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Home My Public Portal AboutButler Av_1307 t DERAL EMERGENCY MANAGEMENT AGENCY 0. M. B. No 3067 -0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE Impoitzet Read the Instructions on pages 1- 7. SECTION A - PROPERTY OWNER IN TION I For knstraroe Company Use BUILDING OWNER'S NAME 1 Policy Number ALVIN L. DAVIS, INC. BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No) OR P.O. ROUTE AND BOX NO. 1 Company hIAIC Number 1307 BUTLER CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12-A, WARD NO, 4 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if rosary.) RES LAT[TUDEA ONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE ❑ GPS (Type): ( - #f - ##.41/C or ##.##f °) ❑ NAD 1927 0 NAD 1983 0 USGS Quad Map ❑ Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bt NRP BLAND 11351B4NAME &COMMUNITY NUMBER I CHATHAM TY NAME 1 STATE GA 8 ID 4. MAP A PANEL 87. ARM PANEL c,. BASE FLOOD ELEVATIONS) NUMBER B5. SUFFIX 136. FIRM INDEX DATE EFFECT1VBREVISEDDATE 88. FLOOD ZONE(S) (Zone AO, use depth eltloodag) 135184 0002 C 8/17188 6117 :: AS 12 B10. inicate the source of the Base Flood Elev n (BFE) data or base flood depth entered in 89. ❑ FIS Proms ei FIRM 0 Cemnunky Determined 0 Cher (Dry): B11. Inctab the elevation datwn used forthe BFE in :••: ► + NGVD 1929 ❑ NAVD 1' : 0 Other (De e): B12. Is the buffing located in a Coastal Barrier Resources System (MRS) Rea or Otherwise Protected Area (OPA)? 0 Yes ► t No Desigriabon Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl . Building efevaions are based on: 0 Consbuction Drawings' 0 Bribing Under Constriction* CI Finished Construction *A new Elevation Cestificae wil be required when consbuction of the bukkig is comae. C2. Building Diaran Number 1 (Select the buiding diagran most similar to the bricfng for %Midi this oertificate is being canes - see peas 6 and 7. If no diagram accurately represents the bufldbig, provide a sketch or photograph.) C3. Elevation -- Zones AlA30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 -A30, ARIAH, AR/AO Complete Items C3. - below ax oniing to the buidirtg &gran speared in Item C2. State the datum used. If the datum is deferent 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 Cormn arts area el Section ID or Section G, as appropriate, to document the datum conversion. Datum NIGVD 29 Coaversion&Conn neris Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes ES No o a) Top of bottom floor (rnduciirg basement or endosuns) 12 3 L(m) 1 6 s,,0 lEt G jA o b) Top of nod hig serf oor NA . .(m) o c) Batton of lowest horizon structural member (V zones only) NA , t(m) M # � ) �1$T El? z , * o d) Attadned garage (top of slab) 11. 7 ft(m) at n o e) Lowest elevation of mah` y and/or equipment w ' in NO. 2249 j�' servicing the buidrng (Describe in a Camm:nis area) 12.41/. (m) 11 + • 4 , o f) Lowest adjacent (finished) grade (LAG) 11.2 ft(m) 2 tP 4 :6 ' o g) Highest a iacent (finished) grade (HAG) 11. 5 ft, (m) '" SU , ('' o h) No. of permanent openings (flood vents) wilhin 1 ft. above atcacent Bade 2 A r 0, ! �� o i) Tatat area of al permanent openings (flood vents) in C3.h 441 sq. in. (sq. cm) 1 I/ 1 v, SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION i / This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation informati0n. / certify that the information in Sections A, B, and Con 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 J. Whitley Reynolds LICENSE NUMBER 2249 TITLE Land Surveyor COMPANY NAIVE ADDRESS CITY STATE ZIP COCE 636 STEPHENSQ TE C � Saramnafn, GA GA 31405 .. TELEPHONE SIGNATUi // 12/17/05 912- 352 -0464 7,____7- — IMPOIiTANT: In these spas, copy the rats spewing Infonna o n from Section A. , For Insure ee Campo Use BUILDING STREET ADDRESS (Including Apt, UnL. Stye, andlor Bldg. No OR P.O. ROUTE AND BOX NO. Poky Number 1307 BUTLER AVENUE Y STATE ZIP CODE I Company NAIC Number TYBEE ISLAND, GA 31328 SECTION D - SURVEYOR ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certlicate for (1) commonly official, (2) insurance agent/company, and (3) building owner. COMMENTS C3.e) =A/C PAD ❑ Check here if attachments SECTION E - BUILDING ELEVATION WPORMATION (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 es supporting donation fora LO IA or LOMRRF, Section C must be compfetect El. Baking Diagram Number _(Select the bulking cfogram most similar to the btikrng for which this certificate is being completed — sex pages 6 and 7. If no diagram accurately represents the bilking, provide a sketch or photograph.) E2. The top of the bottom floor (ncfur ng basement or enclosure) of the txnldng is ft(m) _in(c m) ❑ aide or 0 below (check one) the lighest adjacent grade. (Use nafurd grade, t amiable). E3. For Building Drams 6-8 with openings (see page 7), the next nigher floor or elevated floor (elevation b) of the budding is ft (m) _in.(cm) above the highest grade. Complete ins C3.h and C3.i on front of form. E4. The top of the platform of mawhinery and/or equipment servicing the budding is ft(m) _jn.(cm) 0 alxwe or 0 below (check one) the highest adjacent grade. (Use natund grade, i a+raiable). E5. For Zone AO or If no flood depth number is amiable, is the top of the bottom floor elevated in accordance with the community's floodpialn management ordnance? ❑ Yes ❑ No ❑ Unknown. The locd official rrust certify this intonation in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representafi+re 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 Zane AO must sign her The sfateme& in Sections A 8, G and E are correct to the best of my knowledge. PROPERTY OWNER'S OR ONNER'S AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The kcal official who is authorized by law or ordinance to administer the community's ik>ocipidn management ordnance can complete Sections A, B, C (or E), and G of this Elevotion Certifico. Complete tin applicable Iem(s) and sign below. G1. [] The information in Section C was taken from other doctmentation the has been signed and embossed by a licensed surveyor; engineer, or arrest who is authorized by state or local lawto certify elevation inform/ion. (I ndrle the source and date of the elevation data in the Comments area below,) G2. ❑ A comrntrity official completed Section E for a budding located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO. G3. ❑ The blowing information (items G4-G9) is prtMded for c mmun ty boodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE CF COMPLIANCE/OCCUPANCY ISSUED G7. This pennit has been issued for ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -bult lowest floor (inducing basement) of the buikting is: . _ft(m) Datum: G9. BFE or (n Zorn AO) doh of flooding at the hulking site is: . ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachments