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Home My Public Portal AboutCenter St_5 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 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 1 For Insurance Company Use: BUILDING OWNER'S NAME I Policy Number ROBERT M. CHU BUILDING STREET ADDRESS (Including Apt, Unit Suite, and/or Bldg. No) OR PD. ROUTE AND BOX NO. I Company NAIC Number 5 CENTER STREET CITY STATE ZIP CODE TYBEE ISLAND GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 3-A OFA RECOMBINATION OF LOTS 2 & 3 OF A SUBDIVISION OF BEACH LOTS 31 -34, WARD 2, TYBEE ISLAND - — — BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RESIDENTIAL LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: Li GPS (Type): ( ##° - ##' - ##.#!X' or ##.#0t## D NAD 1927 D NAD 1983 D USGS Quad Map 0 Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE TYBEE ISLAND, GEORGIA- 134164 CHATHAM GA. l I B4. MAP AND PANEL 87. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE 138. FLOOD ZONES) (Zone AO, use depth of flooding) 135164 --0001 C 6/17/86 6/17 V9 17 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. D FIS Profile ® FIRM D Community Determined D Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 D NAVD 1988 D Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? D Yes 4 No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 01. Building elevations are based on: D Construction Drawings* D Building Under Construction* ► Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. 02. 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 acurately represents the building, provide a sketch or photograph.) 03. 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 C3. -a-i below aooarding to the building diagram spec'if'ied 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 NGVD 1929 Conversion/Comments NONE Elevation reference mark used LOCAL Does the elevation reference mark used appear on the FIRM? D Yes t:1 No o a) Top of bottom floor (including basement or enclosure) 12. 44 ft(m) is; o b) Top of next higherfloor 22.00 ft(m) `� Q o c) Bottom of lowest horizontal structural member (V zones only) 20.00 ft(m) a o o d) Attached garage (top of slab) 12. 44 ft.(m) w o e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) 22.00 ft.(m) E o f) Lowest adjacent (finished) grade (LAG) 11.6 ft.(m) z kN o g) Highest adjacent (finished) grade (HAG) 11. 7 fL(m) N / o h) No. of permanent openings (flood vents) within 1 ft above adjacent grade 4 o i) Total area of all permanent openings (flood vents) in C3.h 1652 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. CERTIFIERS NAME BERT B. BARRETT, JR UCENSE NUMBER GA. 2225 TITLE PRESIDENT 1\ COMPANY \ COMPANY NAME BERT BARRE JR LAND SURVEYING, P.C. 145 RUNNER ROAD SAVANNAH GA STATE 0 31410 SIGNATURE - D4 � /( 1\, DATE TELEPHONE 6/1 912-897-0661 IMPORTANT: In these spaces, copy the cor onding information from Section k j For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt, Unit Suite, anu,or Bldg. Na) OR P.O. ROUTE AND BOX Na f Policy Number 5 CENTER STREET Ctrl STATE ZIP CODE I Company NAIC Number TYBEE 4SLAND 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) bulking owner. COMMENTS THE ELEVATION OF THE OUTSIDE HEATPUMP UNIT (CONDENSER) IS AT 1923' NGVD 1929. ❑ 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, Buliding Diagram Number _(Sued the building diagram most similar to the building for which this certificate is being completed —see pages 6 and 7. ff no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (inducting basement or endosure) of the building is ft.(m)_in.(cm) D above or D blow (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) of the building is ft.(m) _in.(crn) above the highest adjacent grade. Complete items C311 and C3.i on front of form. E4. The top of the platform of machinery andlor equipment servicing the building is _ ft.(m) _ fn.(cm) D above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: tf no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? Yes D No D 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 who completes Sections A, 8, C (Items C3.h and C3i 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, 8, C, and E are correct to the best of my knowledge. PROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME • ADDRESS CITY STATE Z1P CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official whot authorizedhy law or ordnance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the appfieftem(s) and sign below. G1. D 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 focal law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 D A community offidal completed Section E for a building located in Zone A (without a FEMA - issued or community-issued BFE) or Zone AO. 03. D The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED I GS. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED ` r G7. This permit has been issued for. 0 New Construction D Substantial Improvement G8. Elevation of as -built lowest floor (induding 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 TFl FPHONE SIGNATURE DATE COMMENTS