HomeMy Public PortalAboutLEWIS AV_134-2.pdfMAYOR
Shirley Sessions
CITY COUNCIL
Barry Brown, Mayor Pro Tem
John Branigin
Jay Burke
Nancy DeVetter
Monty Parks
Michael "Spec Hosti
CITY OF TYBEE ISLAND
October 12, 2021
Mr. Stephen Clark
Hazard Mitigation Division
Georgia Emergency Management and Homeland Security Agency
P.O. 18055
Atlanta, Georgia 30316-0055
Re: City of Tybee Island Elevation - Project HMGP 4294-004-R
Mr. Clark:
CITY MANAGER
Shawn Gillen
CITY CLERK
Janet LeViner
CITY ATTORNEY
Edward M. Hughes
134 Lewis Ave on Tybee Island has been elevated consistent with applicable regulations and local
floodplain ordinance. Construction as well as all engineering and permitting has been completed. A
sealed post construction elevation certificate has been received and reviewed and a subsequent
certificate of occupancy issued. The finished floor elevation has been determined to be in
compliance.
Sincerely,
Geotje Shaw
Community Development Director
gshawCa�citvoftybee.org
912-472-5031
P.O. Box 2749 — 403 Butler Avenue, Tybee Island, Georgia 31328-2749
(866) 786-4573 — FAX (866) 786-5737
www.cityoftybee.org
r
Voluntary Participation Form
FEMA Hazard Mitigation Grant Program (HMGP)
ELEVATION
INSTRUCTIONS: Please fill out this form in its entirety for each structure you wish to be considered for mitigation. Signing this
form does not commit you or the community to any action.
PROPERTY OWNER: bCs l� br vtS I'�i� Phone Number:
CO-OWNER(S) : a& -Ay L I3re1 Email Address:
Property Address:
I3 Li Lekoi s A ✓L'
y26E
q/r)-3()�'�1�FS
►i rle,\1St r C�c �.Atr;Uv .Cum
Mailing Address: ROG-6g t e Z
PO &o x 1 f) c -
13c.,=jSL J) 6n 3(32
HOUSEHOLD INFORMATION — Please provide the following information about your household
Total # of persons who reside in your household:
PROPERTY INFORMATION- At time of Flood Body of water causing Flooding:
For each of the following categories, please circle the features that apply.
STRUCTURE USA
STRUCTURE TYPE:
FOUNDATION PE:
BUILDING TYPE:
owner Occupied -Primary r
Single Family 1
2-4 ami y
Multi (5+)
Manufactured
Vacant Land
Other (Explain)
Basement YOOutside Entranc N
Finished OY N Partial Y,CN
Crawl Space Y
Elevate lets/columns/posts/piles
ood
Masonry (Brick)
Stone
Cement
Other
Owner Occupied- Secondary
Rental
Vacant Lot
Other (Explain)
Slab on Grade '
Vacant Land
Other (Explain)
TAX Parcel #: 000 (1- — I " —0O9
Total Living Area in Sq Ft. (All floors) 1,,1 £2
Heated and Cooled Sq Ft.: NM
Is the property contaminated with hazardous waste (lead -based paint, asbestos, etc.)? vfes _ No
Do you have an Elevation Certificate? Y Is the structure an historic property? _ Yes No°
INSURANCE INFORMATION — Please provide the following information.
Do you currently have Flood Insurance? Y �N ) Insurance Company: Flood Policy #:
Original Date of Construction : If c/57
Number of Stories above ground:
Non -living area Sq Ft.:
Please provide past flood claim information below. Provide details of historical losses on the next page.
Date: Claim Amount: $ _ Date: Claim Amount: $ _
Date: Claim Amount: $ Date: Claim Amount: $
By submitting this form, I affirm the following:
• That the statements on this form are true and complete to the best of my knowledge;
• That I/we own the property located at / ' ( S it ✓C 'FL( hie S5 . GPI .
