HomeMy Public PortalAboutDogwood Av_10 FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM Q.M.B. No, 3067 - 0077
Expires December 31, 2005
ELEVATION CERTIFICATE
Important; Read the instructions on pages 1 -7.
SECTION A - PROPERTY OWNER INFORMATION 1 For lrsu<a1ce Carom Use:
BUILDING OWNERS NAME I Poky Number
STUART N. THOMPSON & SALLY M. THOMPSON
BUILDING STREET ADDRESS (Including Apt, Una, Suite. and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number
10 tXJGWOOD AVENUE
CITY STATE ZIP CODE
TYBEE ISLAND GA 31328
PROPEM DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 5, SIDON35, FORTSCREI/EEN WAfI
BUILDING use (e.g., Residential, Non-residential, Addtan, Accessory, etc Use a Comments area, it rosary)
RESIDENTIAL
1ATITJDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type)_
{ A -##' -##.## or PAW) ❑ NAD 1927 LI NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP CONMUNI7Y NAME &COMMUNITY NUMBER 82. COUNTY NAME 1 B3. STAlE
1 TYDEE ISLAND 135164 CHATHAM COUNTY GEORGIA
84. WP AND PANEL B5. SUFFIX ' B6. FIRIUI INDEX B7. FIRM PANEL 1 B8. FLOOD 1 $9, EASE FLOOD ELEVATION(&)
NUMBER DATE EI-i- CTTVEIREVISED DATE ZONE(S) (Zone AO, use depth of flooding)
1351040001 C 6!1711988 6117/1988 A8 13 .
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in BS.
ID Fis Profile 0 FIRM ❑ Community Determined ❑ Other (Describe):
811. Indicate the elevation datum used for the BFE in 89: CI NGVD 1929 0 NAVD 1988 ❑ Other (Describe): -
Ri 2. Ic ma building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yas $.1 No
Designation Date
_—__- -
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Constru on* t.`a Finished Construction
*A now Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number S (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 Al - A30, AE, Ali, A (with BFE), VE, V1 - V3Q, V (with BFE), AR, AR/A, AR/AE, AR/A1 AR/AH, AR/AO
Complete Items C3. -a-i below according to the building diagram specified in item C2. State the datum used. tf 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
caicuiation. Use ice space provided or the Comments area of Section D or Section G, as appropriate. to document the datum (=version
Datum Conversion /Comments
Elevation reference marls used LOCAL Does the elevation reference mark used appear on the FIRM? ❑ Yes ►:< No )
o a) Top of bottom floor (including basement or enclosure) 13. fL(m)
o b) Top of next higher boar 22. it (m} / g � C ` ,
o c) Bottom of lowest horizontal structural member (V zones only) NIA . it.(m) f4 o / % ALI- ' ' -,
o d) Attached garage (top of slab) 13. 2 tt.(m) II ( ; , , . 4
o e) Lowest elevation of machinery and/or equipment e 0 t .. ' I., l
servicing the building (Describe in a Comments area) 13.8 ft (m) E l t
o E
f) Lowest adjacent (finished) grade (LAG) 14.8 ft.(m) . r r -, ` 1 1� . ( , I
o g) Highest adjacent (finished) grade (HAG) 1 t3 ft.(m} _ - el -• st iciw A' •r
o h) No. of permanent openings flood vents) within 1 ft. above adjacent grade N/A f '% � - te'' ' n
o i) Total area of all permanent openings (flood vents) in C3.h WA sq. in. (sq. cm) �,, M �,,,=
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 MICHAEL J. GARDNER LICENSE NUMBER 2285
TITLE REGISTERED LAND SURVrY)R COMPANY NAME WARD EDWARDS, INC.
ADDRESS / CITY STATE ZIP CODE
4700 HWY 80 E SUITE 1 , • 7 ! i , SAVANNAH GA 31410 TELEPH
SIGNATURE ` / I MAY 24, 2004 1 -912 -897 -55460
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