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Home My Public Portal AboutSecond Av_615 ti0 " d %S6 LSLL ES2 E%6 17E:80 S00Z L0 -1fll FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067 -0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION 1 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 NAIL Number 615 SECONC AVENUE CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 59 -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: El GPS (Type): ( ## ° - ##' ##,##" or ##.##It## ❑ NAD 1927 ❑ NAD 1983 0 USGS Quad Map ❑ Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 51. NFIP COMMJNITY NAME & COMMUNITY NUMBER 132 COUNTY NAME 83. STATE I TYBEE ISLAND 135164 CHATHAM I GA 54. MAP AND PANEL 37. FIRM PANEL 59. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FRM INDEX DATE EFFECIIVEREVISED DATE 68. FLOOD ZONE(S) (Lone AO, use depth oI tcodirg) 135164 0001 0 6/17/86 6/17/86 A8 12 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 0 FIS Profile ® FIRM 0 Community Determined 0 Other (Describe): 811. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 0 NAVD 1988 0 Other (Describe): 812. Is the buiding located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Buildng elevations are based m: 0 Construction Drawings* 0 Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2, Builcfing Diagram Number 5 (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, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARIAE, ARJA1 -A30, AR/AH, AR/A0 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 appropoate, to document the datum conversion Datum NGVD 29 Conversion/Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 0 Yes ® No o a) Top of bottom floor (induding basement or enclosure) 14. 211.(m) d , w I (' �'� o b) Top of next higher f loor NA . _ft (m) a 6 ,S' ER "� o c) Bottom of lowest horizontal structural member (V zones only) NA . _ft(m) ° ? I 4 ( o d) Attached garage (top of slab) NA. _tt.(m) € ; o e) Lowest elevation ofrrachinery and/or equipment w 2 a9 5 servidng the building (Describe in a Comments area) 13.8 ft.(m) E 4tii: r' 0 v t o f) Lamest adjacent (finished) grade (LAG) 10.0 ft (m) 2 • ` I1 • ' ` 4 ,A 1 / o o g) Highest adjacent (finished) grade (HAG) 11. 0 fL(m) "1 r[ - �; 0 o h) No. of permanent openings (flood vents) wthin 1 ft. above adjacent grade 0 ----- _ - , o I) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. an) 1 / / ' , SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 7 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 m Sections A, B, and C on this certificate represents my best efforts to interpret the data available, 1 understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'SNAME J. WHITLEY REYNOLDS LICENSE NUMBER 2249 TITLE LAND SURVEYOR /2 COMPANY NAME ADDRESS UE / CITY STATE ZIP CODE 636 STEPH S A UE, gt(ITE C �.--] SAVANNAH GA 31405 SIGNAT // / DATE / 1T, 912-3 4 7 / // / / � FEMA Pot 81 - 314 ivary 2003 , reverse side for continuation. Replaces all previous editions T - d LBLLL aSE ZTG sPlouRaN RaT'i419 r ef'0 =L0 SO LO InC KO` Y.S6 2,822, ESE ET6 sZt seen -ze -Tyr IMPORTANT: In these spaces, copy the corresponding information from Section A. I For Insurance Company Use: BUILDING STREET ADDRESS (kufudiog Apt, Jolt, Suite, and/or Bldg. No.) OR PD. ROUTE AND BOX NO. Poky Number 615 SECOND AVENUE CITY STATE ZIP CODE I Company NA IC Number TYBEE ISLAND, GA 31328 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) but ding owner. COMMENTS C3.e) = NC PAD • ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zane A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information fora LOMA or LOMR -F, Section C must be completed. El Wilding Diagram Number _(Select the building diagram most similar to the bulking for which this certificate is being completed — see pages 6 and 7. If no dagram accurately represents the building, provide a sketch or photograph) E2 The top of the bottom floc" (inducing basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ 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 buiid'ng is ft.(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and C3,i on front of form. E4. The top of the platform of machinery andior equipment servicing the buidng is ft(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). ES. For Zone AO only. If no flood depth number is available, is the top of the bottom floor elevate in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must oertifylhis information in Secton 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 commurrty- ssued BFE) or Zone AO must sign her The statemen s in Sections A 8, C, and E are correctfo thebesf of my knowledge, PROPERTY OWNER'S OR OWNERS AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law cr 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 appficabte item(s) and sign below. G1. ❑ The information in Section C was taken from other documentation that has been s'cned and embossed by a licensed surveyor, engineer, cr architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data it the Comments area below.) G2, ❑ A community official completed Section E for a building located in Zone A (without a FEMA- Issued or community4ssued BFE) or Zone AO. G3. ❑ The fotowing information (Items G4-G9) is provided for community f oodplain management purposes. G4. PERM NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEftCCUPANCY ISSUED G7. This permit has been issued for: [] New Constn ion ❑ Subsiantia' Improvement G8. Elevation of as -built lowest floor Cndudir.c basement) of the building is: _ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooing at the building site is: , _ ft.(m) Datum: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here if attachments FEMA Form B1 -31, January 2003 Replaces all previous editions 'd LBLL 2SE ZTB sptouRaN Rat -tyt r eftu :LD s0 LO Inc