• That the modification of this property under a FEMA Hazard Mitigation Assistance Program is voluntary in nature, that I
am under NO obligation to participate, and that I may drop out of the application process at any time;
• That I currently intend to participate;
• That I understand my submittal of this form and associated documentation only indicates my willingness to participate
in the program and does not guarantee that my property will be mitigated through the program or by the community.
• If approved for a grant, I understand that I may be required to pay a match amount of up to 15% of the total project cost
to mitigate my home. I affirm that I have the resources to meet the cost -share and cost -reimbursement requirements.
NAME: ROC -7 -C -1Z AIJI SI -EIQ
WITNESS:
DATE: `/ /Ze //8 SIGNATURE:
.G ISM 1'. ��i►1� �� DATE: / /1 //8
SIGNATURE:
MAYOR
Jason Buelterman
CITY COUNCIL
Barry Brown, Mayor Pro Tem
Wanda Doyle
John Branigin
Jackson Butler
Monty Parks
Julie Livingston
CITY OF TYBEE ISLAND
April 13, 2018
Re: Substantial Damage
134 Lewis Ave.
Tybee Island, GA 31328
Dear Beryl and Roger Banister,
CITY MANAGER
Shawn Gillen
CITY CLERK
Janet LeViner
CITY ATTORNEY
Edward M. Hughes
This letter is for a declaration of substantial damage to your home due to flooding from Hurricane
Irma. Based on the estimate from the FEMA damage assessment team of $29,091.89 to renovate
your home to its pre storm state this is more than 50% of the value of the structure which is
currently assessed at $44,077.00. A declaration of substantial damage means that the City may not
issue any permits for renovation of this structure. You may raze the structure or elevate the
structure to one foot above base flood elevation.
If you have any questions feel free to contact me.
Sincerely,
George Shaw
Community Development Director
gshaw@cityoftybee.orq
912-472-5031
P.O. Box 2749 — 403 Butler Avenue, Tybee Island, Georgia 31328-2749
(866) 786-4573 — FAX (866) 786-5737
www.cityoftybee.org
Acknowledgement of Conditions
For Mitigation of Property in a Special Flood Hazard Area
With FEMA Grant Funds
Property Owner /tea s -i- Ck CAY L 4 kOGckJ
Street Address i 4 Lit s
ve
City �Yt3E-C fisLANI State cCvtzGiA
Subject Property Address
Zip Code i 31g,
Deed Dated f EC i S Recorded
Tax Map ss PArM-1-�,,etcz Block
Parcel
-0004 0
Base Flood Elevation at the site is feet (NGVD)
Map Panel Number Effective Date
As a recipient of Federally -funded hazard mitigation assistance under the Hazard Mitigation Grant
Program, as authorized by 42 U.S.C. §5170c / Pre -Disaster Mitigation Program, as authorized by
42 U.S.C. §5133 / Flood Mitigation Assistance Program, as authorized by 42 U.S.C. §4104c the
Property Owner accepts the following conditions:
1. That the Property Owner has insured all structures that will not be demolished or
relocated out of the SFHA for the above -mentioned property to an amount at least
equal to the project cost or to the maximum limit of coverage made available with
respect to the particular property, whichever is less, through the National Flood
Insurance Program (NFIP), as authorized by 42 U.S.C. §4001 et seq., as long as the
Property Owner holds title to the property as required by 42 U.S.C. §4012a.
2. That the Property Owner will maintain all structures on the above -mentioned property
in accordance with the flood plain management criteria set forth in Title 44 of the Code
of Federal Regulations (CFR) Part 60.3, The Official Code of Georgia Annotated.
O.C.G.A. Section 8-2-20(9)(B), and any local ordinance standards as long as the
Property Owner holds title to the property. These criteria include, but are not limited
to, the following measures:
i. Enclosed areas below the Base Flood Elevation will only be used for
parking of vehicles, limited storage, or access to the building;
ii. All interior walls and floors below the Base Flood Elevation will be
unfinished or constructed of flood resistant materials;
iii. No mechanical, electrical, or plumbing devices will be installed below
the Base Flood Elevation; and
iv. All enclosed areas below Base Flood Elevation must be equipped with
vents permitting the automatic entry and exit of flood water.
