.