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HomeMy Public PortalAboutNineteenth St_7 U,S, DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE 1 OMB No. 1660.1008 Federal Emergency Management Agency Expires February 28, 2009 National Flood Insurance Program Important: Read the instructions on pages 1 4, SECTION A - PROPERTY INFORMATION I For Insurance Company Use: Ai. Building Owner's Name ROBERT M, CHU I Policy Number A2. Building Street Address ( including Apt., Unit. Suite, and /or Bldg, No.) or PA, Route and Box No. 1 Company NAIC Number tt 7 19 STREET City TYBEE ISLAND Slate GA ZIP Code 3132$ A3. Property Description (Lot and Block Numbers, Tax Parcel Number. Legal Description, etc,) LOT 0 OF A SUB °. OF LOT 115 -A -2, OF A S1180.OF LOT 115•A OF A 8U BD, OF BEACH LOT 115, WARP 5, TYBEE ISLAND A4. Building Use (e.g„ Residential, Non - Residential, Addition. Aottessory, etc.) friESIDENTIA1., A. Latitude /Longitude: Lat, 31,98789 Long. 60. 85047 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 Afi. Attach at least 2 photographs cf the building If the Certificate is being used to obtain flood Insuranca. A7. Building Diagram Number 8 Ad. Fora taultding with A crawl space or enclosure(s), provide A9. For a building with an attached garage. provide: A) Squats footage of crawl space or eno!osUre(s) 474 sq ft a) Square footage of attached garage NONE sq R b) No. of permanent flood openings in the crawl space or b) No, of permanent flood openings In the attached garage enclosure(s)walls within 1.0 knit above adjacent grade s • walls wlthln 1,0 foot above adjacent grads- ta o) Total not arm of flood openings in AS,b N/A sq in c) To net area of flood opening3 In A9.b N/A sq !n • SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION g1. NFIP Community Name a Community Number ' 92. County Name 83. ate fYBEE ISLAND, GEORGIA - 135164 CHATHAM GA. 94. Map /Pan*I Number B5. Suffix I 88, FIRM Index ' 87. FIRM Punt • B. Flood 139, Base Flood Elevation(s) (Rene Date Effective /Revised Date Zone() AO, use paSO to depth) 139164 C I 6/17/69 E/17/66 V9 '17' 910. Indicate the source of the Base Rood Elevation (BFE) data or base food depth entered In Item B9. 0 FIS Profile tdi FIRM © Community Determined © Other (Describe) B11. Indicate eievaton datum used for BFE in item B9: El NOVO 1929 ❑ NAVE] 1988 ❑ Other (Describe) 812, Is tho building located in a Coastal Barrer Resources System (CBRS■ area or Otherwise Protected Area (OPA)? ❑Yes .! No Designation Date N/A 0 CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1, Building elevations are based on; ❑ Construction Drewlrlgs' a Building Under Construction" Irk Finished Construction "A new Elevation Certificate wilt be required whet construction of the bulldIng Is complete. C2. Etevetions - Zones Al -.A30, AE, AH, A (With BFE, VE. V1 -V3P, V (wit$ BFE), AR, AR /A, AR /AE, AR)A1.A2.0, AR /AH, AR /AO. Complete Items C2,a -g below eeoording to the building diagram specified fn Item A7. Benchmark utilized FOCAL Vortical Datum NGVD 1929 Conversion /Comments NON, Chock the measuremeht used, a) Top of bottom floor (including basement, crawl space, or enclosure floor) 9.90 g.i feet ❑ meters (Puerto Rico ony) b) Top of the next higher floor ,1 feet ❑ meters (Puerto Rico only) C) Bottom of the lowest horizontal structural member iV Zones only) 1.Z.2.1 1:4 feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) NONE._ IR) feet © meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 14,1 ® foot ❑ enters (Puerto Rico ony) (Describe type of equipment in Comments) O Lowest adjacent (finished) grade (LAG) 9.2 -+ feet D ureters (Plzen'() Rico ohty) g) Highest adjacent (finished) grade (HAG) 9,4 4 feet 0 meters (Puerto Pee only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certtficabon is to be signed and sealed by a and surveyor. engineer, or architect authorized by few to certify &ovation information, l Corthy that the information or, Mks Coritioate represents my best edfrorta to interpret the datl at' ilable. _-- -�,, understand that any fa/so staatetnent maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. t �' lie t Check hero If comments are provided on back of form. • . .ar Certifiers Nam* BERT B. BARRETT, JR, License Number GA 2225 ,- . " ' �.y TIte PRESIDENT Company Name BERT BARRETT, JR. LAND SURVEYING, P.C. ... _ r , ", . ' , s • Address 145 R N pep City SAVANNAH State GA ZIP Code 31410 v r Signature / Date 3+'12/07 Telephone 912 -89, -0661 LA + v ` if FEMA Form 8141, February 2006 See reverse side /Or Continuation. Replaces all previous editions IMPORTANT: in these spaces, copy the corresponding information from Section A. I For Insurance Company Use: 13tt(Idin Stroei Address (including Apt, Unit, Suits, and/or Bldg. Na) or P.O. Route end Box No. I Palley Number tI7 19 ' STREET mp Y City TYSEE ISLAND Stain GA ZIP Gods 37328 Company NAIL Number SECTION D • SURVEYOR. ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/cornpany, and (3) blinding owner. Comments 1. THE ELEVATION SHOWN iN C2 e) IS THE BOTTOM OF THE Olt. RESERVOIR FOR THE ELEVATOR. 2. ACCORDiNG TO CHUCK RGERON THE CITY MARSHALL FOR THE CITY OF TYSEE ISLAND MOST OF THE FIRST FLOUR IS NOT CONSIDERED E C ED b3ECAUSE OF THE TWO LARGE OPENING WITH LATTICE IN THEM 3.,ARMI IBS LEGEN r UNIT USED FOR LAT /LONG 11 (( Signature , y \ ter -- I r Date 31121D7 Check here if attachments SECTION E • BUILDING ELEVAVON INFORMATION (SURVEY NOT REQUIRED) FOR ZONiE AO AND ZONE A (WITHOUT FIFE) For Zones Ad end A (without iIFE), complete Items Et -ES. if the Certificate is Intended to support a LOMA or LOMR-F request. complete Sections A, 8, anti C. For Items E1 -E4, use natural grade, If ava ilable. Cheek the measurement used. In Puerta Rico only, outer meters, El . Provide elevation information for the fallowing and aheok the appropriate boxes to show utlother the elevation is aibove or below the Highest adieceM grade (HAG). and the lowest ad)acont grade (LAG), a) Top of bottom floor ( including basement, cr wl spaoo, of enclosure) it re. ❑ feet 0 motors 0 above ov or 0 below the HAG, b) Top of bottom floor (including basement, crawl space, or enclosure) s SA, . 0 feet D meters © above or t] betowtho LAG. E2, For 8ulding Diagrams 6-6 with permanent flood openings provided in Section A Items 8 end /or 8 (see page B of Instructions), the next higher floor (elevation C2,b In the diagrams) of the building is 1_ O foot 0 meters 0 above or 0 below the HAG. E3. Attached garage (top of stab) ie Nom, ❑ feet 0 voters 0 above or 0 botowthe HAG, E4, Top of platform of machinery and /or equipment servicing the building is NA. ❑ feat ❑ motors ❑ above or 0 below the HAG E5. Zone AO only; If no flood depth number is available, is the top of the bottom floor elevated In accordance with the community's Hoodpieln management ordinance? 0 Yes ❑ No In Unknown, The local official mfrs! certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION Tho property owner or owners authorized reprasentativa who oompletos Sections A, 8. and E for Zone A (without a FEMA - Issued or community- issued ISFE) or Zona AO must sign here. The statement 1n Seaters A, B. and eA a e-orroct is the best of my knowledge, Property Owner's or Owner's Authorized Representative's Name 1/A Address N/A City N/A Stets N/ ZIP Code N/A Signature NIA Data NIA Telephone NIA Continents NIA _ n Check here If attstchmet SECTION G - COMMUNITY INFORMATION (OPTIONAL.) The local official who is authorized by law or ordinance to administer the community's floodpiain management ordinance can complete Sections A, 8, C (or E), end G ofthls Elevation Cortl1Gate. Complete the applicable items) one sign below. Check the measurement used in Items 08. and G9, 01, ❑ The Information In Section C was taken from other documentation that hes boon signed and sealed by a tiotteed surveyor, engineer, or architect who it authorized by law to certify alovation information, (indioete the sour.* end data of the &ovation data In the Comments area below,) G2. El A community official comp(ated Section E for a building boated In Zone A (v+l,ttwut a FEMA•tasued or community-issued BFE) or Zone AO. 03. 0 The following : nformation (items 04, -G9.) is provided for community ftoodple in management purposes. I G4. Pmmrb Number I GS, Date Permit Issued 08. Date Cortfloatrs Of Compliance /Occurs,ncy Issued N/A N/A f N/A 07, This permit has been issued for: ❑ New Construction ❑ Substantlai Improvement 08. Elevation of es -built lowest floor (Inc udIng basement) of the building: NA, „p foot 0 meters (PR) Datum NZ 08. BFE or (in Zone AO) depth of flooding nt the buiding alto; J A. ❑ feet [] meters (PR) Datum N/A Local Official's Nerry NA Tide NIA Comansnitr Name N/A Telephone NiA Signature NIA Date .NVA Comments N/A f Cftieck are If attachments FEMA Form 81 -31, February 2006 Replaces ell previous editions