For a complete, detailed list of these criteria, see the Official Code of Georgia
Annotated. O.C.G.A. Section 8-2-20(9)(B) and any local ordinance standards.
1
3. The above conditions are binding for the life of the property. To provide notice to
subsequent purchasers of these conditions, the Property Owner agrees to legally
record with the county or appropriate jurisdiction's land records a notice that includes
the name of the current property owner (including book/page reference to record of
current title, if readily available), a legal description of the property, and the following
notice of flood insurance requirements:
"This property has received Federal hazard mitigation assistance. Federal law
requires that flood insurance coverage on this property must be maintained during
the life of the property regardless of transfer of ownership of such property.
Pursuant to 42 U.S.C. §5154a, failure to maintain flood insurance on this property
may prohibit the owner from receiving Federal disaster assistance with respect to
this property in the event of a flood disaster. The Property Owner is also required
to maintain this property in accordance with the flood plain management criteria of
Title 44 of the Code of Federal Regulations Part 60.3, The Official Code of Georgia
Annotated. O.C.G.A. Section 8-2-20(9)(B), and any pertinent local ordinance."
4. Failure to abide by the above conditions may prohibit the Property Owner and/or any
subsequent purchasers from receiving Federal disaster assistance with respect to this
property in the event of any future flood disasters. If the above conditions are not met,
FEMA may recoup the amount of the grant award with respect to the subject property,
and the Property Owner may be liable to repay such amounts.
This Agreement shall be binding upon the respective parties' heirs, successors, personal
representatives, and assignees.
(C
HOMEOWNER/PROPERTY OWNER SIGNS HERE: /)
Name of Property Owner: ZA-^J S re , ac=n ? 0 F b
STATE OF GEORGIA
COUNTY OF &i-1t1:)1
The foregoing instrument was acknowledged before me this /6* day ofJ 1 ct+
R°5P-r who is (C -personally known to me or (❑) has produced as identification.
Ea_n,s-ems
SEAL:
/ (_
a
N8 by
NOTARY PUBLIC
Lisa F Lanier
NOTARY PUBLIC
Printe FlbtAin fy, GEORGIA
My Comm. Expires 09/25/2021
2
Privacy Act Release
I/We, the undersigned, hereby grant my/our permission for the City of Tybee Island to publish,
through public notice, the location of my real property which is being considered for an elevation
project by the City of Tybee Island.
This information will be used to notify the public that FEMA and the State are considering a
mitigation action that may include my property under Section 404 (HMGP) of the Stafford Act,
as amended, the Flood Mitigation Assistance Program, the Pre -Disaster Mitigation (PDM)
Program, and/or HUD programs.
Further, I/we hereby grant FEMA and the State of Georgia permission to disclose flood
insurance coverage and claim information, and information about disaster assistance payments
received by me/us, to officials of the City of Tybee Island for the purpose of aiding in their
planning and decision -making regarding mitigation or assistance actions affecting my property.
This information will be used for this purpose only and will not be made public.
l�i4l g
Date
R 6/. 1J 1. N'S r gc_
Print Owner's Name Print Owner's Name
/GO. —bd4,1
Signed
L
Social Security Number
l3- LC -kJ/ s vC
Address of Property
Tti EEL fJrG-6 3 (32J
City, State, ZIP
If applicable:
Flood Insurance Policy Number:
Insurance Agent's Phone Number:
Insurance Provider/Company:
Insurance Company's 5 -digit Company Code:
Social Security Number
Duplication of Benefits
The Federal Emergency Management Agency (FEMA) has adopted a policy that
prohibits duplication of benefits in the Hazard Mitigation Assistance Program that
includes Hazard Mitigation Grant Program (HMGP) grants. The policy was developed
in response to federal regulations that dictate the use of the primary funds used to
mitigate property. FEMA provides the following specific instructions in the Hazard
Mitigation Assistance Program Guidelines for mitigation projects.
