HomeMy Public PortalAboutROBINSON AV_10-EC.pdfDEPARTMENT a r SECURITY OMB Nm 1660-0008
ELEVATIONFederal Emergency Management Agency Expiration Datw. November 30, 2022
National Flood Insurance Program
CERTIFICATE
p,i •rtant: Follow the instructions on pages i. _ a.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and () building owner.
SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Ownees Name Policy Number.
JOE MIKIELIAN
AZ Building Street Address (including Apt., Knit, Suite, ander Bldg. No.) or P.O. Route and Company NAIC Number -
Box No.
10 ROBINSON AVENUE
City State ZIP Code
TYBE ISLAND Georgia 31328
Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 10, BLOCK 23, FORT SCREVEN WARD, TYBEE ISLAND 4-0002-08-005
Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitu Longitude: Let 32* 01' 14.35" Long. 080° 50' 45.48" Horizontal Datum, 1927 NAD 1983
6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance,
7. Building Diagram Number 8
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 1151.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 10
c) Total net area of flood openings in A8.b 1606.00 sq in
d) Engineered flood openings? ❑ Yes ® No
For a building with an attached garage:
a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑ Yes ® No
CTI B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
1. NFIP Community Name & Community Number B2. County Name B3, State
CITY OF TYBEE ISLAND 135164 CHATHAM Georgia
. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number bate Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
13051C 0213 G 16-2018 08-16-2018 AE
10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item .
❑ FIS Profile Z FIRM ❑ Community Determined ❑ Other/Sour
11. Indicate elevation datura used for BFE in Item B9. NGVD 1929 ® NAVD 1988 Other/Source:
12. Is the building located in a Coastal Barrier Resources System (C R) area or Otherwise Protected Area (OPA)? ® Yes No
Designation Date: ❑ CBRS EJ OP
FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE OMB No. 16604=8
Expiration Date: November 30, 2022
IMPORTANT: In these spaces, copy the ponding 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.
10 ROBINSON AVENUE
City State ZIP Code Company NAIC Num r
TYBEE ISLAND Georgia 31328
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ 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, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, ARAE, AR/A1-430, ARIAH, 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'. GPS ESTABLISHED Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
NGVD 1929 ® NAVD 1988 ❑ Other/Source:
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)
f) 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
Check the measurement used.
7.5
® feet
❑ meters
12.1
0 feet
❑ meters
NIA
❑ feet
❑ meters
NIA
❑ feet
❑ meters
11A
0 feet
❑ meters
63
x❑ feet
❑ meters
6A
® feet
❑ meters
structural support 63 ® feet ❑ meters
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 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No ❑ Check here if attachments.
MICHAEL J. GARDNER
Title,
LAND SURVEYOR
Company Name
MICHAEL J. GARDNER
Address
120 VARNEDOE AVENUE
City
GARDEN CITY
LAND SURVEYOR
License Number
GA RLS NO. 2285
ZIP Code
31408
I
Signature(Date- Telephone
08-09-2021 (912) 661-0479 CELL , 1__/1
Copy all pag'es of this stio Certifi eand all attachme for (1) community official, (2) insurance agenticompany, and (3) building owner.
Comments (including type of equipment and location, per C ), if applicable)
C2(e): AIR CONDITIONER PEDESTAL AT ELEVATION 11.4 AT REAR OF RESIDENCE. NOTE: VENTS HAVE BEEN ADDED TO
THIS RESIDENCE AND THEY ARE WITHIN T OF THE CRAWL SPACE UNDER THE RESIDENTIAL AREA OF THIS RESIDENCE.
NOTE: THIS ELEVATION CERTIFICATE IS FOR THE FINAL ELEVATION CERTIFICATE OF THIS SITE 08 09 2021.
