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Home My Public Portal AboutSEVENTEENTH ST_105 -EC.pdfU.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Tom Farmer A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 105 17th St. City State ZIP Code Tybee Georgia 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 6-A-2 Sub Of Lot 6-A Ward 5 Ty bee A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. N31' 59.463' Long. W080° 51.024' Horizontal Datum: ❑ NAD 1927 ❑x 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 8 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) sq ft b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in d) Engineered flood openings? ❑ Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? ❑ Yes ❑ No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State Chatham County 135164 Chatham Georgia B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO, use Base Revised Date Flood Depth) 13051C 0326 F 07/07/2014 09/26/2008 AE 13 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? D Yes E] No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7115) Replaces all previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30, 2018 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: 105 17th St. City State ZIP Code Company NAIC Number Tybee Georgia 31328 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x 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 SFE), AR, ARIA, ARAE, AR/Al—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 x❑ 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) 19.1 0 feet ❑ meters b) Top of the next higher floor 29 0 ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NIA x❑ feet ❑ meters d) Attached garage (top of slab) NIA x❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 17. 1 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 9.7 x❑ feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 11.8 x❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 10.5 0 feet ❑ meters 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. 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 9009_ Were latitude and longitude in Section A provided by a licensed land surveyor? 9 Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number Carter M. Patillo GA3114 Title RLS gp* %STt Company Name ace Carter M. Patillo Land Surveying Address er 415 Valentine Dr. ., f��a sura +0 ,p City State ZIP Code .�� d . ��10 Savannah Georgia 31406 x 8 Signat Date Telephone 06102/2018 (912) 433-2889 Copy all pages of tIfs Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) Item C2e is an a/c unit located at the center rear of the residence. FEMA Form 086-0-33 (7/15) Replaces all previous editions. 4-orm Page 2 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018 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: 10517th St. City State ZIP Code Company MAIC Number Tybee Georgia 31328 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 Vevp 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. fi- t' - ,•i.•- =+•fir �: . >k !i 4 -7-r_ 4 . Photo One Photo One Caption Front View Taken 06/02/2018 4 �t 7 Ill! L111 (11111 - Photo Two Photo Two Caption Rear View Taken 06/02/2018 FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6