In the administration of HMGP grants, FEMA and the grantee should avoid any
duplication of benefits with other forms of assistance. FEMA's policy on
duplication of benefits for individuals and families is mandated by Section 312 of
the Stafford Act and is set forth in 44 CFR 206.191. This Section of the FEMA
regulations delineates a delivery sequence establishing the order in which the
disaster relief agencies and organizations provide assistance to individuals and
families. Programs listed later in the sequence are responsible for ensuring that
they do not duplicate assistance which should be provided by a program listed
earlier on the list (the program with primary responsibility).
In the case of flood -damaged property programs (Section 1362, Section 404,
etc.), they are not listed in the delivery sequence, and therefore are positioned
after the eight listed programs. This means that all eight programs listed in the
sequence at 44 CFR 206.191 (d) are "primary programs" in relation to mitigation
grant programs. The Hazard Mitigation Grant Program is required to ensure that
it does not duplicate assistance which should be provided by any of the eight
primary assistance programs.
Certification of Funds Used
Receipt of or pending receipt of the following benefit amounts must be disclosed to the
State of Georgia
1. SBA Loans - A property owner who has an SBA loan on the property being acquired
will either be required to repay the loan to SBA, or roll it over to a new property at
closing. Yes n No 3
2. Flood Insurance for Structure Repairs - That portion of a flood insurance payment
that a property owner has received or is eligible to receive intended to cover structural
repairs to the property being acquired will be deducted from the purchase price of the
property being acquired. If flood insurance funds have been reinvested into repairs to
the property, this amount will not be deducted. Proof of reinvestment can be supplied
through receipts for materials and/or labor, or through on -site verification. Amount
reinvested is $ N,;:4
3. Increased Cost of Compliance -The NFIP Increased Cost of Compliance (ICC) claim
payment from a flood event may be used to contribute to the non -Federal cost -share
requirements so long as the claim is made within the timelines allowed by the NFIP.
ICC payments can only be used for costs that are eligible for ICC benefits; for example,
ICC cannot pay for property acquisition, but can pay for structure demolition or
relocation. In addition, Federal funds cannot be provided where ICC funds are available;
if the ICC payment exceeds the required non -Federal share, the Federal funding award
will be reduced to the difference between the cost of the activity and the ICC payment.
Have you received ICC payments? f'
If so, how much ICC funds have you received?
Do you plan on receiving ICC payment? /'J0
If so, how much ICC funds do you plan on receiving?
4. FEMA Individual Family Grant and Emergency Minimal Repair Grant (EMR) - That
portion of an IFG grant that a property owner has received or is eligible to receive
intended to cover structural repairs to the property being acquired will be deducted from
the purchase price of the property. Additionally, grants received from FEMA as part of
Temporary Housing Assistance Program to quickly repair or restore owner -occupied
primary residences to habitable and safe condition will be deducted from the purchase
price of the property. If the funds have been reinvested into repairs to the property, this
amount will not be deducted. Proof of reinvestment can be supplied through receipts
for materials and/or labor, or through on -site verification. Amount received:
5. FEMA Disaster Housing - FEMA Disaster Housing money received by the property
owner will not be deducted if the property owner has used the grant for housing related
expenses. These can include: transient accommodations while an existing home is
being elevated or relocated; combining it with other funds to make more substantial
home repairs; minor home repairs made to make a home more livable prior to a buyout
offer; down payments toward the purchase of a new home; moving expenses; closing
costs; insurance; and deposits. Amount received:
Owner Name: 'is, L1- g ReAl LI-RoG b Property Address: f 3(f Le j
I hereby certify that the SBA Loans, Flood Insurance for Structure Repairs, FEMA
Individual and Family Grant, Emergency Minimal Repair Grant (EMR) and FEMA
Disaster Housing benefits defined above have been accurately reported and that the
not used for the purposes identified above have been fully disclosed.
irk) 4,_,9)(Q4/07c) ce 4 AL,
Signed
Date J /(o//�
Signed
DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
DECLARATION AND RELEASE
O.M.B. No. 1660-0002
Expires 1/31/2018
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 2 minutes per response. The burden estimate includes the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. This collection of information is required to
obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send
comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of
Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472-3100, Paperwork Reduction Project (1660-0002)
NOTE: Do not send your completed form to this address.
