HomeMy Public PortalAboutButler Av_612 U.S. DEPARTMENT OF HOMELAND SECURITY . LEVATI N CERTIFICATE I OMB No. 1660 -0008
Federal Emergency Management Agency Expires February 28. 2009
National Flood Insurance Program important: Read the instructions on pages 1 -8.
SECTION A - PROPERTY INFORMATION I For insurance Company Use:
Al. Building Owner's Name Patriot Homes, LLC I Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1 Company NAIC Number
612 Butler Avenue
City Tybee Island, State GA ZIP Code 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot G-4-2 of a subdivision of lot G-4, ward no. 2
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential
A5. Latitude /Longitude: Lat. N 32 deo 00.324 min Long. W 80 dea 50.626 min Horizontal Datum: ❑ NAD 1927 +_,4 NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number Q
A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide:
a) Square footage of crawl space or enclosure(s) 1600sq ft a) Square footage of attached garage sq ft
b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage
enclosure(s) walls within 1.0 foot above adjacent grade Q walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b 1768 sq in c) Total net area of flood openings in A9.b sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number 62. County Name B3. State
Tybee island 135164 l Chatham GA
B4. Map /Panel Number 85. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone
Date Effective /Revised Date Zone(s) AO, use base flood depth)
135164 0001 C 6/17/86 6/17/86 A8 13
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ► *+ FIRM ❑ Community Determined ❑ Other (Describe)
B11. Indicate elevation datum used for BFE in Item B9: %. NGVD 1929 0 NAVD 1988 ❑ Other (Describe)
1312. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes CI No
Designation Date 0 CBRS ❑ OPA
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. 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 C2.a -g
below according to the building diagram specified in Item A7.
Benchmark Utilized !goal Vertical Datum -
Conversion/Comments
Check the measurement used.
a) Top of bottom floor (including basement, crawl space, or enclosure floor)_ 1Q.5 ►: feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor 241 tr feet ❑ meters (Puerto Rico only)
c) Bottom of the Lowest horizontal structural member (V Zones only) nla. ► :4 feet ❑ meters (Puerto Rico only)
d) Attached garage (top of slab) S.5 r:+ feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 14.1 C4 feet ❑ meters (Puerto Rico only)
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG) 21 ■:.4 feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade (HAG) 10.Q r'i feet ❑ meters (Puerto Rico only)
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 infam 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. R Gd
❑ Check here if comments are provided on back of form. ,s,$T '4'
Certifier's Name J. Whitley Reynolds License Number 2249 G
/ No. 2249 Q
Title Land Surveyclr' / / en Company Name J. Whitley Reynolds, Land Surveying , �' rs O& o
Address 636,$tepp / irens6nu4, Suite C City Savannah, State GA ZiP Code 31405 ' I
it„ I� S � A
Signature✓ ,, Date 6/21/07 Telephone 912 -352 -0464 � ' `
// ./....,...-
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
612 Butler Avenue
City Tybee island, State GA ZIP Code 31328 CompanyNA1C Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two 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." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
rout View Au • ust 13, 2007
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