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HomeMy Public PortalAboutTWELFTH TER_8.pdfU.S. DEPARTMENTOF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY 'almoal Florxllnyrrr-mrce Pfograin Important: Read the instructions on pages 1-9. SECTION A — PROPERTY INFORMATION Name CARL AND OMB No. 1660-0008 Expiration Date: July 31, 2015 FOR INSURANCE COMPANY USE A2- Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 8 12"' TERRACE City TYBEE ISLAND State GA ZIP Code 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 2-B, PHASE TWO, TYBEE TERRACE A4. Building Use (e 9., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 31.99728 Long, 80.84650 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 11A 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) NIA sq tt a) Square footage of attached garage 499 sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosures) within 1.0 foot above adjacent grade NIA within 1,0 foot above adjacent grade N/A c) Total not area of flood openings in A8.b NIA sq in c) Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes 0 No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION BYBEE SLANDuGEORGIAnity Name -135 6qunirj Number SH THAtMy Name I G3A State B4. Map)Panel Number 35. Suffix Bfi. F€RM Index Date 67. FIRM Panel B8 Flood B9. Base Flood Etevation(s) (Zone 13051CO326 F 7!0712014 Effective/Revised Dale Zones) AO, use base flood depth) ❑ meters 17.4 9126108 AE 12 B10. Indicate the source of the Base Flood Elevation (BFE) data or baso flood depth entered in Item B9. ❑ FlS Profile ® FIRM ❑ Community Determined ❑ Other)Soufce: B11. Indicate elevation datum used for BFE in Item 69: ❑ NGVD 1929 E NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date NIA ❑ CBRS ❑ CPA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based om ❑ Construction Drawings' ❑ Building Under Construction' ® Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations —Zones Al—A30, AF, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR1A1—A30, AR/AH, ARIAO. Complete Items C2.8—h be$ow according to the building diagram specified in Item AT, In Puerto Rico only, enter meters. Benchmark Utilized: LGPS VRS NETWORK Vertical Datum: NAVD88 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 N NAVD 1988 Ll OtherlSource- Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. i certify that the information on this Certificate represents my best efforts to interpret the data availabie. 0 R� I understand that any false statement may be punishable by fine or imprisonment under 18 U. S_ Code, Section 1001. 1$ T�q M Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a (G © Check here if attachments. licensed land surveyor? ®'Yes ❑ No �p Certifier's Name BERT B. BARRETT, JR Title OWNER/PRESIDENT Address 145 RUNN RO Signature FEMA Form License Number GA. 2225 Company Name BERT BARRETT. JR LAND SURVEYING PC City SAVANNAH State GA ZIP Code 31410 Date 3110116 Telephone 912-897-0661 See reverse side for continuation. No:.. 2225 Replaces all previous editions Check the measurement used. 17.7 E feel ❑ meters 26.8 ® feet ❑ meters NIA._ ® feet ❑ meters 17.4 ® feet ❑ meters 17.1 E feet ❑ meters 17.0 E feet ❑ meters 17.5 ® feet ❑ meters NIA.— ® feet ❑ meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seated by a land surveyor, engineer, or architect authorized by law to certify elevation information. i certify that the information on this Certificate represents my best efforts to interpret the data availabie. 0 R� I understand that any false statement may be punishable by fine or imprisonment under 18 U. S_ Code, Section 1001. 1$ T�q M Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a (G © Check here if attachments. licensed land surveyor? ®'Yes ❑ No �p Certifier's Name BERT B. BARRETT, JR Title OWNER/PRESIDENT Address 145 RUNN RO Signature FEMA Form License Number GA. 2225 Company Name BERT BARRETT. JR LAND SURVEYING PC City SAVANNAH State GA ZIP Code 31410 Date 3110116 Telephone 912-897-0661 See reverse side for continuation. No:.. 2225 Replaces all previous editions ELEVATION CERTIFICATE, page 2 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: 8 12TH TERRACE 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 (f) community official, (2) insurance agent/company, and (3) building owner. Comments 1. GOOGLE EARTH USED TO OBTAIN LAT/LONG. 2. THE ELEVATION SHOWN IN C2 e) IS THE OUTSIDE HEATPUMP UNIT (CONDENSOR). SECTION 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, 13, and C. For Items El—E4, use natural grade, if available. Check the measurement used. to 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 NIA. ® feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is N/A. ® 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 8-8 of Instructions), the next higher floor (elevation C2.h in the diagrams) of the building is N/A. ® feet ❑ meters ❑ above or ❑ below the HAG. E3- Attached garage (top of slab) is NIA. ® feet ❑ meters ❑ above or [:1 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is NIA. ® feet ❑ meters ❑ above or E] 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 8FE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge Property Owner's or Owner's Authorized Representative's Name N/A Address NIA City NIA State NA ZIP Code NIA Signature N/A Date N/A Telephone N/A Comments NIA 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 suveyor, engineer, or architect wtto 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 G4—G10) is provided for community floodplain management purposes. G4_ Permit Number G5_ Date Permit Issued G6. Date Certificate Of CompliancelOccupancy Issued NlA N!A NIA G7. This permit las been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: N/A. ® feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: NIA.___ ® feet ❑ meters Datum 010. Community's design flood elevation: NIA. ® feet ❑ meters Datum Local Official's Name N/A Title NIA Community Name NIA Telephone NIA Signature N/A Date N/A Comments NIA 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: 8 12TH TERRACE City TYBEF ISLAND State GA ZIP Code 31328 Company NAIC 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. FRONT VIEW RIGHT SIDE VIEW r t,I I Int i� (I y I r _ t REAR VIEW FEMA Form 086-0-33 (7112) Replaces all previous editions.