JOB NO: JOE MIKIELIAN (03) 07/29/2021 F.B. MJG 2021 B, PG 12
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6
OMB No. 1 0-0
ELEVATION IExpiration Date' November 30, 2022
IMPORTANT: In these spaces, copy the conrespondinginformation fro ion' 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:
10 ROBINSON AVENUE
City State ZIP Code Company NAIC Number
TYBEE ISLAND Georgia 31328
SECTIONE — BUILDING ELEVATION INFORMATION (SURVEY T REQUIRED)
FOR ZONE AO AND ZONE A (MTHOUT BFE)
For Zones AO and A (without FE), complete Items E1—E5. If the Certificate is intended to support a LOA or LOMR-F request,
complete Sections A, Band C. For Items E1—E4, use natural grade, if available_ Check the measurement used. In Puerto Rico only,
enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is a ve or below
the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement„
crawlspace, or enclosure) is feet ❑ meters above or low the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is feet ❑ meters 0 above or 0 berm the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions),
the next higher floor (elevation C2.b in
the diagrams) of the building is El feet ❑ meters ❑ above or 0 below the HAG.
E3. Attached garage (top of slab) is feet ❑ meters above or 0 below the HAG.
E4_ Top of platform of machinery and/or equipment
servicing the building is 0 feet ❑ meters ❑above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance `th the community's
floodplain management ordinance? ®Y No Unknowm The local official must certify this information in Section G.
CTI — PROPERTY OWNER (OR OWNEWS 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
commun*iss d 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 orOwner's Authorized Representative's Dame
Address city State ZIP Code
Signature _ Date Telephone
Comments
EJ Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30, 2022
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:
10 ROBINSON AVENUE
CityState ZIP Code Company NAIC Number
TYBEE ISLAND Georgia 31328
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 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 (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
Compliance/Occupancy Issued
G7. This permit has been issued for. ❑ New Construction ® Substantial Improvement
G8. Elevation of as -built lowest floor (including basement)
of the building: ❑ feet a meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. Community's design flood elevation: ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments (including type of equipment and location, per C2(e), if applicable)
❑ Check here if attachments.
FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of 6
VV,is6/,,.47-7-,,oi,I A w OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 2022
,-, I
Building Permit Number
Ti—
Applicant's Name:
Owner's Name:
Site Address, Tax#, Parcel#:
Address: a
Telephone:)4 9"It — ff &-
Telephone:
1. All development ® Base Flood Elevation Data Provided:
A. The as -built elevation certification from a registered land surveyor or
Professional engineer has been submitted?
B. The lowest floor elevation is at or above the required lowest floor elevation?
C. Electrical, heating, ventilation, plumbing, air conditioning equipment (including
duct work) and other service facilities are located above BFE or flood proofed?
II. Development in Zones A, AE, Al -A30 and .
A. Solid foundation perimeter walls located below BFE
1. There are at least two (2) openings?
2. Square footage of enclosed area subject to flooding
3. Square inches of venting required
4. Square inches per opening (multiply 1 by w)
5. Number of required vents (3 above divided by 4 above)
6. Foundation contains the minimum number of vents?
7. The bottom of each opening is no higher than one (1) foot above grade?
8. Any cover on openings will permit the automatic flow of floodwaters
In both directions?
B. Base flood elevation and/or fioodway data not available orAO Zones:
1. The lowest floor is at least one (1) foot above the highest adjacent grade?
2. The development meets the setback requirements of the ordinance?
3. If 2 above was "no", has a No -Rise Certification been submitted?
Reviewer's Name: Date reviewed:
B. Floodway data is provided.
1. Did this development encroach in the floodway?
2. Do the actual field conditions meet the proposed actions and technical
date requirements?
3. If C1 was "yes", has a No -Rise Certification been submitted?
Reviewer's Name: Date reviewed
or NO
S or
YES or NO
OR NO
YES or NO
YES or NO
YES or NO
YES or NO
YES or NO
YES or NO
Ell. 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: 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: Date:LD
City of Tybee Island
403 Butler Avenue - P.O. Box 2749
Tybee Island, Oa. 31328-2749 t
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