HomeMy Public PortalAboutEagles Nest Dr_120 rtutrcAL tM LKUINUY MANAGEMENT AGENCY 0. 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 I Forinsurance Company Use:
BUILDING OWNER'S NAME I Policy Nurnk)er
FREDA RUTHERFORD
BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number
120 EAGLES NEST DRIVE
CITY STATE ZIP CODE
TYBEE ISLAND, GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 7, EAGLES NEST SUBDMSION
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RES
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ## ° - ##' - ##.##" or ##.##f>r##) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME 83. STATE
TYBEE ISLAND 135164 CHATHAM GA
B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S)
NUMBER 85. SUFFIX 86. FIRM INDEX DATE EFFECTIVE/REVISED DATE 88. FLOOD ZONE(S) (Zone AO, use depth of flooding)
135164 0001 C 6/17/86 6/17/86 A8 12
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 69.
❑ FIS Profile t 4 FIRM ❑ Community Determined ❑ Other (Describe):
B11. Indicate the elevation datum used for the BFE in B9: ►1 NGVD 1929 ❑ NAVD 1988 0 Other (Describe):
B12. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ►4 No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* a Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number 7 (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, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 A30, AR/AH, AR/A0
Complete Items C3. -a-i below according to the building diagram specified 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 29 Conversion/Comments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes a No
o a) Top of bottom floor (induding basement or enclosure) 11. 0 ft(m) 1 ' 0 l ' .
o b) Top of next higher floor 21 .1 ft.(m) " ��
o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft.(m) o o ' e Q � G > S i E RF p •9
o d) Attached garage (top of slab) 11. 0 ft.(m) E ,
o e) Lowest elevation of machinery and/or equipment �'
servicing the building (Describe in a Comments area) 16.5 ft(m) ( 9 e p
o f) Lowest adjacent (finished) grade (LAG) 10.6 ft(m) z m � '` �, O • O v
o g) Highest adjacent (finished) grade (HAG) 18. 7 ft(m) S , '
o h) permanent No. of P -- M
pe openings (flood vents) 1 ft. above adjacent grade 0 .
o i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. crri) / ' 1 'l\
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,
1 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 J. WHITLEY REYNOLDS LICENSE NUMBER 2249
TITLE LAND SURVEY9P /
� f COMPANY NAME
ADDRESS / �� CITY STATE ZIP CODE
636 STEPHENSON AVyf C, SUITE, SAVANNAH GA 31405
SIGNATURE ,� /-..7//7 j 5/3/05 912 - 352-0464
///
FEMA Form r-31, January 103 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
BUILDING STREET ADDRESS (Induding Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Policy Number
120 EAGLES NEST DRIVE _
CITY 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 Certificatefor (1) community offidal, (2) insurance agent/company, and (3) building owner.
COMMENTS
C3.e) = A/C PAD
❑ 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 E1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F,
Section C must be completed.
El. 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 accurately
represents the building, provide a sketch or photograph.)
E2. The top of the bottom floor ( induding basement or endosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (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.(cm) above the highest adjacent
grade, Complete items C3.h and C3.i on front of form.
E4. The top of the platform of machinery and/or equipment senridng the building is ft.(m) _ in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the communitts 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, C (Items C3.h and C3.i 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, B, C, and E are coned to the best of my knowledge.
PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVES NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
❑ 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.
G1. ❑ 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 local 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 G4-G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPUANCE/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 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 TELEPHONE
SIGNATURE DATE
COMMENTS
_ ❑ Check here if attachments
FEMA Form 81 -31, January 2003 Replaces all previous editions