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Home My Public Portal AboutGabby LN_6 - FEDERAL EMERGENCY MANAEMENT AGF • - - ` O.M.B. No. 3067 -0077 NATIONAL FLOOD INSURANCE PRQGRAP. Expires December 31, 2005 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. S DING NER NAME SECTION A - PROPERTY OWNER INFORMATION f F ltOl r be ornpany. L se: • M R..% CP Cat% BUILDING STREET ADDRESS (including Apt., Unit, Sulte, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. gt)triparjci t+iAlCftdurriber CITY,.,...., STATE ZIP CODE ' ' ! G 4_4..".4 04 C12 i .3/32.6 PROPERTY DESCRiPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) ,_ -c12r 3 MA4 14. TAP-4x Sv,D l2 B UILDING USE (e.g., Residential, Non - residential. Addition, Accessory, etc. Use Comments area if necessary,) E I D .Eg.o..1 Ti 4.-c-.. LAT ITUDEILONGiTUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: LI GPS (Type), (##''- ##' - ###.##" or ##.441441# ) I_I NAD 1927 LI NAD 1983 1__I USGS Quad Map LI Other. _ - �_ _ . SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION i E 1. NFIP GUMr11uNrrY NAME & COMMUNITY NUM$R 1E42. COUNTY NAME B3. STATE Bd. MAP N D PANEL B5. SUFFIX B6. FIRM INbEX B7. FIRM PANEL B8, FL OoD F9. BASE FLOOD ELEVATIONS) DATE EFFECTIVE /REVISED DATE ZONES 1 I C... 0 14, - 1 $ fn 00 - 11 2 Ga AS /Z.0 810, indicate the source of the Base Flood Elevation (5FE) data or base flood depth entered in B9. I_j FIS Profile IX FIRM LJ Community Determined 1 -1 Other (Describe): ... -__- B 11. indicate the elevation datum used for the BFE in Bg: p j NGVD 1929 I_I NAVD 1968 i_I Other (Describe): _- .,,- ,._.... 912. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 Lj Yes N No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: LIConstruction Drawings* 1_llBWlding Under Construction* Jx1Finlshed Construction 'A new Elevation Certificate will be required when construction of the building is complete. 02. Building Diagram Number ( (Select the building diagram most similar to the building forwhich this certificate is being completed - see pages 6 anc 7- if no diagram accurately represents the building, provide a sketch or photograph.) 03. 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 C3.a -I below according to the building diagram specified in Item 02. State the datum used. If the datum is di'ferert 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 npvlded or the Comments area of Section D or Section G, as appropriate, to document the datum cor.ve,sior Q Datum_Ntsa .., 19 2,1 Conversion/Comments ht :-- . __ Elevation reference mark used Does the elevation reference mark used appear on tie FIRM? Yes .?Cl No Oa) Top of bottom floor (including basement or encios.ire) 7 . ell ft.(m) (]b) Top of next higher floor I"7 . (.'f (m) 0 R + . ®c) Bottom of to vest horizontal structural member (V zones only) P4 - A _ ft.(m) -c N` od) Attached garage (top of slab) '7 . jQft. b s \s1 -813 pe) Lowest elevation of machinery andior equipment - i w -52 O ,� servicing the building (Describe in a Comments area.) B (n - ii N0,274 El f) Lowest adjacent (finished) grade (LAG) "7 . 2. (m) .4 -1- 44 : ' O g) Highest adjacent (finished) grade (HAG) 7 ..._.ft (m) g 2 p. rm � . � ; ❑ h) No, of permanent openings (flood vents) within 1 11 above adjacent grade 7 w - vQ U F v'G p� (3 1) Total area of all permanent openings (flood vents) in C3.h'+ /_ 2.2.0 sq. in. (sq. cm) 2 �F�t 1„1 K E 1'' f f SECTION D - SURVEYOR, ENGINEER, DR 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. 