HomeMy Public PortalAboutBillfish Ln_1 FEDERAL EMERGENCY MANAGEMENT AGENCY IO.M.B. No. 3067 - 0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
sECT iOtd A - f'ROf'ERTY OWN R
FORMATION och siirende' Use:
BUILDiNG OWNER'S NAME m Poilcy Number
. P46. t> E. k Ewe S; td, t r' � � S,7" a v c_ t ®n..t , s A! G . . _
BUILDING STREET ADDRESS (inoluding Apt., Unit. Suite,.andlor Bldg. No.) OR P.O. ROUTE AND BOX NO. I Coany I:G
mp NA'Nurriber
,,
CI I Y STATE ZIP CODE
`7'1'8Ea. t 5e :sa> core C:zas. t 3Z. 8
PROPER TY DESCRIPTION (Lot and Btock Numbers, Tax Parcel Number, Legal Description, etc.)
/. A 2 l- ' A n"i - i`A.Ciss. "'Sf, i 9 v i rJ t C9/./ • .
BUILDING USE (e.g., Residential, Non - residential, Addltion, Accessory, etc. Use Comments area if necessary.)
LATITUDE /LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: jJ GPS (Type):
( I!# t1# - ##.##" or M44UU# °) l_j NAD 1927 Li NAD 1983 Lf USGS Quad Map LJ Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
I 81. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME STATE
C « oc r16- _ % , 4 , t A . " - I ! t.35 ( { (.�a-I,aCT' 44 1 83; Cfl rec,4.�
B4. MAP AND PANEL 85. SUFFIX 86. FIRM INDEX 87. FIRM PANEL • 88. FLOOD B9. BASE FLOOD ELEVATIONS)
NUMBER DATE EFFECTIVE /REVISED DATE ZONES
( 3c,t(0_4 0662 e. 60 1 71 - il(o OCt>m 411 - Vo A8
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89.
1 FIS Profile XI FIRM I I Community Determined Li Other (Describe):
811. indicate the elevation datum used for the BEE in B9: IX NGVD 1929 L.I NAVD 1988 L! Other (Describe):
B12. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? J_J Yes Pal No
Designation Date:
SECTION C - al IILDiNG ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: LJConstruction Drawings` Lit:Wilding Under Construction' J Finished Construction
'`A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number (_ (Select the building diagram most similar to the building for which this certificate is being completed - see I .
pages 6 and 7. if no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations — Zones A1-A50, AE, At A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, AR /AE, AR/A1 -A30, AR/All, ARIAO
Complete Items C3.a - below according to the building diagram specified in item C2. State the datum used. If the datum is different from
the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the s ace provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion.
Datum Mt'JO 11 2 9' ConverslonlComments Alto A.-P.;.7
Elevation reference mark used Does the elevation reference mark used appear on th��s ( No
®a) Top of bottom floor (including basement or enclosure) 7 . i ft.(m) 1 .c(„,t.J Q/ ❑b) Top of next higher floor i 4o . '7 ft.(m) Gt5T ``/
EJ c) Bottom of lowest horizontal structural member (V zones only) - A ft.(m ,n ) Q`G ' %,
lJd) Attached garage (top of slab) s..$— . _ ft.(m) . a A,
(3e) Lowest elevation of machinery and /or equipment w �
b NO. 2743
servicing the building (Describe in a Comments area.) I a . 'I ft.(m) o_ >v > M. i
(] f) Lowest adjacent (finished) grade (LAG) . ft.(m) _ �• ®� / )
Ca g) Highest adjacent ( fnished) grade (HAG) d ft.(m) z m �, 9 I` O Sr� B�1 - � - / �
1� h) Na. of permanent openings (flood vents) within 1 ft. above adjacent grade "' N., M. Ki h , ..
ID i) Total ar of ail permanent openings (flood vents) in C3.h 0 sq. in. (sq. cm) -1 I Z i06 0(0- --�. :;;�: = f
• SECTION D - SURVEYOR ENGINEER. ORARCHITECT CERTIFICATI
This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. l certify that the information in Sections A, B, and C 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.
CERTIFIER'S NAME LICENSE NUMBER
JAMES N. KEATON GA# 274_9
TITLE COMPANY NAME
REGISTERED LAND SURVEYOR CHATHAM SURVEYING SERVICES, INC.
ADDRESS CITY STATE ZiP CODE
P. 0. BOX 61649 SAVANNAH GEORGIA 31420
SIGNATURE J /�_ DATE TELEPHONE
i � s / ?+~S rte- 441...4_ Oen 2./71' (912) 303 -0302
�_ r"
�A For 1 -31, January 2003 SEE REVERSF Rine Fny nor.rrinn iATInKI
IMPORTANT: in these spaces, copy the corresponding information from Section A. 1 For Insurance Company Use: (
BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.U. ROUTE AND BOX NO. § Policy Number
t L-t- t , tit t✓ .o+ n, i
CITY STATE ZIP CODE ( !Company NAIC Number
r)'i .E 1 S�.e - tid,a Gee digG .. ot� 3 - z. 8
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
COMMENTS /TAM e "0.. 1 E.tir-Irre re _ s- Y' E tZ � ►. w-a rk �'^ „ I.._ E • P 'rmsw+'t
C 312 VS 714Ir Fl A. 13 17 J=t O'2.. .j r �M (, 3 . t 5 .fin .a., i2. - r te9.j
c ) A.1' 4 4. s c s . o r? s 2 i t / ! . 7 4 g tr►ear 0-4
2 /tom .a c tit
iC[..- e9c1:0s2 . m1G- l2 t�C®- 2. C,
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT rkCk..to ir.cs.1) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete items E1. through E4. If the Elevation Certificate Is intended for use as supporting
information for a LOMA or LOMR -F, Section C must be completed. /
E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed -
see pages 6 and 7. if no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor (including basement or enclosure) of the building is Lf — ( ft.(m) ( �(_(in.(cm) ! above or (( below
(check one) the highest adjacent grade. (Use natural grade, if available.)
E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b the building is
ft(m) L_(In.(cm) above the highest adjacent grade. A/ - A._
E4. The top of the platform of machinery and /or equipment servicing the building is L_L( ft. (m) I L( in. (cm) ; - _ •
below (check one) the highest adjacent grade. (Use natural grade, if available.)
E5. For 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? LJ Yes Li No L( Unknown. The local official must certify this information in Section a
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, C (items C3.h and C3.i only), 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, C, and E are correct to
the best of my knowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS CITY STATE. ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS ( oki -
L Ch'eek.l .r ' tiirchments
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.
G1. L The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2. L( A community official completed Section E fora building located in Zone A (without a FEMA - issued or community- issued BFE)
or Zone AO.
G3. i( The following information (Items G4-G9) is provided for community floodplain management purposes.
1G4. PERMIT NUMBER - I G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
I ISSUED
G7. This permit has been issued for: LJ New Construction Lj Substantial improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: r ft.(m)Datum:
G9. BFE or (in Zone AO) depth of flooding at the building site is: _ ft.(m)Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
SIGNATURE DATE
COMMENTS t.
Li Check here if attachments
FEMA Form 81 -31, January 2003 REPLACES ALL PREVIOUS EDITIONS