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HomeMy Public PortalAboutButler Av_510 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. 3067 - 0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION I For Insurance Company Use: BUILDING OWNER'S NAME Policy Number THAD REARDON INC BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and / Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number -- 0 CENTER Ia A _h D Ba -r G /j LJ CITY ) /U �C / 1 V STATE ZIP CODE TYBEE ISLAND GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 6 OF A SUBDIVISIONOF BEACH LOTS 35 & 36, WARD 2, TYBEE ISLAND BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type) : (##- ##'- ##.##" or ##.1#414/4) ❑NAD 1927 ❑ NAD1 983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE 135164 CHATHAM GA B4. MAP AND PANEL NUMBER B5. SUFFIX B6. FIRM INDEX DATE B7. FIRM PANEL B8. FLOOD ZONE(S) B9. BASE FLOOD ELEVATION(S) EFFECTIVE/REVISED DATE (Zone AO, use depth of flooding) 1351640001 C 6/17/1986 6/17/1986 A8 14 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile I1 FIRM ❑ Community Determined ❑ Other (Describe) B11. Indicate the elevation datum used for the BFE in B9: II NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Ii No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 5 (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.) C3. Elevations - Zone A1-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 C3a -i 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 space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NONE Conversion /Comments NONE Elevation reference mark used NONE . Does the elevation reference mark used appear on the FIRM? ❑ Yes El No II a) Top of bottom floor (including basement or enclosure) 22.1 ft ( License Number, Embossed Seal D b) Top of next higher floor N/A ft. ( Signature, and Date O c) Bottom of lowest horizontal structural member (V zones only) N/A ft. (m) • d) Attach garage (top of slab) N/A ft. (m) CI e) Lowest elevation of machinery and/or equipment servicing the building 16.8 ft. (m) (Describe in a Comments area) © f) Lowest adjacent (finished) grade (LAG) 11.6 ft. (m) CI g) Highest adjacent (finished) grade (HAG) 12.1 ft. (m) CI h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 CI i) Total area of all permanent openings (flood vents) in C3h 0 sq. in. (sq. cm) 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. 1 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 BERT B. BARRETT SR 1239 TITLE COMPANY NAME R.L.S. BARRETT LAND SURVEYING INC ADDRESS CITY STATE ZIP CODE PO BOX 10091 SAVANNAH GA 31412 SIGNATURE DATE TELEPHONE 8/25/2000 (912) 897 -5460 FEMA Form 81 - 31, January 2003 See reverse side for continuaton. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. I For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Policy Number 0 CENTER PL AVE CITY STATE ZIP CODE Company NAIC Number TYBEE ISLAND GA 31328 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of the elevation Certificate for(1) community offficial, (2) insurance agent/company, and (3) building owner. COMMENTS COMMENTS F.B.(492 -70) ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. 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 I I ft.(m) I I in.(cm) ❑ above or ❑ below 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) of the building is 1 ft.(m) I 1 in.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is I I ft.(m) I I in-(cm) ❑ above or Dbelow 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? ❑ 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 Section A, B, C (Items C3.h and C3.i only), and E for Zone A (without FEIVIA- 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 ❑ Check here if attachments 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. ❑ 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. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. ❑ The following information (Items G4 - G9) 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 is: 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 ❑ Check here if attachments FEMA Form 81 - 31, January 2003 Replaces all previous editions t®A1), FEDERAL EMERGENCY MANAGEMENT AGENCY O.M. No. 3067 - 0077 / NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002 �✓` ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION f For Insurance Company Use: BUILDING OWNER'S NAME I Policy Number THAD REARDON, INC. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 0 CENTER PLACE e` 1 ;' CITY STATE ZIP CODE TYBEE ISLAND GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 6 OF A SUBDIVISION OF BEACH LOTS 35 & 36, WARD 2, TYBEE ISLAND BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ##° - ##' - ##.##" or if#. ) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME I 83. STATE TYBEE ISLAND 135164 CHATHAM i GEORGIA B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX 87. FIRM PANEL B8. FLOOD 89. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding) 135164 0001 C 06/17/1986 06/17/1986 A8 14 BI0. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: /1 NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* r Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 5 (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.) C3. Elevations — Zones A1-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 C3a -i 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 space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum Conversion /Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ❑ No o a) Top of bottom floor (including basement or enclosure) 22. 1ft.(m) o b) Top of next higher floor _ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) _ft.(m) o d) Attached garage (top of slab) _ft.(m) E • o e) Lowest elevation of machinery and /or equipment w " servicing the building 16 . 8 ft.(m) e 11 o f) Lowest adjacent grade (LAG) 11 . 6 ft.(m) z o g) Highest adjacent grade (HAG) 12. 1 ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 o i) Total area of all permanent openings (flood vents) in C3h 0 sq. in. (sq. cm) 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. I 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 BERT B. BARRETT SR. LICENSE NUMBER 1239 TITLEPRESIDENT COMPANY NAME BARRETT LAND SURVEYING, INC. ADDRESS CITY STATE ZIP CODE 4700 HIGHWAY 80 ST SAVANNAH GA 3 , L41n SIGNATURE CC DATE TELEPHONE /t6' 1 , 08/25/0(1 1 9l289-5.40 rrOaA r.._._- n- nI ♦,,n nn nrr r+r, 7r runt n,nr , r,ry I/�A,'�', ♦,, 1AT,ny, pwrn, *n.-n •, , p4„lr,,,Iti, ,n r,�,T,/��,/1 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 0 CENTER PLACE 1- CiTY STATE ZIP CODE Company NAIL Number TYBEE ISLAND GA 31328 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 F.B.(492 -70) ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El 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 _ ft.(m) in.(cm) ❑ above or 0 below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) in.(cm) above the highest adjacent grade, E4. 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? ❑ 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 BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments 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, 8, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below, G1. ❑ 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. ❑ A community official completed Section E for a building located in Zone A (without a FEMA - issued or community - issued BFE) or Zone AO. G3, ❑ The following information (Items G4 -G9) 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 is: _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 ❑ Check here if attachments