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Home My Public Portal AboutFIFTH AV_1209.pdfU.S.T F I o Federal Emergency Management AgencyO D e: Navmr 30, 2 National Flood Insurance r ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments f (1) community official, (2) insurance agent/company, and (3) building r. SECTION — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Ownefs Name Policy Number: JOSEPH & ERIN PAYNE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number Box No. 1209 5TH AVENUE --City State ZIP Code TYBEE ISLAND Georgia 31328 Property a ription (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 270, WARD 4, TYBEE ISLAND 4 -MI -02-003 Building U (.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat, 31° 59 54.58!' Long. 080` 5l'0423" Hon n I tum: 1927 x NAD 1983 Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. 7. Building. Diagram Number 1A A8. For a building with a crawlspace or enclosure(s), a) Squaref a of craWspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawispace or enclosure(s) within 1.0 foot above adjacent grade /A c) Total net area of flood openings in A8.b NIA sq in d) Engineered flood openings? Yes El No A9: For a building with an attached garage: a) Square footage of attached garage N/A sq ft b) Number of pe anent flood openings in the attached garage within 1.0 foot above adjacent grade -N/A c) Total net area of flood openings in A.b N/A sq in d) Engineered flood openings? Yes x No SECTION FLOOD t (FIRM) INFORMATION 1. NFIP Community Name & Community Number rKCOunty Na a 3. State CITY F TYEE IS D 1351 A Georgia Map/Panel B5. Suffix 6. FIR Index 7. FIR =AE 9. a Flood Elevation(s) Number Date Effective/ (Zone , use Flood Depth) Revised 13051C 0326 08-16-2018 0 16-2019.0` 110.9 10. Indicate the source of the Base Flood Elevation ( FE) data or base flood depth entered in Item B9: ❑ FIS Profile x FIRM EJ Community Determined other/Source: 11. Indicate elevation datum used for BFE in Item 9: NGVD 1929 x NAVD 1988 Other/Sour 12. Is the building located in a Coastal Barrier Resources System (C RS) area or Otherwise Protect (OPA) ❑ Yes x No Designation Date: CBS ❑ OPA FERIA Form 086-0-33 (12/19) P 1 f 6 Replaces all previous editions. orm age o OMB No. 660-0008 I CERTIFICATE Ex iration1 Date,- November 30,2022 IMPORTANT: In these spaces, copy the corresponding Information f tl INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O, Route and Box No. Policy Number 1209 5TH AVENUE city state ZIP Code Company NAIC Number TYBEE ISLAND Georgia 31325 S — BUILDING ELEVATIONINFORMATION (SURVEY NOT REQUI ) FOR ZONE AO AND ZONE A (VATHOUT F' For Zones AO and A (without Fcomplete items E1—E5. If the Certificate is intended to support a LOMA or L -F request, complete Sections A B.and C. For Items EI—E4, use natural grade, if available. h measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the followirxj and check the appropriate boxes to showwhether 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, orenclosure) is f meters above or EJ below the HAG. ) Top of bottom ffoor (including basement crawlspace, or enclosure) is feet ❑meters v or the G. For Building Diagramspermanent flood openings provided in Section A Items 5 and/or 9 (see pages 1-2 of Instructions), the next higher fl(elevation C2.b in the diagrams) of the building is feet mete or below the HAG. 3. Attached garage (top of slab) is feet 0 meters above or below the HAG. E. flop of platform of machinery and/tar equipment servicing the building is feet meters 0 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 with thecommunity's floodplain management ordinance? Yes 0 No Unknown. The local official must certify this information in Section G. SECTION -- PROPERTY OWNER ( REPRESENTATIVE) CERTIFICATION The property owner orowner'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 Owners Authorized Representatives Name Address city State ZIP Code Signature Date Telephone Comments Check here if attachments. FEMA Form 086-0-33 (12/19) Replaces all previous editions, Form Page 3 of 6 OMB No. 08 ELEVATION CERTIFICATE Expirationte0ovm f 30, 2022 IMPORTANT: It spaces, copy the correspondingInformation from tion A. FOR INSURANCE COMPANY USE Building Street Address (including Apt, Unit, Suite, and/or Bldg. o.) or P.O. Route and Box No. Policy Number: 129 5TH AVENUE City State ZIP Code Company NAIC Number TYBEE ISLAND Georgia 3132 SECTION — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance n complete Sections A, B, C (of , and G of this Elevation Certificate. Complete the applicable item(s) and sin below. Check the measurement used in Items G 10. 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. El A communityofficial completed Section E for building located in Zone A (without a FEMA -issued or communitymissued FE) or Zone AO. G3. The following information (items 1) is provided for community floodplain management purposes. GIC—Perm—it Nu-mber G5. Date Permit issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for. Construction Substantial Improvement GS. Elevation of as -built lowest floor (including basement) feet meters of the building: D m G9. BFE or (in Zone AO) depth of flooding at the building site feet meters Datum G10. mmunity's design flo 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 app, li ble) Check here if attachments. FEMA Form 086-0-33 (12119) Replaces all previous editions. Form Page 4 of BUILDING OMB No. 1660-0008 ELVATION CERTIFICATE Continuation Pao Eviration Date. November 30, 2022 FEMA Form 086-0-33 (12119) Replaces all previous editions. F-ul Ili rawv V v! V