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Home My Public Portal AboutLEWIS AV_127-EC.pdfU.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2022 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 LAWRENCE A. & DONNA C. PIPER Policy Number: A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 127 LEWIS AVENUE Company p ny NAIC Number: City State ZIP Code TYBEE ISLAND Georgia 31328 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 23 PALM TERRACE A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building a) Square footage b) Number of 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, Lat. N 32 ° 00' 43.3 ° Long. W 80 ° 50' 52.6 etc.) RESIDENTIAL ° Horizontal Datum: insurance. above grade ■ NAD 1927 adjacent grade 0 p NAD 1983 0 2 photographs Number with a crawlspace of crawlspace permanent flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? of the building if the .$- Certificate is being used to obtain flood 0.40 sq ft or enclosure(s): or enclosures) openings in the crawlspace in A8.b or enclosures) 0.00 sq in within 1.0 foot 1.0 foot above adjacent in 0.00 sq ft ■ Yes D No garage: garage openings in the attached garage within in A9.b 0.00 sq ❑ Yes • No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number TYBEE ISLAND 135164 B2. County Name CHATHAM B3. State Georgia B4. Map/Panel Number 13051CO213 85. Suffix G 136. FIRM Index Date 08-16-2018 B7. FIRM Panel Effective/ Revised Date 08-16-2018 B8. Flood Zone(s) AE 69. Base Flood Elevations) (Zone AO, use Base Flood Depth) 9.0 510. Indicate the source 1111 FIS Profile B11. Indicate elevation 812. Is the building Designation Date: of the Base Flood Elevation ❑ FIRM ❑ Community Determined datum used for BFE in Item 99: located in a Coastal Barrier Resources 0 (BFE) data or base flood ❑ Other/Source: ❑ NGVD 1929 System (CBRS) CBRS ❑ OPA depth entered in Item B9: p NAVD 1988 ❑ Other/Source: area or Otherwise Protected Area (OPA)? • Yes p No FEMA Form 086-0-33 (12119) Replaces all previous editions, Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Budding Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 127 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 Building Under Construction* *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones A1 —A30, AE, AH, A (with BFE), VE, V1 —V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, Benchmark Utilized: LOCAL Vertical Datum: NAVD 1988 x Finished Construction AR/AH, AR/AO. enter meters. Indicate elevation • datum NGVD 1929 used p for the elevations NAVD 1988 • in items a) through h) below. Other/Source: - Datum used for building elevations must be the same as that used for the BFE_ Check the measurement a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 16.8 0 feet • used. meters b) Top of the next higher floor N/A 0 feet meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A Ei feet Q meters d) Attached garage (top of slab) N/A Q feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 16.6 xx feet ■ meters f) Lowest adjacent (finished) grade next to building (LAG) 5.4 p feet 0 meters g) Highest adjacent (finished) grade next to building (HAG) 6.1 p feet • meters h) touets adjacent dl ja pn tgrade at lowest elevation of deck or stairs, including 5,4 Q feet ■meters SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect 1 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 by law the data available. 1001. Yes ❑ No to / understand • certify elevation information. that any false Check here if attachments. Certifier's Name License Number VINCENT HELMLY 1882 `� ,, ', �, Title LAND SURVEYOR 3 „� �‘ rse:e -`. . Company Name VINCENT HELMLY 63434..Y Address 129 A BURTON ROAD r s '� - . € ,�. ' City State ZIP Code SAVANNAH Georgia 31405 Signature t1 . Date Telephone Ext.,!� 02-01-2021 (912) 429-9395 Copy all pages of this Elevation Certificate and all attac ents 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 OMB No. 1660-0008 • 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. 127 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 complete Sections A, B,and C. For Items E1 —E4, use natural grade, if available. Check the enter meters. El. Provide elevation information for the following and check the appropriate boxes to show the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is 0 feet support measurement whether 1■ a LOMA or LOMR-F request, used. In Puerto Rico only, the elevation is above or below meters ❑ above ❑ below b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ■ meters ■ or above or • the HAG. below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items the next higher floor (elevation 02.b in the diagrams) of the building is • feet 8 ■ and/or 9 (see meters ❑ pages 1-2 above or of ■ Instructions), below the HAG. E3. Attached garage (top of slab) is 0 feet 0 meters • above or ■ below E4. Top of platform of machinery and/or equipment servicing the building is 0 feet ❑ meters 0 above ❑ the HAG. below E5. Zone AO only: If no flood depth number is available, floodplain management ordinance? 0 Yes ■ or the HAG. is the top of the bottom floor elevated in accordance with the community's No 0 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 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 ■ 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: N 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. 127 LEWIS AVENUE Policy Number. City State ZIP Code TYBEE ISLAND Georgia 31328 Company NAIC Number SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local Sections used G1. G2 G3. in ■ • ❑ official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete A, 9, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement Items G8 -G10. In Puerto Rico only, enter meters. 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.) A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. 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: 0 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 066-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE BUILDING PHOTOGRAPHS See Instructions for Item A6. OMB No. 1660-0008 • 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. 127 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. •. "vim _ �- ir. 111111111 Z...--.: a di w1 . . Photo One Photo One Caption FRONT: 02101/2021 Clear Photo One 33�w�.rr'r �ibti �l.y - r '''''..i y+ la r I,St a .r tiff ail1 -� lig liiI --� II I, �I • s tp w ,. IIIII r" Photo Two Photo Two Caption BACK: 02/01/2021 Clear Photo Two FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 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.O. Route and Box No. 127 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. Pia'. tD Theo Photo Three Photo Three Caption Clear Photo Three Photo Four Photo Four Photo Four Caption Clear Photo Four BUILDING PHOTOGRAPHS Continuation Page OMB No. 1680-0006 Expiration Date: November 30, 2022 FEMA Form 086-0-33 (12119) Replaces all previous editions Form Page 6 of 6 Building Permit Number C=am/ Oa' 7 Applicant's Name: e es( Site Address, Tax#, Parcel#: I r/ Le. , S Owner's Name: Address: • Telephone: Telephone: I. 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? [1. Development in Zones A, AE, Al -A30 and AH: A. Solid foundation perimeter walls located below BFE: tv') 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 floodway data not available or AO 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 01 was "yes", has a No -Rise Certification been submitted? Reviewer's Name: Date reviewed 111. Development in Zones V, VE and V! -V30, VO (Coastal High Hazard Areas). A. Development location complies with all coastal setback requirements? B. Structure is securely anchored to pilings or columns and certification by a Registered, professional architect or engineer has been submitted? 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? Reviewer's Name: Date review Local Administrator's Signature: City of Tybee Island 403 Butler Avenue - P.O. Box 2749 Tybee Island, Ga. 31328-2749 or NO or NO ES i or NO YES or NO YES or NO YES or NO YES OR NO YES or NO YES or NO YES or NO YES or NO YES or NO YES or NO YES or NO YES or NO YES or NO Date: eZ— l