HomeMy Public PortalAboutFIFTEENTH ST_3.pdfNATIONAL FLOOD INSURANCE PROGRAM
�-� ELEVATION CERTIFICATE
Important: Read the instructions on pages 1.7.
SECTION A- PROPERTY OWNER INFORMATION
BUILDING OWNER'S NAME
BRASS RAIL VILLAS, LLC
13UI�OINGSTREET ADDRESS (Including Apt., Unit, Suite, andlorBldg. No.) OR P,0. ROUTEAND BOX NO.
#3 FIFTEENTH STREET
CITY STATE
TYBEE ISLAND, GA
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Leg@' Description, etc.)
BUILDING 200, BRASS RAIL VILLAS CONDOMINIUM
SLALDING JSE (e.g., Residential, Non-residential, Addition, Accessary, etc Use a Comments area, i necessary.)
RES
O.M.B. No. 3067-0077
Expires December 31, 2005
1=a Insurance Carnrany Use:
IPoFcy Number
Company MAIC Nu+nber
ZIP CODZ
31328
tAT1TUDEILONGfTUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE ❑ GPS (Type):
-#q.##" or #9.0#041 ❑ NAD 19.27 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE ASAP (FIRM INFORMATION
B1. NFIF
COMMUNITY
NAME&COMrti1UNTYNUMBER + B2.C( JJN NAME ESTATE
EES
94. MSP AND PANEL 87. FIRM PANEL I B9, BASE FLOOD ELEI+ATION;S)
NU�ER I B5, 51JFFIX B6. FIRM iNOEX DATE EFFECTIVEIREMSEb DATE BB. FLOOD ZONES) I (Z(ne AO, usa depth of 5oo ft)
1351640002 C U17% EIt7186 A8 tq
BIO. Ind.raie the source of the Base Flood Elevation,BFE) data or base flood depth entered in B9.
❑ FIS Proflae N FIRM ❑ Community Determined ❑ Otne,• (Describe):
B11. lnditate the elevation datum used For the BFE in BO; N NGVD 1929 ❑ NAVD 1988 ❑ Other (Rescribe; _
B12. Is the binding located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes N No Designation Date
SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) -
C1. Buildng elevations are based on, ❑ Construction DraNings` ❑ Building Under Consirkion" ® Finished Constructor,
'A rtew Elevation C&tfrcatewWl be required when construction of the huildng i; Complete.
C2, Building Diagram Number 5 (Select the building diagram moss similar lo the building to which this mrtificale is beirg completed - see oages S and 7. If no diagram
accurately represents the buiiding, provide a sketch or photograph.)
C3. Elevatcns — Zones Al-A3O, AE, AH, A (u4th BFE), VE, VI -V3D V (with BFE), AR, ARJA, APJAE, ARJA1-A30, AWAH, AR1A0
Complete Items C3 -M i elara accordng to the building diagram specified in Item C2. Stale the datum used It the datum is different from the datura used for the BF7 in
Sectior B, convert the datum to that used for the SFE. Show Wd measu'ements and datum conversion calculation. Use the space provided or the Comments area of
Section D or Section G, as appropriate_ to document the datum ccnkW0or:.
Datum NGVD 2S Conversion'Comnents _
Elevation reference mark used Dees the elevation reference mark used appear ora the FIRM? ❑ Yes ®14o
o a) Top of botlom floor (including basement orendoaure) 19. 6 Nrn) F,
o b) Top of red ll her floor NA . _fl (m)
o c) Ecdom of lowest horizontal stntdurai member (V zcnes only) NA . —ft.(m)
r
o d) Attached garage (top of slab) NA _ti.(m) b
o e) Lowest elevation of machinery andlor equipment uJ M N 22e9
co
servicing the building (Describe fn a Comments area) 19.8 it.)m) O� D
o f) Lowest adacent (finish ed) grade (LAG) 11 .0 ft.{m) �� OUR6o g) Highest adjaczilt (finished) grade (HAG)
o h) No of permanent qx rings (floodvems) wfttfn 1 ft above adjacent grade O I — AT
—
o i) Total area of all oemnaneni cpepings (flood vents) in C3.h sq in, (sq cm) -
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certifiation is to be signed and sealed by a land surveyor, engineer, or architeci authorized by law to certify elevation information
I certify that the information in Sections A, B. and C on this certificate represents my best' efforts to interpret the data available. r
I understand that any False statement maybe punishable by fine or imprisonment under 18 U. S Code, Section 1071,
CERTIFIERS NAME 1 WKT_EY REYNOLDS LICENSE NUMB -R 2249
TITLE LAND SURVEYOR
C(huRANY NAME
ADDRESS Y& CITY
636 STEP{ aN A N dJITE C SAVRNNA_H
SIGNAT DATE
FEMA FarV81-39, January ee reverse side for continuation.