PRIVACY ACT STATEMENT
AUTHORITY: The Robert T. Stafford Disaster Relief and Emergency Assistance Act as amended, 42 U.S.C. § 5121 -5207 and Reorganization Plan No. 3 of
1978; 4 U.S.C. §§ 2904 and 2906; 4 C.F.R. § 206.2(a)(27); the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. 104-193) and
Executive Order 13411. DHS asks for your SSN pursuant to the Debt Collection Improvement Act of 1996, 31 U.S.C. § 3325(d) and § 7701(c) (1).
PRINCIPAL PURPOSE(S): This information is being collected for the primary purpose of determining eligibility and administering financial assistance under a
Presidentially -declared disaster. Additionally, information may be reviewed within FEMA for quality assurance purposes and used to assess FEMA's customer
service to disaster assistance applicants.
ROUTINE USE(S): The information on this form may be shared outside of FEMA as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as
amended. This includes sharing this information with state, tribal, local, and voluntary organizations to enable you to receive additional disaster assistance and as
necessary and authorized by other routine uses published in DHS/FEMA-008 Disaster Recovery Assistance Files System of Records, 78 Fed. Reg. 25,282 (April
30, 2013), and upon written request, by agreement, or as required by law.
DISCLOSURE: The disclosure of information on this form is voluntary; however, failure to provide the information requested may delay or prevent the individual
from receiving disaster assistance.
DECLARATION
In order to be eligible to receive FEMA Disaster Assistance,
of the United States. Please read the form carefully, sign
photo identification. Please feel free to consult with an attorney
I hereby declare, under penalty of perjury that (check one):
tiff I am a citizen or non -citizen national of the United
I am a qualified alien of the United States.
I am the parent or guardian of a minor child who
alien of the United States. Print full name and
By my signature I certify that:
* Only one application has been submitted for my household.
* All information I have provided regarding my application
knowledge.
* I will return any disaster aid money I received from
do not use FEMA disaster aid money for the purpose
I understand that, if I intentionally make false statements
violation of federal and State laws, which carry severe
both (18 U.S.C. §§ 287, 1001, and 3571).
I understand that the information provided regarding
the Department of Homeland Security (DHS) including,
I authorize FEMA to verify all information given by
order to determine my eligibility for disaster assistance;
I authorize all custodians of records of my insurance,
release information to FEMA and/or the State upon
AND RELEASE
a member of the household must be a citizen, non -citizen national or qualified alien
the sheet and return it to the Inspector, and show him/her a current form of
or other immigration expert if you have any questions.
States.
resides with me and who is a citizen, non -citizen national or qualified
age of minor child:
for FEMA disaster assistance is true and correct to the best of my
FEMA or the State if I receive insurance or other money for the same loss, or if I
for which it was intended.
or conceal any information in an attempt to obtain disaster aid, it is a
criminal and civil penalties, including a fine up to $250,000, imprisonment, or
my application for FEMA disaster assistance may be subject to sharing within
but not limited to, the Bureau of Immigration and Customs Enforcement.
me about my property/place of residence, income, employment and dependents in
and
employer, any public or private entity, bank financial or credit data service to
request.
NAME (print)
SIGN TURE
M
"DATE OF BIRTH
t a i ii (5-,/
DATE SIGNED
I /t ea /I"Cr
INSPECTOR ID #
FEMA A LIGATION #
DISASTER #
ADDRESS OF DAMAGED PROPERTY
134- is ��
CITY
iyec- . t�-,)A
STATE
GA
ZIP CODE
3 (32
FEMA FORM 009-0-3
REPLACES ALL PREVIOUS EDITIONS
Voluntary Participation Form
ELEVATION
FEMA Hazard Mitigation Grant Program (HMGP)
HISTORICAL LOSS INFORMATION: Please attach any photos or historical loss documentation that may be helpful.
I affirm that, to the best of my knowledge, the following information is true and complete.
NAME: Ro602. b DATE: / Ind/fi SIGNATURE:
FIRST FLOOD EVENT Date and Name (if known) of Event: ,
L/L ICA- 16 M i A -t Z ! oh f
Source of Flooding (Body of Water): SALT WATF Back up documentation attached? _ Yes No
Please list the back up documentation source: Depth of flooding: !:
Duration of flooding: +0' S Damages (_ Estimated Known): $
_
Displaced from home: Yes 7 No How long? Types of Damages: ''V r E 2 (0 f W {t (I S
-AJ; • k4 C4r 4._ : 19-130 Li 1i- j ccS , F
Notes: LI -,elf Ccf'S C`tinoc�
SECOND FLOOD EVENT Date and Name (if known) of Event:
(J►g2(Cft A 2rt+^AA Q17 17
Source of Flooding (Body of Water): SALT I,JATE& Back up documentation attached? _Yes ✓o
TH
Please list the back up documentation source: Depth of flooding: 45
Duration of flooding: i't 0 Vets Damages (_ Estimated _ Known): $
No How long? Types of .1 'T ° `- ; l POLYI-) C f
Displaced from home: Yes Damages:
-O., ,.r:-tvfe, -E+�� i.f44 P C a s -S
Notes: C.Jr. oAl=.1-s
THIRD FLOOD EVENT Date and Name (if known) of Event:
Source of Flooding (Body of Water): Back up documentation attached? _ Yes _ No
Please list the back up documentation source: Depth of flooding:
Duration of flooding: Damages (_ Estimated _ Known): $
Displaced from home: Yes No How long? Types of Damages:
Notes:
Voluntary Consent to Enter Property
Our records indicate that you have elected to apply for the Federal Emergency Management Agency's
Hazard Mitigation Grant Program. As part of the application development process, a qualified
professional must develop a rough cost estimate and assess the structure to ensure that implementing
the elevation project is technically feasible.
The purpose of this document is to obtain homeowner consent for Contracted staff to enter the
property located at )3Y L-C—kiis PI V6 IL/ p - - . 6A- , for the purposes stated herein.
The City of Tybee has selected a team of contractors to provide technical assistance and support for the
grant application development process. The purpose for this site visit is to take exterior structure and
property photographs as well as necessary measurements to perform a feasibility study and gather
information for cost -estimating and scoping purposes. It is not necessary at this time to enter the home.
If signed and returned, staff may be assessing properties as early as the week of January 22"d, 2018.
You will be notified via e-mail and/or the phone number you provided with additional details.
P)<A___, 4a/A-f_t_A__/
Property Owner Signature Witness Signature
P oG-6 R ,J (s rEE l /[tai
Print Name Date Print Name Date
J/ice/'s
Homeowner Acknowledgement of Cost Estimate and
Structure Elevation Project Local Match
Owner Name: Roger and Beryl Banister
Property Address: 134 Lewis Avenue, Tybee Island, GA 31328
Phone Number: (912)786-7012
Email:
Dear Mr. and Mrs. Banister;
Through the City of Tybee Island, you have indicated intent to voluntarily participate in an application to
the Federal Emergency Management Agency's (FEMA) Hazard Mitigation Grant Program (HMGP) for DR -
4338 Hurricane Irma, administered through the Georgia Emergency Management Agency. This program
requires a cost -sharing commitment from participants as previously discussed. This notification is
intended to inform homeowners of the total project cost and their estimated financial responsibility if
the grant is awarded. The amounts provided below are estimates. Exact financial responsibility will be
calculated based upon actual project costs, which will be determined following grant award. Per HMGP
program guidance, FEMA may contribute up to 75 percent cost share for eligible project costs. In
addition, as Chatham County received a Presidential Disaster Declaration for DR -4338, the State may
contribute up to 10 percent of the total project cost share. Homeowners are responsible for the local
cost share, the remaining 15 percent share of eligible project costs.
