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Home My Public Portal AboutBay St_1217 O.M.II. No. 3067-0077 ELEVATION CERTIFICATE xpires May 31,19 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood Insurance purchase requirement. This form is used only to provide elevation information necessary to ensure compliance with applicable community floodpiain management ordinances, to determine the proper insurance premium rate, and /or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMB). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I Fon INSURANCE COMPANY USE BUILDING O■NER'S NAME POLICY NUMBER (� , E HALL STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIL NUMSED ODlER DESCRIPTION (Lot and Block Numbers, etc.) Sr JAN NA f4 t) FA,_ H d Ac(gi.JF i C(—v6 P1--1 se u)r AIZD CITY STATE ziP CODE 7y 8&i= ) s L4 N p, G A . -3 i 5 - ' SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX A. DAIS OF FIRM INDEX 5.5610100E 6. BASE FLOOrt ELF.VAt Orl I �J J f 6 es r J) / (In AO Zones, use depth) 5t' / V I5 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): IANGVO '29 LI Oilier (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the commuriily has established a BFE for this building site, Indicate the community's BFE: I I_ IJ.LJ feet NGVD (or other FIRM datum -see Section B, item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, Indicate the diagrarn number from the diagrams found on pages 5 and 6 that best describes the subject building's reference level 5 . 2(a). FIRM Zones Al - A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of L_LL_f_L_I .L - _i feet NGVD (or other FIRM datum -see Section B, 4e01 7). (b). FIRM Zones Vl - V30, VE; and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I I I I 1 15A feet NGVD (or other FIRM datum -see Section 0, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is L_L.LL 1 feel above I.. 1 or below L_ I (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagrarn is LL .L feet above L.] or below 1 I (check one) the highest grade adjacent to the building. If no flood depth number Is available, is the building's lowest floor (reference level) elevated in accordance with the community's ftoodpialn management ordinance? LI Yews C] No LI Unknown 3. Indicate the elevation datum system used In determining the above reference level elevations: KNGVO '29 Li Other (describe under Comments on Page 2). (NOT: If the elevation datum Used in measuring the elevations is different than that used on the FIRM (see Section 8, Item 7J, then convert the elevations Id (he datum system used on the FIRM and show the conversion equation under Conrnlenfs on Page 2.) r � 4. Elevation reference mark used appears on FIRM: ❑ Yes M,No (See Instructions on Page 4) 5. The reference level elevation is based on: F actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post- construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: U I 1 _ LLi J .feet NGVO (or other FIRM daturn - see . Section 0, Item 7). SECTION 0 COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level Indicated Iii Section C, Item t is not the "lowest floor" as defined in the community's floodplaln management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance Is: 1 1 1 1 1 I.L-I feet NGVD (or other FIRM datum -see Section B, Item 7). 2. Dale of the start of construction or substantial improvernetit TEMA r0 ,, B1 -31, MAY 93 REPLACES All PREVIOUS EbI11O-1S SEE REVERSE SIDE TOR COr4IINUATION ` • .' _ SECTION oER7F)cAnnN ~ This codification |p* be signed by a land survoyor, engineer, or arohltect who Is authorlzed by state or tocal law \ocertify elevation information when the elevation information for Zones A1—A30, AE, All, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law nr ordinance \o provide | Information, ma also sign the certification. In the case ef Zones A0 and A (without a FEMA or conirnunity issued RFB.e building official, a property ownr, owner' repreSentalive may also sign the cefflication. Relerence level diagrams 6, 7 pud9 Distinguishing Features—It the certitier is unable to certity to bteakaway/nori-breakaway wall, enclosure size, location v| servicing equipment, area use, wall openings, m unfinished area Feature(s), then fist the Fealure(s) oot included h` the cv'NicaUou under Comments below. The diagram number, Section S.Item 1, niusl st be entered. / certify that The information i/ Sections 5 and Cnn This certificate represents ny best efforts /o interpret Ueda/a uvu0oblh. /understand that any false statement may be punishable by fine or imprisonment under /VU.S. Code, Section 1001. Bert 13. Barrett, Sr. � Ga. #1239 rcnrmsnoy^vp LICENSE NUMBER (or Affix Seal) R. L. S. — Barrett Land Surveying, Inc. __'-_____-_- ---_ Ill, COMPANY NAME P' 0_ Box 10091 Savannah, Ga 31412 __________ CITY STATE ZIP 2i=lt __ _ _�__ ' /~ __ 1 — gl 2 _ 897-546 O _ ____ om�mone ' DME P ONE Copies should be made ol this Cettificate for: - I) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: __ ' ____'-_--___- on mm on PILES, SLAB BASEMENT nEnS, A V A A V ZONES ZONES t ZONES ZONES ZONES =""�"`. o � �=� [�m] � . - . ~~` /| / ---- _~_- /�� — � � . ADJACELIT:'.' "nERENo "~m �� u,� ��^'~~ �u°.m" \on��m | ��/ vO" ;Li / . ? !•;.\)-'v�/. .�~�� i " ^ `� • T he diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the lop of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. -