HomeMy Public PortalAboutMORTAR AV_904-EC.pdfU.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2022
National Flood Insurance Program
_.
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 R PE T INFORMATION FOR INSURANCE COMPANY USE
A1. Building Owner's Name Policy Number:
CHRIS KONCUL CONSTRUCTION, LLC
Building Street Address (including Apt., Unit, Suite, and/or Bldg. o.) or P.O. Route and Company MAIC Number:
Box No.
904 MORTAR AVENUE
City State ZIP Code
TYBEE ISLAND Georgia 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 7, BLOCK 15, BAY WARD BOOK 51, PAGE 631
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. 32.021411 Long. -80.848987 Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A& 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) N/A sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A sq in
d) Engineered flood openings? ❑ Yes ❑ No
A9. For a building with an attached garage:
a) Square footage of attached garageN/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 area of flood openings in A9.b N/A sq in
d) Engineered flood openings? E] Yes ❑ No
SECTION INSURANCE RATEA (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
B9. Base Flood Elevation(s)
Number
Date
Effective/
Zone(s)
(Zone AO, use Base Flood Depth)
Revised Date
13051 00213
G
05-16-2018
08-16-2018
AE
9.0
10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 9:
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CRS) area or Otherwise Protected Area (OPA)? ❑ Yes No
Designation Date: ❑ CBS ❑ OPA
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE 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:
904 MORTAR AVENUE
City State ZIP Code Company NAIC f4—umber
TY EE ISLAND Georgia 31328
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 0 Construction Drawings* E] Building Under Construction* 21 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 PLAT Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below.
[] NGVD 1929 Z NAVD 1988 E] 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) 14.9 0 feet E] meters
b) Top of the next higher floor 25.1 N feet [] meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A E] feet F] meters
d) Attached garage (top of slab) N/A 0 feet [] meters
e) Lowest elevation of machinery or equipment servicing the building 10.6 Z feet E] meters
(Describe type of equipment and location in Comments)
0 Lowest adjacent (finished) grade next to building (LAG) 5.3 Z feet E] meters
g) Highest adjacent (finished) grade next to building (HAG) 5.6 N feet E] meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural 5.3 ®feet E] meters
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.
/ 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?. 0 Yes El No E] Check here if attachments.
Certifier's Name License Number
MICHAEL HUSSEY 2509 0 R
Title T
LAND SURVEYOR
Company Name
SUNDIAL LAND SURVEYING, PC Nm 2wo
Address
1410 W U.S. HIGHWAY 80, SUITE 2 t
City State ZIP Code A.
BLOOMINGDALE Georgia 31302
Signature Date Telephone Ext.
06-16-2022 (912) 235-2477
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type of equipment and location, per C2(e), if applicable)
BUILDING PAD/PARKING ELEVATION 5.8'
C2e - HVAC UNIT
FEMA Form 086-0-33 (12/19)
Form Page 2 of 6
CERTIFICATEELEVATION
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:
904 MORTAR AVENUE
City State ZIP Code Company NAIC Number
TYE ISLAND Georgia 31328
SECTION E— BUILDING ELEVATIONINFORMATION (SURVEY T IRR
FOR ZONE AO AND ZONE (WITHOUT )
For Zones AO and A (without F), complete Items 1—E5. If the Certificate is intended to support a LOMA or LOMR-F request,
complete Sections A, B,and C. For Items El—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 above 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 ❑ below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below 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 ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is " ❑ feet " ❑ meters " ❑ above or ❑ below the HAG.
4. Top of platform of machinery and/or equipment
servicing the budding is ❑ 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 with the community's
floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
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 FE) 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
❑ Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6
ELEVATION CERTIFICATE
OMB No1660-0008
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:
904 MORTAR AVENUE
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 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 G 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.
3. - ❑ 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 ❑ 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 (12/19) Replaces all previous editions. Form Nage 4 or e
FENIA check list
Building Permit Number 622 11 Z0
Applicant's Name: Owner's Name:
Site Address, Tax#, Parcel#: " Address: <°
Telephone: Telephone:......
. All development — Base Flood ElevationData Provided:
A. The as -built elevation certificate from a registered land surveyor or
Professional engineer has been submitted?
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 BFE or flood proofed?
es or No
H. Development in Zone
A. Solidfoundation perimeter walls located below BFE:
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 1 by
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
. Development in; Zones V, VE and V! -V30, VO (Coastal High HazardAreas).
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:
DealAdministrator's Signature: ate:
City of Tybee Island
403 Butler Avenue-P.O. Box 2749
Yee Island, Ga. 31328-2749