The total cost estimate for the structure elevation project proposed at the above property address is
provided below.
134 Lewis Structure Elevation Cost Estimate
Total Cost
Federal Share Amount
State Share Amount
Local (Homeowner)
Share Amount
$113,384.00
$85,038.00
$11,338.40
$17,007.60
The cost estimate to mitigate your property was calculated using local construction market knowledge
in conjunction with field -collected structure data. Per applicable guidance, FEMA will accept cost
estimates established using nationally published or local cost estimating guides to support the project
cost estimate and determination of cost effectiveness.
It is important to reiterate that the HMGP program is a cost -reimbursement program and actual eligible
costs incurred by the participating homeowner will be reimbursed following the submittal of necessary
supporting documentation should the grant be awarded. Further, the total Federal and State share
amounts shown above, if approved, demonstrate the total amount available for reimbursement to the
homeowner.
By signing this form, I affirm and understand the following:
• I have been notified and understand the total cost estimate of my structure elevation project.
• Participation in the application process and grant program is voluntary.
• Project award and funding is not guaranteed.
• A local engineering firm produced this cost estimate for my structure elevation project. It is
important to note that formal grant application and construction costs will be established after
grant award and prior to the project start date.
• If approved for the grant, I am required to pay the local match to mitigate my home and I have
the resources to meet such requirement.
• I understand that the program is cost reimbursable and that I may be reimbursed at 85 percent
of the actual eligible costs of the project. Reimbursement will occur as requests, using
prescribed forms with all appropriate and required source documentation, are submitted to City
of Tybee Island. Upon grant award, additional information will be provided on the
reimbursement process.
-669L-
Homeo ner Signature
3--‘- /
.15
Commu&ty Official Signature
9"
n4 kta
Date Title
Homeowner Signature
Date
Substantial Damage Estimator
Subdivision
Community
Subdivision
Parcel # 4-0004-14-009
Lot #
Elev. of Lowest Floor
Datum NAVD
ft.
Structure Address
Owner's Name Banister, Beryl
Street Address 134 Lewis Avenue
City Tybee Island
County/Parish Chatham
State Georgia
Zip 31328
Phone
Structure Information
Year of Construction 1970
Residence Type Single Family Residence
Quality Average
Damage Information
Date of
Assessment
inspector Name
Inspector Phone
NFIP Community Name Tybee Island
NFIP Community ID # 135164
Latitude 32.011406 Longitude 80.848206
134 Lewis Ave, Tybee Island, GA 31328
0118*SE (T) LAT: 32.011436 LON: -80.848251 ±16.4ft
Residence Information
10/04/2017
Ron Smith
Date of Damage 09/10/2017
Cause of Damage Flood
Duration of Flood 6 Hours
Est. Depth of Flood 27.00
Above Lowest Floor
No sheet rock cut out. Stuff still in the house
—NFIP Information
Firm Panel # Suffix Date of FIRM Panel Firm Zone BFE Regulatory Floodway
13051CO213 F 09/26/2008 AE 11.00 No
Percent Damaged
Basis for Value of Structure
$44,077.00
Adj. Tax Assessed Value
Percent Damaged
66.0 %
Substantially Damaged
Basis for Cost of Repairs
$29,091.89
Computed Damages
Damage Summary
Computed Damages $29,091.89
Replacement Cost $89,280.00 Percent of Existing Improvements and Repairs Pre -Disaster
Depreciation % 24.2 % Repair/Reconstruction % 43.0 %
Computed Actual Cash Value* $67,674.24
Other Depreciation Explanation
* Per FEMA Publication 213, Actual Cash Value may be used as Market Value.
0.0 %
Optional User Entered Data
Professional Market Appraisal $0.00
Tax Assessed Value $44,077.00
Factor Adjustment 1
Adjusted Tax Assessed Value $44,077.00
Contractor Estimate
$0.00
Community Estimate
$0.00
Authorized Local Official : Authorized Local Official :
Signature Printed Name
Friday, April 13, 2018 Page 1 of 1