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HomeMy Public PortalAboutBRIGHT ST_11.pdfU.S. DEPARTMENT OF HOMELAND SCURT Federal Emergency Management Agency OMB No. 1 ate: N08 Y Y Expiration Date: November 30, 2022 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 - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Ownees Name Policy Number: MIKE AND DEBRA GOLDBERG A2. Building Street Address (including Apt., Unit Suite, and/or Bldg. o.) or P.O. Route and Company NAIC Number: Box No. 11 BRIGHT STREET City State ZIP Code TYBEE ISLAND GEORGIA 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) CHATHAM COUNTY PIN 4000215006 / LOT 38 & LOT 39 CAMPBELL A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Lat ude/Longitude:Lat. N3 2 ° 011 0 0 .3 511 Lon Q 5 0 ` 4 5 ®15 11 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 5 A& For a building with a craWspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sqft 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 X/A sq in d) Engineered flood openings? 0 Yes No A9, For a building with an attached garage: a) Square footage of attached garage N/A sq ft b) 'Number of permanent flood opening in the attchedgarage within 1.0 foot above adjacent grade / c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? Yes 2 No CTIA - FLOOD I (FIRM) INFORMATION B1. NFIP Community Name & Community Number 72, County Name B3. State CITY OF TYBEEISLAND 135164 CHATHAM I GEORGIA B4"Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 13051 C 0213 G9.0 08-16-2018 08-16-2018 1310. Indicate the source of the Base Flood Elevation FE) data or base flood depth entered in Item : ❑ FIS Profile X FIRM ❑ Community Determined ❑ Other/Sour B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 El NAVD 1988 ❑ Other/Sour / B12. Is the building located in a Coastal Barrier Resources System (CBS) area or Otherwise Protected Area (OPA)? 0 Yes No Designation Date: N/A C RS OPA F€MA.Form 0850=33V'Z/19) Replaces all previous editions. Form Page 1 of 6 * '10 .al Ill. ----- — ------ IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. I'l Policy I �I Number:+ 11 BRIGHT STREET Company NAIC Number city State ZIP Code TYBEE ISLAND GEORGIA 31328 SECTION: a i . Grt ■ . © i ' til , •. '- 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, I 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 16 U. S. Code, Section 100 1. 1 Certifiers Name License Number GEORGE M. FERREIRA GRLS #2607 Tide GEORGIA Company Name MITR GIS/GPS/SURVEY Address 374 EAST RIDGE DRIVE city State ZIP Code SAVANNAH GEORGIA 31406 Signature 1 912-657-3091 a. y #entfcomiit • ! i owner. Comments (including type of equipment and location, per C2(e), if applicable) ITEM A5 = * . 1TEM C2 = TRIMBLE GPS—VRS NETWORK SOLUTION BUILDINGITEM C2e-- OUTDOOR HVAC UNIT (RAISED PLATFORM) rOTAL FROM •' ROOF ROUND FLOOR SLABRLEVATION = 6.11 HOTOS TAKEN ON I OF THE CURREW. FEMA Form 086-0-33 (12(19) Replaces all previous editions. Form Page 2 of 6 eet Address (including Apt,, Unit, Suite, and/or Bl • or i RoutePolicy c I� N'TYBEE ISLAND IIIII III 11 BRIGHT STREET state ZIP Code Company NAIC Number ,.. i a Y.. SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) —E5. If the Certificate is intended to support a LOMA or LOMR-F request, For Zones AO and A (YAthout BFE), complete Items El complete Sections A, B,and C. For Items EI—E4, use natural grade, if available. Check the measurement used, In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the r adjacent grade and the lowest adjacent grade a) Top of bottom floor (including basement N/A [a7, _ a G. crawlspace, or enclosure) is b) Top of bottom floor (including basement 9/A Mxfeet meters [] above or [:] below the LAG. crawlspace, or enclosure) is For +F # Diagrams r-• with permanent flood openings provided es t and/or r .. #;!- of • the nexthigher# _ • the diagrams) of the building is N/A MR feet E] meters EJ above or E] belowthe HAG. E3. Attached garage (top of slab) is N/A E]feet E] meters E] above or E] below the HAG. E4. Top of platform of machinery andfor equipment Zone `O • no flood depth number is available, •! of the bottomfloor ^# in accordance with the community's i floodplain management ordinance? E] Yes E] No E] Unknown. The local official must certify this information in Section G. 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 BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP rr Signature N/A Date N/A Telephone NI Comments FEMA Form 086-0-33 (12/19) Replaces all previous editions. [� Check here if attachments Form Page 3 of 6 OMB No. 1660-000$ ELEVATION CERTIFICATE Expiration Date: November 30, 2022 IMPORTANT: In these spaces, copy the corresponding information fr i n 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: 11 BRIGHT STREET city State ZIP Code Company NAIC Number TYBEE ISLAND GEORGIA 31328 CTI — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the communitys floodplain management ordinance can complete Sections A, B, C (or , and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G1 0. In Puerto Rico only, enter meters. G1 " ❑ The information in Section C wastken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who 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 (withouta FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (items G4—G 10) is provided for community flood plain management purposes. G4, Permit Number G5, Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction E] Substantial Improvement G6: Elevation of as -built lowest floor (including basement) ❑ feet ❑ meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: feet ❑ meters Datum G% Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of RIGHT SIDE VIEW previous editions. Form Page 5 of 6