HomeMy Public PortalAboutSecond Av_613 FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067 -0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
EL E_ CERTIFOCATE
Important Read the instructions on pages 1-7.
SECTION A - PROPERTY OWNER INFORMATION I For Insurance Company Use
BUILDING OWNER'S NAME I Policy Number
THE COTTAGE COMPANY
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number
613 SECOND AVENUE
CITY STATE ZIP CODE
TYBEE ISLAND, GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 58-A, WARD NO.2
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RES
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##° - ##' - ##.##A' or ##.#####°) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME B3. STATE
TYBEE ISLAND 135164 CHATHAM GA
B4. MAP AND PANEL 87. FIRM PANEL B9. BASE FLOOD ELEVATION(S)
NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFEC11VE/REVISED DATE 88. FLOOD ZONE(S) (Zone AO, use depth of foaling)
135164 0001 C 6/1786 6/17/86 A8 12
B10. Indicate the source of the Base Rood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other (Describe):
B11. Indcete the elevation datum used forthe BFE in B9: I4 NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe):
812.1s the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 0 No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ► Building Under Construction* ❑ Finished Construction
*A new Elevation Certificate wit be required when construction of the budding is complete.
C2. Building Diagram Number 1 (Sele t the budding dagram most similarto the btuilding for which this certificate is being completed - see pages 6 and 7. ff no dagram
accurately represents the building, provide a sketch or photograph.)
C3. Elevation- Zones Al -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 C3. -a-i below wording to the budding diagram specified in Item C2. State the datum used. If the datum is drfferent from the datum used forthe 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 NGVD 29 Conversion/Cot
Elevation reference mark used Does the elevation reference mark used appear on the RRM? ❑ Yes r .v No
o a) Top of bottom floor (including basement or enclosure) 13. 7 ft. (m) m
o b) Top of ned higher floor NA _ft(m) $OR G44
o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft(m) o o Lk. *
o d) Attached garage (top of slab) NA ft(m) .
L1
o e) Lowest elevation of machinery and/or equipment W NO. 2249
servicing the budding (Describe in a Comments area) = — ft.(m)
o f) Lowest adjacent (finished) grade (LAG) 10.9 ft(m) �tl1 � �
o g) Highest adjacent (finished) grade (HAG) 11. 4 ft.(m)
j m , , + ( 7
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 ea.
o i) Total area of at permanent openings (flood vents) in C3.h sq. in. (sq. an) rr J , \
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.
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 maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CERTIFIERS NAME J. Whitley Reynolds LICENSE NUMBER 2249
TITLE Land Surveyor COMPANY NAME
ADDRESS CITY STATE ZIP CODE
636 STEPHENS UE Savannah, GA GA 31405
SIGNATURE / /' ` (r 3/17/05 912-352-0464