The URL can be used to link to this page

Home My Public Portal AboutChatham Av_1701_Unit F U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660 -0008 Federal Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1 -9. SECTION A - PROPERTY INFORMATION I For insurance Company Use: Al. Building Owner's Name I Policy Number 7 � C. . V.../Y&.c.Y 1 ..11L . A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No I Company NAIC Number I'70I C3 A■iE0.1c)a' L2/ ...t tr F City--, State ZIP Code N aga 15L C oaccra..3I32$ Al Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) L,-r D- 2 -2. -A op a 5u3 Divfs1O.1 or Len- D-2 . RecomMMariO4 O •oTS 1_ Z, 3 wars.aCo A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) R E 510E41/43 A. r--- A5. Latitude/Longitude: Lat. NI 31 ° 54 'LS .'( °j Long. \d R Oe51 ` ®T . "7 'f Horizontal Datum: ❑ NAD 1927 � *2 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 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) L i OZ- sq ft a) Square footage of attached garage 1 -11 ). sq ft b) No of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade J within 1.0 foot above adjacent grade X - c) Total net area of flood openings in A8.b 7CaO sq in c) Total net area of flood openings in A9.b Ai A sq in d) Engineered flood openings? Yes ❑ No 9 ®.N4 d) Engineered flood openings? 0 Yes ❑ No "1 ' • SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION C+ CF see lsr�.wstr S I �.'_ 64c0, i d ccr,a B4. Map /Panel Number B5. Suffix B6, FIRM Index B7. FIRM Panel 138. Flood 89. Base Flood Elevation(s) (Zone Date Effective /Revised Date Zone(s) AO, use base flood depth) I3061C- 03ZCa F o4 -z , o9- z, -oe, ad.E 1 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FiS Profile a FIRM ❑ Community Determined ❑ Other (Describe) B11 indicate elevation datum used for BFE in Item B9: ❑ 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 ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* L7 Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al -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 -h below according to tie building diagram specified in item A7. Use the same datum as the BFE. Benchmark Utilized (ASK. 1 V 02 S -47/4/ Vertical Datum N((W) 1929 Conversion /Comments0 RIP 4U13i2.64:rEO riZ0/ WINO I41.'S VAt re> 4810VI/0,427 re, /t(®YD l9 8S Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) i .0 Ii feet ❑ meters (Puerto Rico only) b) Top of the next higher floor . 6 ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) 1 ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 1..4 A• . ❑ feet 0 meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 1 3 , 9 ® feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 7 , ' ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) a _ ® feel ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including A . 3 Eil feet ❑ meters (Puerto Rico only) structural support 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 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.❑ A t O R c , Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a eS GP _ licensed land surveyor? Ca ❑ No 'ERfi Certifiers Name JAMES M. KEATON, RLS License Number GEORGIA #2743 1\40. 274 T itle LAND SURVEYOR Company Name CHATHAM SURVEYING SERVICES, INC. l '' 7 , L p Ad P. 0. BOX 61649 City SAVANNAH State GA ZIP Code 31420 : r SURN � 0 's = , Sign ure Date Telephone 912 - 303 -0302 ; - 5 !i9 t � E - �i. ,e�ezt. J.E.cT. .? 0 7. 2d!/ IMPORTANT: In these spaces, copy the corresponding information from Section A. I For Insurance Company Use: Building Street Address (including Apt., t., Unit, Suite, and /or Bldg. No,) or P.O. Route and Box No. ot C� �— v «9 (iIT F I Policy Number _ C State ZIP Code Company NAIC Number / / YOee L,. •1 , t�t_.eva G, t,a 3132 F SEC`TION 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 T? a► C z . f sill R . 4 . 4 . 0 0 ty i ic.. 4# ACCESS . Cz. /, t 5 i7�d L I- 4a..31 -i .L_6 1=G-oOM . ,T ■•4 C2. e.. t S - E - r►eiC E. alt. Pis Foez 7 )4•14,..e._ E. Q- r i' M r I s 4430v E 1 W.0 #. .2 I C-214- is &RAPE AT- 'T'{F_ serises Si n�atur� AA Date / \ ^ " r ' ∎ s 2,7:0■1130 47, ZO (/ ❑ Check here if attachments \ --.SECtION E - BOLDING ELEVATION INFORMATION (SURVEY NOT RtQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Items El -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters, El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above er ❑ below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8 -9 of Instructions), • next hig floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3, Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. /`.(.- �-• E4. Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ beta • - -. E5. 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. The statements in Sections A, B, 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 ��d l Comments n 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. Check the measurement used in Items G8 and 09. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by 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 04 -09) is provided for community floodplain management purposes. G4. Permit Number 05. Date Permit Issued I 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: 0 feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title / ) Community Name Telephone Signature Date Comments n Check here if attachments