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Home My Public Portal AboutFifth Av_203-B FEDERAL EMERGENCY MANAGEMENT AGENCY O.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 For Insurance Company 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 203-B FIFTH AVENUE CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lt and Bloc Numbers, Tax Parcel Number, Legal Description, etc.) LOT 2-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: ❑ GPS (Type): ( ##° - ##' - ##.##' or ##.# #°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAIL & COMMUNITY NUMEO2R 1 92. COUNTY NAME 193, STATE TYBEE ISLAND 135164 CHATHAM GA B4, MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATIONS) NUMBER B5. SUFFIX B6. FIRM RsIDEX DATE EFFECT1VEREVISED DATE : ;. FLOODZONE(S) (Zane AO, use depth of Hooding) 1351640001 C 6/17: • 6I17At6 A8 12 810. Indicate the source of the Base Float Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ►:4 FIRM ❑ Community Determined ❑ Other (Describe): _ B11. Indicate the elevation datum used for the BFE in 139: ►Z1 NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building hated in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ►1 No Designation Date... __. SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) - Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Co>strudion* Finish Construction 'A new Elevation Certificate will be required when construction of the buldng is complete. C2. Biking Diagram Number 7 (Select the burg diagram most similar to the buidng for which this certificate is being corndeled - see pages 6 and 7. If no diagram accurately represents the buldng, provide a sketch or photograph.) C3. Elevations - Zones Al.A30, AE, AH, A (w h BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/A0 Complete Items C3. -a-i bear according to the butidrng diagram spedfied in Item C2 Stale the datum used. If the datum is dim 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 ► No o a) Top of bottom floor (inducfing basement or enclosure) 7. 8 ft.(m) d / / o b) Top of next higher floor 16.9 ft(m) a o c) Bottom of lowest horizontal structural member (V zones only) NA . `ft.(m) 3 o o d) Attached garage (top of slab) 7. 8 ft.(m) t 2 RI o e) Lowest elevation of machinery and/or equipment w sevidng the biking ( Descrbe in a Comments area) 12.3 ft(m) o f) Lowest adjacent (finished) grade (LAG) 6.4 ft.(m) i o g) Highest advent (finished) grade (HAG) 7. 3 ft.(m) i ) I o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 5 o i) Total area of all permanent openings (flood vents) in C3.h 1 sq. in. (sq. am) / t°L-- SECTION D - SURVEYOR. ENGMER, OR ARCHITECT CERTFICATION / 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. CERTIFIERS NAME J. WHITLEY REYNOLDS LICENSE NUMBER 2249 TITLE LAND SURVEYOR COMPANY NAME ADDRESS CITY STATE ZIP CODE 636 STEPHE A SUIT _--- SAVANNAH GA 31405 TELEPHONE SIGMA J // 11/17)6 912 V ,''‘--"----C----- FEMA Fo 81 -31, Ja 2003 See re _for continuation. Replaces all previous editions IMP")RTANT: In these spaces, copy the coreeP —coding information from Section A. I For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt, Unit, Suite, ar, .kig. No.) DR P.O. ROUTE AND BOX NO. I Pokcy Number 203-B FIFTH AVENUE - 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 Certificate for (1) community official, (2) insurance agent/company, and (3) Bing 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 El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be carnple#ed. El . Building Diagram Number _(Select the building diagram most similar to the buldng 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 (inducting basement or enclosure) of the building is ft(m) _in.(cm) ❑ above or ❑ below (check one) the highest acacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (see page 7), the nerd higher floor or elevated floor (elevation b) cite buitc uig is _ ft.(m) __in.(an) 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 servicing the building is ft.(m) ❑ above or ❑ bellow (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 iloodplain management ordinance? ❑ Yes ❑ No 0 Unknown. The local official musty this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized , C,,, G:,G i re who completes Sections A, B, C (Items C3.h and C33 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 correct to the best ofmyknowledge- 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 local official who is authorized by lam or ordnance to administer the community's Main management nt ordnance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable iterrn(s) and sign below. G1. ❑ The information in Section C was taken from other documentaidon that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or Zonal 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 lammed in Zone A (without a FEMA -sued 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 partit has been issued for: ❑ New Construction 0 Substantial Improvement G8. Bevatiorn of as-built lowest floor (induding basement) of the buildng is: _ __ft(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site Ls: _. _ ft(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS El Check here if attachments FEMA Form 81 -31, January 2003 Replaces all previous editions