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Home My Public Portal AboutFifth Av_201-B FE^icRAL EMERGENCY MANAGEMENT AGENCY O, M. B. No. 3067 -0077 0 - 5° 7 TIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE �`�� I mportant Read the instructions on pages 1.7. SECTION A- PROPERTY OWNER INFORMATION 1 For Insurance Company Use: BUILDING OWNER'S 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-B FIFTH AVENUE CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lo and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 1-B, 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: L_i GPS (Type): ( # # ° - ' - # " or ##.#414#0) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1, NAP COMMUNITY NAME & COMMUNITY NUN BER B2. COUNTY NAIVE B3, STATE TYBEE ISLAND 135164 I CHATHAM GA B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER 85. SUFFIX 86. FIRM INDEX DATE DATE FLOOD ZONE(S) (Zap AO, use depth of ioodog) 1351640001 C 6/17/86 6/17 A8 12 B10. Indicate the source of the Base Flood Elevation (BFE) data or base fwd depth entered in B9. ❑ FIS Profile ►:1 FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 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 Designaion Date_ SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* r Finished Construction *A new Elevation Certificate will be required when construction of the erg is complete. C2. Building Diagram Number 7 (Select the building diagram most similar to the building for Whit this certificate is being completed - see pages 6 and 7. If no diagrath accurately represents the bulling, provide a sketch or photograph.) C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA AR/AE, AR/A1 -A30, AR/AH, AR/A0 Canptele items C3. -a-i below awaiting to the building gram specified in Item C2 Stale 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/Convnents Elevation reference mark used Does the elevation reference mart used appear on the FIRM? ❑ Yes r No o a) Top of bottom floor (inducting basement or enclosure) 7. 7 ft(m) Ta o b) Top of nand higher floc 16.9 ft(m) w o c) Bottom of lowest horizon ra min structural member (V es only) NA • _ft.(m) on o d) Attached garage (top of slab) 7. 7 ft.(m) E 2 , o e) Lowest elevation of machinery and/or equipment w m servicing the building (Describe in a Comments area) 12.3 ft(m) -Cm W o f) Lowest aclaee nt (finished) grade (LAG) 6.5 ft.(m) z oi / o g) Highest adjacent (finished) grade (HAG) 7. 1 ft.(m) , (' I a a o h) No. of permanent openings (flood vents) within 1 ft. above a rent grade 5 ! / ,.., o i) Total area of all perrnanent openings (flood vents) in C3.h 1685 sq. in. (sq. cm) / # e 4.. SECTION D - SURVEYOR, ENGIPEER, OR ARCHTTECT 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 Con 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 J. It/HITLEY REYNOLDS LICENSE NUMBER 2249 TITLE LAND SURVEYOR COMPANY NAME ADDRESS „ CITY STATE 3P CODE 636 STEPHENS E, . SAVANNAH GA 31405 SIGNATURE/ Zz /7/77 1 912TE1�t 0464 / /. / FEMA Form -31, Januar003 See reverse side for continuation. Replaces all previous editions IMPQRTANT: In these spaces, copy the correspo- "'ng information from Section A. I For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or b, m.) OR P.O. ROUTE AND BOX NO. l Poicy Number 201 -B FIFTH AVENUE CITY STATE ZIP CODE ( 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 olr , (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 (WRHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. lithe Elevation Certificate is intended for use as supporting information fora LOMA or LOMR -F, Section C must be completed. El . Building Diagram Number _(Select the building diagrafn most similar to the building for Which this certificate is being completed — see pages 6 and 7. tf no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) 0 above or 0 below (check one) the highest adjacent grade. (Use natural grade, If available). E3. For Bung 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 piaionn of machinery and/or equipment servicing the building is ft(m) ,_in.(an) 0 above or 0 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 community's l000dplain management ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized i ,ire who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMAMsstu or community- issued BFE) or Zane AO must sign here. The statements in Sections A B, C, and E ere correct to the best of my knowledge. PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS 0 Check here if attachments SECTION G • COMMUNITY INFORMATION (OPTIONAL) The local Acid who is autittrrized by Iaw or aninanoe to adrninisterthe corrrtuunity s ibodplain management ordnance can oomph Sections A, B, C (or E), and G of this Elevation Certificate. Convlete the applicable item(s) aid sign below. GI . 0 The Information in Section C was taken from other documentation that has been signed and embossed by a li censed surveyor, ems, or a chited who is authorized by state or local law to certify elevation information. (Indicate the source and date of the ovation data in the Comments area below.) G2. 0 A community official completed Section E for a building located in Zane A (without a FEMA- issued or community-Issued BFE) or Zone AO. G3. 0 The lolb*ing information (Items G4-G9) is provided for community floodpiain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF CONFUANCFJOCCUPANCY ISSUED G7. This permit has been issued for 0 New Construction 0 Substantia Improvement G8. Elevation of as -built lowest floor (including basement) of the twiidng is: ___ft(m) Datum: G9. BFE or (in Zane AO) depth of flooding at the builting site is: _ _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS 0 Check here if attachments FEMA Form 81 -31, January 2003 Replaces all previous editions