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Home My Public Portal AboutFifth Av_201-A C/ FFnERAL EMERGENCY MANAGEMENT AGENCY p g Na. 3067 -0077 TIONAL 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 Careny Use: BUILDING OWNERS NAME I Policy Number R. J. GROOVER CONSTRUCTION CO. BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 201-A FIFTH AVENUE CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Desaiption, etc.) LOT 1-A, TYBEE TRACE SUBDIVISION BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RES. LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type): ( ##° - ##' - ##.##" or ##.#i!### 0 NAD 1927 ❑ NAD 1983 0 USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFP COMMUNITY NAIVE &COMMUNITY NUMBER B2. COUNTY NAME B3. STATE TYBEE ISLAND 135164 CHATHAM GA 84. MAP AND PANEL B7. ARM PANEL 89. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX 86. ARM tNDEX DATE EFFECTTVDREVISED DATE FLOOD ZONE(S) (Zone AO, use depth of tooting) 1351640301 C 6I17/I6 6/17/66 AS 12 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 0 FIS Profile ►Zi FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ► NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): 1312. Is the building located in a Coastal Berner Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date„_,.. J SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: 0 Canso Drawings* ❑ Building Under Construction* ► 4 Finished Construction `A new Elevation Certificate will be required when won of the building is complete. C2. Bulking Diagram Number 7 (Select the building diagram mast similar to the building for which this certificate is being come - see pages 6 and 7. If no diagram accurately represents the bulking, provide a sketch or photograph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR1A1-A30, AR/AH, AR/AO Complete Items C3. -a-i below Ong to the bung &gram 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/Cornme nts Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Ye No o a) Top of bottom floor (inducing basement or enclosure) 7. 7 ft.(m) o b) Top o f nerd higher floor 16 , 9 ft(m) rn o c) Bottom of lowest horizontal structural member (V zones only) NA . ,_ft(m) i o o d) Attached garage (top of slab) 7. 7 ft(m) . � E ( A w i6 `V o e) Lowest elevation o f machinery and/or equipment V servicing the building (Describe in a Comments area) 12.3 ft(m) it o f) Lowest aefiace nt (finished) grade (LAG) 6.5 ft(m) z k , o g) Highest (finished) grade (HAG) 7. 1 ft(m) V ` o h) N of permanent openings (flood vents) within 1 ft. above anent grade 5 \ . r r1 o i) Total area of all permanent ope nincjs (flood vents) in C3.h 1b�85 sq. in. (sq. cm) V SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 1 This certification is to be signed and sealed by a and 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 maybe punishable by fine or imprisonment under 18 U.S_ Code, Section 1001. CERTIFIERS NAME J. WHITLEY REYNOLDS UCENSE NUMBER 2249 TITLE LAND SURVEYOR COMPANY NAME ADDRESS CITY STATE ZIP CO 636 STEPHENSE SUITE CODE SAVANNAH GA 31405 / HONE �% /, / C 11117106 91 2352 -0464 FEMA Forr(81 -31, Jury 2003 See reverse side for continuation. Replaces all previous editions IMFORTANT: In these spaces, copy the correspn-aing information from Section A. I For Insurance Company Use: BUILDING STREET ADDRESS (Indudrg Apt, Unit, Suite, and/or No.) OR P.O. ROUTE AND BOX NO. I Polcy Number 201 - A FIFTH AVENUE - C(TY 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 Certificate for (1) community official, (2) insurance agent/ company, and (3) building owner. COMMENTS C3.e) =A/C PAD [�J 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 BEE), complete items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Salim C must be completed. El . Bulking Diagram Number _(Select the building elagram most similar to the building for Which this certificate is bang 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 (inducing basement or endosure) of the building is — ft.(m) _in.(cm) 0 above or 0 below (check one) the highest adjacent grade. (Use natural grad, if available). E3. For Bang Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ R(m) _in.(cm) above the highest atacent grad. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is ft.(m) __in.(cm) 0 above or 0 below (check one) the highest adjacent grade. (Use natural grad, 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 cornmunitys floodplain management ordnance? 0 Yes 0 No 0 Unknown, The local official must certify tit information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authored representative who completes Sections A, B, C (Items C3.h and C3.i ally), and E for Zane A (wilhaA a FEMA-Issued or community- issued BEE) or Zone AO must sign here. The statements in Suns A a C and E are correct to the best of knowledge. PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS [� Check here if attachments SECTION G • COMMUNITY INFORMATION (OPTIONAL) The loll official whoa authorized by law or ordnance to acininisterthe xatys floodplain management ordnance can complete Sect A, B, C (or E), acrd G of this Elevation Certificate. Complete the thpficable item(s) and sign below. GI.0 The information in Sedtion C was taken from other documentation that has been ski and erticssed by a tioensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Imitate the source and date of the elevation data in the Comments area below.) G2.0 A community official completed Section E fora building locate in Zane A (*tout hout a FEMA- issued or community-issued BEE) or Zone AO. G3.0 The following information (Items G4-G9) is provided for corm unity floodplain management purposes. G4. PERMIT NUNBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CONPUANCEIOCCUPA CY ISSUED G7. This permit has been issued for 0 New Construction 0 Substantial Improvement 08. Bevation of as -built lowest floor (inducing basement) of the building is: ft.(m) Datum: G9. BEE or (in Zone AO) depth of flooding at the buikirg site is: _. _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS 0 Check here if attachrrents FEMA Form 81-31, January 2003 Replaces all previous editions