— STATE
GA _
TEuT- HONE
912.352-041-4
ZIP CODE
31405
Replaces all previous editions
1
6—
T -d LBLL 25E 216 SPIOUROM I;algiHm C ea9:917 SD Bo unc
IMPORTANT: In these spaces, copy the cc ionding information from Section A.
BUILDING STREET ADDRESS (Inducting Apt, Ura, Suite. a n... Bldg. No.)OR P.O. ROUTE AND BOX NO.
93 FIFTEENTH STREET
CITY
TYBEE WND,
STATE
GA
For Insurance Company Lisa
I Pony Vumber
2P CODE !� Company NK Number
31328
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Cert'frcate for(1) community official, (2) insurance agenUoompany, and (3) building owner,
COMMENTS
C3 e) =A1C PAD
❑ Check here If attachment;
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT RERUtREt)) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (withor 16FE), co.mplale Items E1 through E4. If the Elevation Certifica e is intended for use as sipporfvrg information for a LOMA or LOUR -F,
Section C must oe cempla:ed,
E1. Building Diagram Number _(Seled the hu(ldhg diagram most similar to the twilding for which this cerificate is being ccmpleted -see page; 6 and Z If no dagrarn accurately
=—esenfs [he building, provide a sketch or photograph.)
E2. The top of the bottorn floor (including baserr.cnt or enclosure) of the WIding is _ ft.(m) _in.(cm) ❑ atove or ❑ below (check one) the highest adjacent grade, (Use
natural grade, if availad.e).
E3. For Building Diagrams 6-8 with openings (seepage 7), the next higher fbo- or etevatec floor (elevation b) of the bunting Is _ ft.(m) —in (cri) above the highest adjacen#
grade. Complete items C3.h and C3.1 on frorf of form.
E4. Ths top of the ptatforrn of machinery andla equipment seslicing the building is _ ft.(m) r in.(crr:} ❑ zbow or [I Wow (check one) tie highest adjacent grade. (Use
raW grace, if available).
E5. Fo- Zone A0 cniy: K into depth comber is available, is the top of the bottom floor elevated in accordance v& the eommungs floodplain managemert ordinance?
❑ Yes ❑ No ❑ Unkrown, The local official must certify this i1crmalior in Smicn G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE} CERTIFICATION
The property owrer orowner's authorized representative who completes Sedions A, l3, C (!lams C3.h aid C3.i only), and E for Zone A (witha�t a FEMA -issued or aarrmunity-
issued SFE) or Zone AO must sign here. The statements In Sedfons A, a C, and E are correct to the beat of my kr?oMedge,
PROPERTY OWNERS OR 0l%ER'S AUTHOR2FD REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
SECTION G • COMMUNITY INFORMATION (OPT)ONAL)
❑ Check here if attachments
The Iota! official ,uho is aufhorizec by law o, ordinance !o administer the community's foodplain management ordinance can complete Sections A, B. C (or E), and G of this Eievaten
Certificate. Comdete the applicable Rem(s) and sign belun.
G1. ❑ The informalion in Section C was taken from other documerdatcn that has tin signed and embos.<�o3 by a licensed surveyor, eng reer, or arcn tett who Is authorized by state
or focal law to certify devaim information. (Indicate the source and date of the elevaion data in tie Comments wea below.}
G2. ❑ A comm.tn ty atrial completed Sedan E for a building located In Zone A (without a FENW-issued or community -issued BFEI or Zone A0.
G3, ❑ "he foll6n'ing information (Items G4-Gg) is provided for community floodplain management purposes.
G4, PERIAT Nl1,UEER G5. DATE PERMIT SSUEO
G7. This peril has been issued for. ❑ Now Construction ❑ Substanlial irrprovemeit
G8. Eleralion of as-buitt lopes! `foci (nduding basement) of Ifte builcing is,
G3. BFE or (in Zone AO) depth of floodIng at the bUI&N site Is:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
&GNATJRE
COMMENTS
-E MA Farm 81.31, January 2003
GB. DATE CERTFICATEOF COVPLIANCEIOCCUPANCY 135UEC
TELE
TELEPHONE
DATE
— _ft.(m) Datum:
_• _R.(m) Dalum:
❑ Check here if attachrrients
Replaces all previous editions
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