HomeMy Public PortalAboutFirst St_827-A FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067 -0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 200E
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
BARRY A. BROWN
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number
827 FIRST STREET UNIT A
CITY STATE ZIP CODE
TYBEE ISLAND GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 300 -A -1 OF A S/D OF LOTS 300-A OF A S/D OF LOT 300 OF AN EXTENSION OF DAVID THOMAS S/D, FORT WARD, TYBEE ISLAND, GEORGIA.
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RESIDENTIAL
LATITUDEJLONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: D GPS (Type):
( ##° - ##' - ##.#A" or ##.ice# ❑ NAD 1927 D NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE
TYBEE ISLAND, GEORGIA - 135164 CHATHAM GA.
B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S)
NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone A0, 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 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):
812. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date N/A
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
01. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® 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 A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO
Complete Items 03.-a -i below according to the building diagram specified in Item 02. 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 1929 Conversion/Comments NONE
Elevation reference mark used LOCAL Does the elevation reference mark used appear on the FIRM? ❑ Yes ►5 No
I a) Top of bottom floor (including basement or enclosure) 8. 00 ft.(m)
❑ b) Top of next higher flow 17.65 ft.(m) cV
❑ c) Bottom of lowest horizontal structural member (V zones only) N/A . _ft.(m) o o
❑ d) Attached garage (top of stab) 8. 00 ft.(m) t "2
e) Lowest elevation of machinery and/or equipment
servicing the building (Describe in a Comments area) 17.65 ft.(m) § ro c /
❑ f) Lowest adjacent (finished) grade (LAG) 7.2 ft.(m) 4
❑ g) Highest adjacent (finished) grade (HAG) 7. 9 ft.(m) n N
❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 2
1) Total area of ail permanent openings (flood vents) in C3.h 638 sq. in. (sq. cm)
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 BERT B. BARRETT, JR. LICENSE NUMBER GA. 2225
TITLE PRESIDENT _... ...._..___..._....___....__.... _ ........._..._.__ -.- COMPANY NAME BERT BARRETT, JR. LAND SURVEYING, P.C.
A a I a
ADDRESS / / /I .. /I 11 .._..._. _......... _ SAVANNAH.. STATE ZIP CODE
145 RUNNER ROAD
SIGNATURE I .. L.._... 1/ DATE TELEPHONE
12/06 912 - 897 -0661
FEMA Form 81 -31, January 2003 u See reverse side for continuation. Replaces all previous editions
IMPORTANT:" In th ' : rresponding inform -� o nom Sectton =a :or Insurance Company Use:
BUILDING STREET ADDRESS (Inducting Apt, Unit Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO, Policy Number
827 FIRST STREET UNIT A
CITY STATE ZIP CODE Company NAIC Number
TYBEE ISALND GA 31328
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community offidal, (2) insurance agent/company, and (3) building owner,
COMMENTS
THE Fl FVATION OF THE OUTSIDE HEATPUMP UNIT (CONDENSER) IS AT 15.43' NGVD 1929.
❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone A0 and Zone A (without BFE), complete Items El through E4, tithe Elevation Certificate is intended for use as supporting information for a LOMA or LOMB 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 (including basement or enclosure) 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 servicing 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 community's floodplain management ordinance?
❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section a
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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 correct to the best ofmyknowledge.
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
N/A
ADDRESS CITY - - - - - --
STATE ZIP CODE
N/A N/A NA NA/
SIGNATURE — DATE TELEPHONE
NA/ N/A N/A
COMMENTS N/A
WA
NIA ❑ 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 A0.
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 COMPLIANCE/OCCUPANCY ISSUED N/A
N/A NN
G7, This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (induding basement) of the building is: NN. _ft.(m) Datum: N/A
G9, BFE or (in Zone AO) depth of flooding at the building site is: NA/ . — ft.(m) Datum: N/A
LOCAL OFFICIAL'S NAME N/A TITLE NA/ - — COMMUNITY NAME N/A TELEPHONE NN
SIGNATURE N/A _.. DATE N/A
COMMENTS N/A
N/A
N/A ❑ Check here if attachments
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FEMA Form 81 -31, January 2003 Replaces all previous editions