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HomeMy Public PortalAboutMILLER AV_8 O.M.9. NO. 3067-0077 ELEVATION CERTIFICATE Expires May 31, 19 FEDERAL EMERGENCY MANAGEMENT AGENCY . NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood Insurance purchase requirement. This form is used only to provide elevation Information necessary to ensure compliance with applicable corhmuhily tloodplaln Management ordinances, to determine the proper insurance premium rate, and /or to support a request for h Letter of Map Amendment or Revision (LOMA or LOMR). Instructions for completing this form can be found On the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER.5.4AME POLICY NUMBER Al !( Igo rr, AA- o I STREET (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER A'1 /LLE/ 14YF •UE. OTHER DESCRIPTION (Lot and Block Numbers, etc.) L o r/ 0 7, u /q,zL / CITY STATE ZIP CODE T Y3 E ISLA- N A A . 3/ 3 Z8 SECTION U FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. coMMUNIr ' NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. FARM ZONE 6. BASE FLOOD ELEVATION j 3 5 , 1 6 4 00 © G / (In AO Zones, use depth) / G /���ro 1 z- 7.indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ISINGVD ❑Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FiRM, and the community has established a BFE for this building site, indicate the community's BFE :.I 1 I 1 1 1.11 teat NGVO (or other FIRM datum —see Section B, item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level _ , 2(a). FiRM Zones Ai -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram Is at an elevation of 1 1 1 1 1 feet NGVD (or other FiRM datum —see Section B, Item 7). (b). FiRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level horn the selected diagram, Is at an elevation all 1 1 1 1 1 ,❑ feet NGVD or other FIRM datum —see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is 1 1 1.11 feet above El or below ❑ (check one) the highest grade adjacent to the building. • (d). FIRM Zone AO. The floor used as the reference level from the selected diagram Is 1 1 I .0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. N no flood depth number is available, Is the building's lowest (loor (reference level) elevated in accordance with the community's tloodplain management ordinance? Li Yes ❑ No ❑ Unknown 3. indicate the elevation datum system used In determining the above reference level elevations: NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used In measuring the elevations Is different than that used on . the FIRM [see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FiRM: ❑ Yes 1 No (See Instructions on Page 4) 5. The reference level elevation Is based on: actual construction ❑ construction drawings (NOTE: Use of construction drawings Is only valid It the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post - construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building Is:1 1 I 1 I / l,U.leet NGVD (or other FIRM datum -see . Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible tor verifying building elevations specifies that the reference level indicated In Section C, Item i is not the "lowest floor" as defined in the community's fioodplatn management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance Is: 1 I I 1 1 1 .0 feet NGVD (or other FIRM datum — see Section B, Item 7). 2. Date of the start of construction or substantial Improvement . FEMA Form 81-31, MAY 93 REPLACES All PREVIOUS EbITIONS SEE kEVERSE SIDE FOR CONTINUATION SECTION E., CERTIFICATION h,4>IN,Rr SAT : pa!+ This certification Is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al —A30, AE, AH, A (with,BFE),V1— V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management Information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community Issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8 - Distinguishing Features —If the certifier Is unable to certify to breakaway /non;brg0kawamalf,' enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), than list the Feaiure(s) hot` ' Included In the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. 1 certify that the information in Sections 8 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, Bert B. Barrett, Sr. Ga. #1239 CERTIFIER'S NAME L10ENSE NUMBER (or Affix Seal) R.—L. S. Barrett Land Surveying, Inc. TITLE COMPANY NAME P. 0. Box 10091 Savannah, Ga. 31412 ADDRESS CITY STATE ZiP Xd/P1- y 9/ 1- 912 - 897 -5460 SIGNATURE / ()ATE PHONE Copies should be made of this Certificate tor: 1) community official, 2) insurance agent /company, and 3) building owner. COMMENTS: Co,VF2 c T - od,' g11EA/E CA -p e,) g LC_ ON WITN ON PILES, SLAB BASEMENT PIERS, OR COLUMNS A V A A V ZONES ZONES IT ZONES ZONES ZONES . REFERENCE ri.I REFE RENCE I LEVEL REFERENCE LEvEt I\ 1�I ELEVATION 11 _ - LEVEL ` a._,_____ ..� ��- v t� �� —� -'fi `� 1 i -dal B ASE ,. ADJACENT : d REFERENCE B OOB ELEVATION GRADE ' . LEVEL ELEVAI REFERENCE ADJACENT x LEVEL GRADE ) '. ,. . ': AW '• ACENT •'i : ,,:,, :. GRADE The diagrams above illustrate the points at which the elevations should be measured In A Zanes and V Zones. Elevations for all A Zones should be measured at the top of the reference level Iloor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.