1 understand that any false statement may be punishable by fine or Imprisonment under 18 U.S, Code, Section 1001 - CERTIFIER'S NAME LICENSE NUMBER Janes M. Keaton, PLS Georgia #2743 TITLE COMPANY NAME Land Surveyor Chatham Surveying Services, Inc. ADDRESS CITY STATE ZIP G3DE P.O. Box 61649 Savannah Georgia 31 GNATUIRE r ' DATE TELEPHONE • _ 44 • Pl- SEPT' 03, 2bO. 912- 303 -0302 A Form 81 -31, January 2003 SEE REVERSE SIDE FOR C.ONTINt !ATM RFP1 L(^P L(^ Al t Dpl,ir, i■. r„Y y r ut sSe Saaces 'nee corresponum to p1 uo,, ig rn been ILA. " r"oninsurance l.G all V ' gtl)LDING aTREET ADDRESS (Ir: ;lading Apt 'u!te, and /or Bldg. No) OR PA, ROUTE AND BOX NO. 011>ry Nu0b6 Ct STATE ZIP CODE p I?i!C �luTnber SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) C opy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS ..C E ,1+ C• 3,. r -, ":).4. /4 #s (m .iiJ.a s 72) .2 -Co'? - .. rJM 6.36 - /5 11-r,Z" - ''rr"4 : S F"Z,oOfa . . r x/01 e.3C 0 .a.., .e►rre e.e i3 /rJ.s7N /hl 4�•v•'t' p At A 4441 +0 p i - . a r p are Al , - /4i,e. e, 9- 03 -G3. ....- ✓'" '.I ------ LJ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO end ZoneA (without BFE), complete Items El. through E4. If the Elevation Certificate is intended for use as supporting information fora LOMA or LOMB -F, Section C must be completed. El . Building Diagram Number -. (Select the building diagram most similar to the building for wttich 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 1_1 I fl.(m)1 I lin.(cm) J above or 1_1 below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6.8 with openings (seepage 7), the next higher floor or elevated floor (elevation b) of the building is 1_1_1 ft.(m) I— l.._..Itn•(cm) above the highest adjacent grade. E4. The top of the platform of machinery and/or equipment servicing the building is 1JJ ft. (m) (_j ^ I in. (cm) 1_,,,1 above or j_; below (check one) the highest adiacent grade. (Use natural grade, If available.) E6. 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 floodplaln management ordinance? 1_ 1 Yes 1,J No 1_ Unknown. The local official must certify this Information in Section C SECTION F . PROPERTY OWNER OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.11 and C3.1 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, 8, C, end !r are correct to the best of my knowled, e. - _ • . _.. PROPERTY OWNERS OR OWNER'S AU Rl'RESEN IA71VE'S NAME ' ADDRESS CITY STATE ZIP CODE SIGNATURE -`'� DATE TELEPHONE COMMENTS .. �/ . LJ Check here if attachments SECTION G - COMMUNITY INFORMATION {OPTIONAL) . The iacal official who is authorized by taw or ordinance to administer the community'sfloodplain management ordinance can complete Sections A, 8, C (or E), and G of this Elevation Certificate, Complete the applicable itam(s) and sign below. G1, 1__1 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 Me elevation data in the Comments area below.) G2. 1 ^ 1 A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. Cpl. PERMIT NUMBEt3 G5. DATh PERMI . ° ... IFIC .. G3. 11 The following information (Items G4 -G9) is provided for community �oodplain management purposes. ` t lSSUtt7 GG11. t]fit E CERTIFICATE E OF COMPLIANCI='OCCUPAtJCI' i I ISSUED • G7. This permit has been issued for: 1 ^ 1 New Construction Li Substantial improvement GS, Elevation of as- built lowest floor (including basement) of the building Is: ft.(m)Datum: _ GS. BFE or (in Zone AO) depth of flooding at the building site is: __ ft.(m)Datum: _ LOCAL OFFICIAL'S NAME .„ TITLE TELEPHONE COMMUNITY NAME _ — • SIGNATURE DATE COMMENTS / • . - . TOTRL P.0.13