HomeMy Public PortalAboutHorsepen Pt Dr_18 U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE I OMB No. 1660 -0008
Federal Emergency Management Agency Expires March 31, 2012
National Flood Insurance Program Important: Read the instructions on pages 1 -9.
SECTION A - PROPERTY INFORMATION I For Insurance Company Use: 1
Al. Building Owner's Name I Policy Number
•
Thomas R. Ellis
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. I Company NAIC Number
18 Horse Pen Point Drive
City State ZIP Code
Savannah (Tybee Island) Georgia 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 9, Horse Pen Point Subdivision, Tybee Island - P.I.N. 4- 0013 -01 -010
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential
A5. Latitude /Longitude: Lat. 32.00139 °N Long. 080.85597 °W Horizontal Datum: ❑ NAD 1927 1 NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 1 ,
A8 For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 950 sq ft
b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b 140 sq in
d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ■ No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
.
B1. NFIP Community Name & Community Number B2. County Name B3. State `°"
Tybee Island 135164 Chatham Georgia
B4. Map /Panel Number B5. Suffix B6. FIRM, Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone
Date Effective /Revised Date Zone(s) AO, use base flood depth)
13051'C' - 0213 'F' 9/26/08 9/26/08 AE 13.0'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile I FIRM ❑ Community Determined 0 Other (Describe) GIS Manning
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ►Z1 NAVD 1988 ❑ Other (Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 4 No
Designation Date ❑ CBRS ❑ OPA
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 building is complete.
C2. 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 C2.a -h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized SMB '2S' -82 Vertical Datum 1988
Conversion /Comments
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 13.8 ►Z1 feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor N /A. ® feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontal structural member (V Zones only) N /A. ® feet ❑ meters (Puerto Rico only)
d) Attached garage (top of slab) 8.4 A feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 13.6 0 feet ❑ meters (Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 7.5 ►1 feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade next to building (HAG) 11.8 0 feet ❑ meters (Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N /A. 5 feet El meters (Puerto Rico only)
structural support
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. l certify that the information on this Certificate represents my best efforts to interpret the data available.
1understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �� i 1 t l 1 I 11/ ``+
@ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a 0, sC9i F.,9 s
licensed land surveyor? 2 Yes ❑ No �' f •''•.• i, j
Certifiers Name License Number :
Carl R. Jackson Ga.2555 2"144- •;
Title Company Name F
Ga. Registered Land Surveyor Carl R. Jackson Land Surveyor, Inc. = ., ' // p •
Address City State ZIP Code .- ♦ ,• . 0
411 Pine Street / Bloomingdale Ga 31302 s �•'• ••'.�� a t
Signature Date Telephone 0 ,if ' , - 1, , 1
``'1 d 2/21/11 988 -3355 or 596 - 2189 .7 /� •, 1 °1 ; ;;'g11% 1 ‘