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HomeMy Public PortalAboutLEWIS AV_116.pdfU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2022 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 STEPHEN W. & KARLA E. KNUDSEN Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 116 LEWIS AVENUE Company NAIC Number City State ZIP Code TYBEE ISLAND Georgia 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 64 PALM TERRACE A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Accessory, etc.) Lat. N 32 ° 00' 45. 1 " Long. W 80 ° 50' 50. RESIDENTIAL 2 " Horizontal Datum: insurance. above ❑x NAD 1983 0 • NAD 1927 adjacent grade grade 0 2 photographs Number a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? of the building if the 8 Certificate is being used to obtain flood 0.00 sq ft or enclosure(s): or enclosures) openings in the crawlspace in A8.b or enclosure(s) 0.00 sq in within 1.0 foot foot above adjacent in 0.00 sq ft • Yes a No garage: garage openings in the attached garage within 1.0 in A9.b 0.00 sq 0 Yes Q No SECTION B- FLOOD INSURANCE RATE MAP (FIRM) INFORMATION , 81. NFIP Community Name & Community Number TYBEE ISLAND 135164 B2. County Name CHATHAM B3. State Georgia B4. Map/Panel Number 13051CO213 B5. Suffix 0 B6. FIRM Index Date 08-16-2018 B7. FIRM Panel Effective/ Revised Date 08-16-2018 B8. Flood Zone(s) AE B9. Base Flood Elevations) (Zone AO, use Base Flood Depth) 9.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood t] Other/Source: depth entered in Item B9: ■ FIS Profile 811. Indicate elevation 812. Is the building Designation ■ FIRM • Community Determined datum used for BFE in Item B9: located in a Coastal Barrier Resources Date 0 • NGVD 1929 x NAVD 1988 si Other/Source: System (CBRS) area or Otherwise Protected CBRS ❑ OPA Area (OPA)? ❑ Yes MI No FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 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. 116 LEWIS AVENUE Policy Number: City State ZIP Code TYBEE ISLAND Georgia 31328 Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* *A new Elevation Certificate will be required when construction of the C2. Elevations - Zones Al A30, AE, AH, A (with BFE), VE, V1 V30, V Complete Items C2.a-h below according to the building diagram specified Benchmark Utilized: LOCAL Vertical • building (with Datum: Building Under Construction* is complete. BFE), AR, AR/A, AR/AE, AR/A1-A30, in Item A7. In Puerto Rico only, NAVD 1988 x Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation • datum NGVD 1929 used x for the elevations in items a) through h) below. NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check a) Top of bottom floor (including basement, crawlspace, or enclosure Floor) 16.1 p the measurement used. feet ❑ meters b) Top of the next higher floor N/A x feet • meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A x feet • meters d) Attached garage (top of slab) N/A p feet • meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 13.8 p feet ❑ meters f) Lowest adjacent (finished) grade next to building (LAG) 55 x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 6.1 x feet • meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 6.1 (al feet III meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect I certify that the information on this Certificate represents my best efforts to interpret statement may be punishable by fine or imprisonment under 18 U.S. Code, Section Were latitude and longitude in Section A provided by a licensed land surveyor? x authorized the data 1001. Yes • by law to certify elevation information. available. I understand that any false No ❑ Check here if attachments. Certifier's Name License Number VINCENT HELMLY 1882 �'- . ' ':' r.' / A. Nc. I tin • \ - Title LAND SURVEYOR - Z.11-7- , i \:',,,, tSec.1) •fir`' u!?..„.--"�'. _ CJ Company Name VINCENT HELMLY Address 129 A BURTON ROAD City State ZIP Code SAVANNAH Georgia 31405 Signature j Date Telephone Ext. �,.,,_,4--",.. \ 02-12-2022 (912) 429-9395 Copy all pages of this Elevation Certificate and all a merits for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) C2 ( e) = AIR CONDITION UNIT PLATFORM FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE 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.Q. Route and Box No. 116 LEWIS AVENUE Policy Number: City State ZIP Code TYBEE ISLAND Georgia 31328 Company NAIC Number SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 —E5. If the Certificate is intended to support a complete Sections A, Band C. For Items E1 —E4, use natural grade, if available. Check the measurement enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet 0 meters LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below ❑ above or 0 below the HAG. 0 above or ❑ below the LAG. 9 (see pages 1-2 of Instructions), b) Top of bottom floor (including basement, crawlspace, or enclosure) is 0 feet ■ meters E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is • feet ■ meters ■ above or ❑ 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 ❑ feet 0 meters 0 above or ■ below the HAG. with the community's certify this information in Section G. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must SECTION F— PROPERTY OWNER (OR OWNER'S 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 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 Code Signature Date Telephone Comments 0 Check here if attachments. OMB No. 1660-0008 Expiration Date: November 30, 2022 FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE O M B 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. 116 LEWIS AVENUE Policy Number. City State ZIP Code TYBEE ISLAND Georgia 31328 Company NAIC Number 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. 0 A community official completed Section E for a budding 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 New Construction ❑ Substantial Improvement basement) G7. This permit has been issued for: • G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone AO) depth of flooding at the G10. Community's design flood elevation. • feet • meters Datum ❑ meters Datum building site: • feet ❑ meters Datum • feet 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 (12/19) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. 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. 116 LEWIS AVENUE Policy Number. City State ZIP Code TYBEE ISLAND Georgia 31328 Company NAIC Number 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. i.'" g w •, 1. '4 • z e Cc. - k.a * 'V Ti i y r ri /✓ -- Photo One Photo One Caption FRONT: 02/12/2022 Clear Photo One • f$ . t �� - r I ;yl,•,. ,. .. . .. - . �r - - z. ! ry �,. r` -yam. r.41 Photo Two Photo Two Caption BACK: 02/1212022 Clear Photo Two FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS Continuation Page OMB No. 1660-0008 Expiration Date: November 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. 116 LEWIS AVENUE Policy Number: City State ZIP Code TYBEE ISLAND Georgia 31328 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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, Photo Three Photo Three Photo Three Caption Clear Photo Three Photo Four Photo Four Photo Four Caption Clear Photo Four FEMA Form C86-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6 Building Permit Number FEMA check list Applicant's Name: T" 1 n&se,\ Owner's Name: Site Address, Tax#, Parcel*: /llp Jcuis IL.. Telephone: Telephone: „Address: All development - Base Flood Elevation Data Provided: A. The as -built elevation certificate 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 Zone AE: 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? III. Development in Zones V, VE and V! -V30, VO (Coastal High Hazard Areas). A. 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