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HomeMy Public PortalAboutJones Av_208IMPORTANT: In these spaces, copy the rresponding information from Section A. For Insurance Company Use: BUILDING STREET ADDRESS (Including Apt., Ui Jite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO Policy Number Z. 0 8 7,1-0/%t e5 d8.V -6■VU CITY STATE ZIP CODE Company NAIL Number G1-r:' 0P -re t33Et: 1Sc-- d.A../t) C,EDaa.Cv »A► 3 t 3Z f3 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION JCONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. / TEA4 C3 is .a.v ja /-/7 A.-aGE F*OY!,2 ,d-Atv /=".4., 1,4 1".it_o cj v6r2 -g COMMENTS /14.4. in./ ..e..00,-e... 1 TE.As b / S 71-4 e N A.3 t 1-.0. 05414 Fc_c02 . r6'.44 G 3d tZ A....1 A..t'2 Go^t D' T 1c.)A.1:•2. o"-t .o. w400 ti.t Pt✓ATF0teA4 . %>-i E V 4) JTS `. 19 7- is- p 0 NA t 'r e M S C31, A"-+13 C 3 t .ts.iZ E O N -t-%- s i^` A.r r ►Z na G t= Fe Y 1Z , /C " ' to SECTION E - BUILDING LEVA ION IN ORMATION (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 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 i -1._I ft.(m) 1 ^I__lin.(cm) 1 -1 above or II 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 • uilding is 1_1_1 ft.(m) I_1 lin.(cm) above the highest adjacent grade. E4. The top of the platform of machinery and /or equipment servicing the building is 11_1 ft. (m) 1_j_1 in. (cm 1 I above o _l 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? 1_1 Yes 1_1 No L1 Unknown. The local official must certify this information in Section G. 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 of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE A./ 4-- SIGNATURE DATE TELEPHONE COMMENTS !` - IJIeachments SECTION G - COMMUNITY INFORMATIONSOPTIONAL) 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 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. 1_1A community official completed Section E for a building located in Zone A (without a FEMA - issued or community - issued BFE) or Zone AO. G3, 11 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 G7. This permit has been issued for: 1 New New Construction L Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: G9. BFE or (in Zone AO) depth of flooding at the building site is: LOCAL OFFICIAL'S NAME . ft.(m)Datum: ft.(m)Datum: TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS L_I Check here if attachments FEMA Form 81 -31, January 2003 REPLACES ALL PREVIOUS EDITIONS Fr ORAL EMERGENCY MANAGEMENT AGENCY IONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME BUILDING STREET ADDRESS (Including Apt., Unit, Suite, andlor Bldg. No.) OR P.O. ROUTE AND BOX NO. ©8 3'c�titi ,4.'�Eosi 2 - . . STATE ZIP CODE of Y3 ai iSe.d•va C�EO�Z c,, .. .313Z4g, PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) c7"7- Co 6 r3 ' k y/.o.:2ra /∎l um eb rei3 E E ' Di. G SE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments area if necessary.) (� 5 t T1.d. 4-- LATITUDE /LONGITUDE (OPTIONAL) ( ## °- ##' - ##.##" or ###.44####°) O.M.B. No. 3067 -0077 Expires December 31, 2005 •Foi' #lnsurancetornpany Use: Company::NAI:C'Number HORIZONTAL DATUM: NAD 1927 L NAD 1983 SOURCE: LI GPS (Type): j_j USGS Quad Map jJ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bi.. �NF1P COMMUNITY NAME & COMMUNITY NUMBER 52. COUNTY NAME 1,.. , T t' o TT'r3e TS L :A.A.) 0 1 5 I I -t CN a a. •4(1 B3. STATE 84. MAP AND PANEL 65. SUFFIX B6. FIRM INDEX 57. FIRM PANEL • NUMBER EFFECTIVE /REVISED DATE (36ICoq QOOI C, O49 -17 -SGT B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. {_{ FIS Profile {K{ FIRM 1_1 Community Determined Lj Other (Describe): B11. indicate the elevation datum used for the BFE in B9: j NGVD 1929 Lj NAVD 1988 Lj Other (Describe)• B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? j_{ Yes j>c{ No Designation Date' DATE tfo- (? -8& Be. FLOOD ZONES 1 B9. BASE FLOOD ELEVATION(S) /3 SECTION C - BUILDING ELEVATION INFORMATION SURVEY REQUIRED C1. Building elevations are based on: (_,_ JConstructlon Drawings* LjBuilding Under Construction" j>eiFinished Construction *A new Elevation Certificate will be required when construction of the building is complete. 02. Building Diagram Number (a (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 Al -A30, AE, Ali, 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 C2. 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 �uD (9 Zf Conversion /Comments 42Aia Elevation reference mark used Does the elevation reference mark used appear on the F ' Yes {_{ No ❑a) Top of bottom floor (including basement or enclosure) ( 0 . 5 ft.(m) ❑b) Top of next higher floor (4 77 ft.(m) ❑ c) Bottom of lowest horizontal structural member (V zones only) 1..L A . ft.(m) ❑d) Attached garage (top of slab) /. A. ft.(m) ❑ e) Lowest elevation of machinery andlor equipment servicing the building (Describe in a Comments area.) ❑ f) Lowest adjacent (finished) grade (LAG) ❑ g) Highest adjacent (finished) grade (HAG) ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade ❑ 1) Total area of all permanent openings (flood vents) in C3.h Z 2 b 15 . Z ft.(m) ft.(m) • $ ft•(m) 3 sq. in. (sq. cm) a° wo z r 8 07 /0 IP G \S T I O ;cF N27.13 G /1 /1 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICA ION 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 JAMES M. KEATON REGISTERED LAND SURVEYOR TITLE LICENSE NUMBER GA /I 2743 COIMPTHAM SURVEYING SERVICES, INC. ADDRESS P. 0. BOX 61649 CITY SAVANNAH STATE GEORGIA 31420 ZIP CODE rN ATU R Form 8 -31, January 2003 Z t_ S DATE TELEPHONE z.Y 10 ZOOCQ (912) 303 -0302 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS