HomeMy Public PortalAboutPine St_14 6:.6 91296623c: CARL JACKSON PAGE 92/03
FEDERAL EMERGENCY MANAGEMENT AGENCY 0. M. B. No. 3067
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
Important Read the Instructions on pages 1 -7.
— SECTION A - PROPERTY OWNER INFORMATION 1.;f07;01;ir*Oon.r6
.. .-. ::: 7 ' l G MINER'S NAME 1. : ' . : . ., . •
--.: C Smith _._ C. ..
•.- 7 : - -1EET ADDRkSS (Including Apt, Unit. Sulte, and/or Bldg. No.) OR P,O, ROUTE AND BOX NO. P.fT)0)Y-'NNP: NOrribr .. ''
-- ' (\sta e 54' • u.tius) 14
STATE ZIP CODE
17`tle:".0, --Zstar,et GA
_.....,,,... —
7 7 DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
L... 04- ii a ,:r. r .4 LA.,;(7.k" ci , (Tci 10 e a, - 1)) pq .14 -Do 03-02 - .013
'. (e.q.. Residential, Non Ad Acceesory, etc, use a Comments area, tt necessary.)
ts: N.\ (n e I- e.
-. --- -
10NAL) HORIZONTAL:5ATUM: SOURCE: 0 GPS (Type):
0 rim) 1027 I:I NIAD 1983 ID USGS land Map 0 Other
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
\ ' NAME & COMMUNITY NUMBER I g2 COUNTY NAME E3 STATE
135164 i Chathsxn GEORGIA
_ _____. _............. ....,
-
B(. ARM PANEL . .
89. BASE FLOOD ELEVATION(S)
65. SUFFIX B6. ARM INDEX DATE EFFECTIVE/REVISED DATE 68. FLOOD ZONE(S) (Zone A), use depth of loadirg)
IS 51(44 ' .._ C ,„ „,...,... 611 6/17/66 A8 12.0
— .'- --, yr of the Bass mood Elevaroon (BFE) data cr base Itood depTheiiter tin B9,
• FIRM IDGcmmunity Determined El Other (Describe): _
- ' ' -•:-, -,..:/t:-. fielrri vied for the BFE in 139: 2) ND 10 0 VD 1,:; El Other (ascribe):
-; d 'r a Coastal Barrio Resources System (CBRS) area cr Otherv4e Protected Area (OPA)? El Yes E No Deskination Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
... .
-,-.., . ere based or. III Constartion Drawings f=1 BuilIng Uric& Corstructice El Finished Constucticn
:: -, Gertitake WII be requ'red whon ccnstruction of the buklin9 is canpiete.
'7-2 :;:' Dia9 Ntrnber 5 (Select the buidng dagam most similar to the building for Mich this certificate iS being completed - see pages 6 and 7. If no ciagam
-.!.'.' -, the buickig, provice a sketch a pho h.)
tograp
- - - - --- -- ..- A14:30. AE, All, A (WM BI VL, V1 V (YAM EIFE), AR, AR/A, ARIAE, AR/A1 AR/RH, AR/AO
1 - . -- 3"`.C.Cra Ca-a-i beloWticCOrding to the buiding ciagarn speci6ed in ;tern C2. State the (kit= used If the CiailIM is dfferent from the dahrn used fa the BFE in
,..‘..--. e. datum to that used for the BFE. ShoWfiek1 nei4tIn:rnents and datum conversion ca;culation. Use the space provided or the Commits area of
section G, as appropiate, to document the datum conversion.
-.-'-- CorweisiotY0cmcrents
- -- ---.-.. - wed SITE_Does the elevation reference mark used Vpear on the FIRM? 0 We 121 No
.0,,•1//
j,
- • - .-, - : - . -- :".o.7, - ' basement or enciostre) 8.9 ft
tS
i
- - , , - -; f)
';'.; N/Aft ,.,'* / ST
A • 4, . 1.:.
,!‘ -*---- -''' herri7nntal stud' ral mmbar 6/ zones only) ULLA I ;
L-2 ,- " M, t. :-:
...-7se. (tor■ of slab) N/A ft E C' -' , 0 f . -: --
.. . .
x ,
'!'...'5', t4 ermachinety and/ar equIrtnent
-
buffing (D..,cribo in a Comment area) e 4ft_
I 12 1 :4, ,plip 06/
• (finheid) gade (LAG) 7.5 It. 2.0 G (
I 41)
,/ f t Jt.OT". \\"17
(flood vents) vAthin 1 ft. daove acjacent grads NA 3 ii .t el\_
Inn, inkpx, • ,:.,.:* -, of a'i permanent openings (flood vents) in C3,h Y In.
•
SECTION D - SURVEYOR. ENGINEER. OR ARCHITECT CERTIFICATION
... ..
' 7 - 7 '7 `.t.' 5*:: ricred and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information.
- - - '- St A, 8, and C an this certificate represents my best efforts to interpret the data available.
- ,-,' , .-ly ;'Els-e statement Tay be punishabloby fine or imprisonment under 18 U.S. Code, Section 1001. _......,
, 1:-Wr 7 7: CARL R. JACKSON LICENSE NUMBER GA 2555
. .
REdISTVOZE6 LAND LRCie COMPANY NAME A& C Professional Suveying ..._
C ITY STATE ZIP CODE
.. .:- - ;.:^i Hardeeville S.C. 29927
-
_ .. _......-_,
.—') DATE TELEPHONE
1', - 4 ..
7/12/04 912-210-2804
- , -.- -- -.- -2' . ,;vit., dry 2a_152 r..;te reverse aide for continuotion. Renlaceo all orevioue editfont
3/2E 00:10 912966239r CARL JACKSON PAGE 03/03
- " copy the conesponuing information from Section A i-sof 14..;
(lncludng t Unt Suite, ancticr Rt. No) OR P.O. ROUTE AND BOX NO.
STATE ZIP CUD E compery NAlc NI0Oer
GA
SECTION 0-SURVEYOR ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
". Certificate for (1) immunity official, (2) insurance Nentanpany, and (3) bulling owner.
F*rie Bkng
•
ai r el t's
.......
- MOBILE HOME AND SUBDIVISION PRE-DATE FEMA FIRM INDEX & PANEL El Check hom if attxtrnents
LG ELEVA11ON INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT EWE)
BFE), ocmpiete Items El through E4. If the Elevation Certificate is intended fcr uSe as supporting information for a LOMA or LOMR-F,
. - the buidng diatyarn most similar to the tailoring fOr which this cgtificate 15being rttyptpipri — sag pages 6 and7. If no ciagam accurate
provide a sketch or photocjaph.)
`7.-.str fineludng basement or enclosire) of the bulking is ft,(m)__In.(crn) 0 abwe ID below (Check one) the hjghest adjacent glade.
. 6-8 with openings (see pacie 7), the next higher fiocr or elevated flocr (elevation b) of the Witting is ft (m) _in.(orn) above the highest actacent
Comp4ete items 03,h and MI co front of form.
ot maohinery ancYor equprnent serVicing the buitog Is Tim _In.(orn) (7 above or [l] below (check ate) Ue I igl mtat, 119 ade. (Use
: available).
7' ':" If no good depth ntiriber is availEtie, is the top of the bottrm floc( elevated in accordance vitti the carimun tloot.ptain manamnient ordnance?
- - r 'The local official mist certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
cr cutler's nuthortadrecresentative who ccmpletes Sodom A, B, C (Herrn Catt and C3.i onty). and E for Zone A (Nithol it A FFMA-kseted or carrnunity•
c•, Zone AO must sign here. The stdements in Sedons A B, C, and E are camel to the best of my knowledge,
TO ,0%14'S gaTiCINgt AUTILioRI7D REPRESENTATIVES NAME -----
CITY STATE Zlf
-
DATE TELEPHONE
El . _
check here if attxtrients
_
SECTION 6 - CONINIUNITY INFORMATION (OPTIONAL)
aif‘lictized by law or ordinance to administer the canmunity's floccplainnvinagement ordnance can complete Seams A, B, C (or E), and G of us Elevation
xrTie.o the appicabie Item(s) and sign betow.
b in Section C wes wen from other ciccurentation that has been signed and embossed by a licensed styveya; engineer, cr architect viino is authorized by stale
., emotion infoirnation. (Indic2ib the source and date of the elevation data in the Comments erne below.)
, zr, - -. - 1.9.11:.cniplvtod Section E for a building located in Zone A (out FEMA.issued ccrnmunity-issned BFE) or 7.one. AO
irribm-laton (Items G4-G9) is oraided for ccrrrnunity lloociplain management purposes.
G5. DATE PERMIT ISSUED d6;DATE C CF COMPLIANCE/OXUPANCYMUED
- - ;, for 0 New Constructon 0 StbstsntiaIrni.x7ement"
'..;r!rUt fax (Int:luring tesement) of the builcing is: _&(m) Patin:
• ' AO) dePth of toodng at tha buildrtg site is: . ft(m) Palm;
77'`_:S NAME TITLE
TELEPHONE
PATE
. .
El Check here if attxhmeds
•
Replaces ell crevioUS e<lltion$