HomeMy Public PortalAboutCHATHAM AV_1608-EC.pdfFEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
Important: Read the instructions on pages 7.7.
SECTION A - PROPERTY OWNER INFORMATION Forinsulbrimc "wUse:
BUILDING OWNER'S NAME
BRYAN & LAUREL RIEMANN
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P_O. ROUTE AND BOX NO. Company NAIC Number
1608 CHATHAM AVENUE I d
CITY STATE ZIP CODE
TYBEE ISLAND GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 6, MCCLEOD SUBDIVISION, WARD NO.5
BUILDING USE (e.g-, Residential, Non-residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RES
LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##°- ##'- ##.##" or ##.#####I ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1, NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE
TYBEE ISLAND 135164 1 CHATHAM I GA
B4. MAP AND PANEL
B7. FIRM PANEL
B9. BASE FLOOD ELEVATION(s)
NUMBER
B5. SUFFIX
B6. FIRM INDEX DATE
EFFECTWIREVISEDDATE
88. FLOODZONE(S)
(Zone AO, use depth oftboding)
135164 0002
C
6117186
6117186
A8
14
B10. Indicate the source of the Base Flood Elevation (BFE) data or base Hood oepin enterea in w,
❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other (Describe):
BI 1. Indicate the elevation datum used forthe BFE in Bg: ® NGVD 1929 ❑ NAVD 1988 ❑ Otho (Describe): —
812 Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ®No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building UnrlerConstmuction* ® Finished Construction
A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 6 (Select the building diagram most similar to the building for which this certificate is being completed -seepages 6 and 7. If no dagram
accurately represents the building, provide a sketch or photograph.)
C3. Elevations - Zones Al -A30, AE, AN, A (with BFE), VE, V1 -V30, V (with BFE), AR, AWA, AR1AE, AR(A1-A30, ARIAH, AR/AO
Complete Items C3. -a4 below according to the budding diagram specified in )tem C2. State the datum used. If the datum is different from the datum used for the BFE in
Section B, convert the datum to that used for the BFE. Show fold measurements and datum conversion calculation. Use the space provided or the Cornments area of
Section D or Section G, as appropriate, to document the datum conversion.
Datum NGVD 29 Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM?
o a) Top of bottom floor (induding basement or enclosure) 8. 2 ft.(m)
o b) Top of next higher floor 18.6 ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only) NL.
o d) Attached garage (top of slab) 8. 2 ft.(m)
o e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area) 17.4 ff.(m)
o f) Lowest adjacent (finished) grade (LAG) 7.3 ft.(m)
o g) Highest adacent (finished) grade (HAG) 7. 6 ff.(m)
o h) No. of pemianent openings (flood vents) within 1 ft. above adjacent grade 2
o i) Total area of all permanent openings (flood vents) in C3.h 288 sq. in. (sq. cm)
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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 in Sections A, B, and C 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 19 U.S. Code Section 1001.
CERTIFIERS NAME J. Whitley Reynolds LICENSE NUMBER 2249
0. 0�R-
QG�STEq fio
TITLE Land Surveyor COMPANY NAME
ADDRESS CITY STATE ZIP CODE
636 STEPHENS E , ITEC Savannah, GA GA 31405
SIGNATU Z/
DATE TELEPHONE
4/22104 912352-0464
FEM orm 81-31, January 2003 See reverse side for continuation. Replaces all previous editions
- - --- --- ---- - ^---- - - ,� r.,
IMK)RI'ANT: In these spaces, copy the corresponding information from Section A.
Unt Suite. andfor Bldg. No.) OR P.O. ROUTE AND BOX NO. I Pofrcy Number
1608 CHATHAM AVENUE
CITY STATE ZIPCODE CarrjianymcNrmnber
TYBEE ISLAND GA 31328
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner.
COMMENTS
C3.e) = ALC PAD
_ ❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items Et through E4. If the Elevation Certificate is intended for use as supportirx3 inforrrrafion for a LOMA or LOMR-F,
Section C must be completed.
El. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in,(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is ^ tL(m) Vin.(cm) above the highest adjacent
grade. Complete items C3.h and C3.i on front of form.
E4. The top of the platform of machinery ardor equipment servicing the building is ` ft.(m) _in.(c m) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
ES. For 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 0 Unknown. The local official must cerfrfy 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, C (Items C3.h and C3.1 only), and E for Zone A (without a FEMA4ssued or community -
issued BFE) or Zone AO must sign here. The stalemanfs in Sections A, B, C, and i= are corect to the best ofmy knowledge,
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE ZIP CGDE
SIGNATURE DATE TELEPHONE
COMMENTS
❑ Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the oorn munly's fl000ciplain management ordinance can complete Sections A, R, C (or E), and G of this Elevation
Certificate. Complete the applicable itenn(s) and sign below.
G1. ❑ The information in Section C was taken from other documentation that has been signed and ernbossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. F1 A community official completed Section E for a building located in Zone A (without a FEMA -issued or communilyissued BFE) or Zone AO.
G3. ❑ The following information (items G4 -G9) is provided for community floodplain management purposes.
to
G7. This-
perm t has been issued for: ❑ New Construction Q Substantial hnprovement
G8. Elevation of as -built lowest floor (including basement) of the building is:
G9. BFE or (in Zone AO) depth of flooding at the building site is:
Datum:
Datum.
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE, DATE
COMMENTS — -
n Check here if attachments
FEMA Farm 81-31, January 2003 Replaces all previous editions