HomeMy Public PortalAboutBUTLER AV_1113.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:
William Lanier
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Company NAIC Number:
Box No.
1113 Butler Ave.
City State ZIP Code
Tybee Island Georgia 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 23A WARD 3 TYBEE
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. N31 59.903' Long. W080d 50.822' 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.
A7. Building Diagram Number 5
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 crawlspace 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 0 No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
B2. County Name
B3. State
CITY OF TYBEE ISLAND 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)
13051 C 0326
G
07/07/2014
08/16/2018
AE
9
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ 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)? ❑ Yes X No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
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:
1113 Butler Ave.
City State ZIP Code
Company NAIL Number
Tybee Island 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 BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO.
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) 11 1
❑X feet ❑ meters
b) Top of the next higher floor 21. 0
❑X feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) NSA.
❑X feet ❑ meters
d) Attached garage (top of slab) NSA.
❑X feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building 11. 7
❑X feet ❑ meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 8 5
❑X feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 9.0
❑X feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 9 1
❑X 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.
l 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 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? X❑ Yes ❑ No
❑ Check here if attachments.
Certifier's Name License Number
Carter M. Patillo GA3114
Title
RLS
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Company Name
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Carter M. Patillo Land Surveying
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Address
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415 Valentine Dr.
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City State ZIP Code
Savannah Georgia 31406
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Signature. ° r Date Telephone
05/02/2019 (912) 433-2889
Copy all pages of this levation Certificate and all attachments for (1) community official, (2) insurance
agent/company, and (3) building owner.
Comments (including pe of equipment and location, per C2(e), if applicable)
Item C2e is an electric meter box located on the right front corner of the residence.
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form 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:
1113 Butler Ave.
City State ZIP Code
Company NAIC Number
Tybee Island 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 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.
Photo One
Photo One Caption Front View Taken 05/02/2019
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Photo Two
Photo Two Caption Rear View Taken 05/02/2019
FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6
Building Permit Number 13—OS-7 O
Applicant's Name:�� ` YAsGrp
Owner's Name: �� ! �,� �, 1 t
Site Address, Tax#, Parcel#: t ?�Address:
Telephone:
Telephoe: '( f7952,�
I. All development—Base Flood Elevation Data Provided:
A. The as -built elevation certification from a registered land surveyor or
Professional engineer has been submitted? YES or NO
B, The lowest floor elevation is at or above the required lowest floor elevation? or NO
C. Electrical, heating, ventilation, plumbing, air conditioning equipment (including
duct work) and other service facilities are located above BFB or flood proofed? YE or NO
H. Development in Zones A, AE, AI -A30 and AH:
A. Solid foundation perimeter walls located below BFE: Mwla
1. There are at least two (2) openings? YES or NO
2. Square footage of enclosed area subject to flooding
3. Square inches of venting required
4. Square inches per opening (multiply I by w)
5. Number of required vents (3 above divided by 4 above)
6. Foundation contains the minimum number of vents? YES or NO
7. The bottom of each opening is no higher than one (1) foot above grade? YES or NO
8. Any cover on openings will permit the automatic flow of floodwaters
In both directions? YES OR NO
B. Base flood elevation andlor floodway data not available orAO Zones:
1. The lowest floor is at least one (1) foot above the highest adjacent grade? YES or NO
2. The development meets the setback requirements of the ordinance? YES or NO
3. If 2 above was "no", has a No -Rise Certification been submitted? YES or NO
Reviewer's Name: Date reviewed:
B. Floodway data is provided.
1. Did this development encroach in the floodway? YES or NO
2. Do the actual field conditions meet the proposed actions and technical
date requirements? YES or NO
3. If Cl was "yes", has a No -Rise Certification been submitted? YES or NO
Reviewer's Name: Date reviewed
III. Development in Zones V, VE and V! -V30, VO (Coastal High Hazard Areas).
A. Development location complies with all coastal setback requirements? YES or NO
B. Structure is securely anchored to pilings or columns and certification by a
Registered, professional architect or engineer has been submitted? YES or NO
Reviewer's Name: I Date reviewed:
C, Walls permitted below the base flood elevation consist of decorative lattice work or,
Where permitted, are breakaway and have been certified by a registered, professional
Architect or Engineer? YES or NO
Reviewer's Name: _ Date reviewed:
`
Local Administrator's Signature: i ate: 0 �Y r
City of Tybee Island
403 Butler Avenue - P.O. Box 2749
Tybee Island, Ga. 31.325-2749 .,,