HomeMy Public PortalAboutSecond Av_1015 Jun 28 11 01:10p Brian Short 404 - 847 -0669 p.1
FEDERAL EMERGENCY MANAGEMENT AGENCY 0.M.B. No 3067 -0077
NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005
ELEVATION CERTIFICATE
Important: Read the instructions on paqes 1.7.
SECTION A - PROPERTY OWNER INFORMATION I For Insurance Company Use I
BUILDING OWNER'S NAME I Policy Number
BRIAN J. SHORT & PATRICIA MARTIN SHORT
BUILDING STREET ADDRESS (Including Apt., Unft, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 1
1015 SECOND AVENUE
CITY STATE ZIP CODE
TYBEE ISLAND, GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description. etc.)
LOT 64-A, WARD 3, TYBEE ISLAND
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, ifnecessary.)
RES
LATITUDEJLONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##° -##' - ##•##f' or ##.atemr) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
1 B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME B3. STATE
TYBEE ISLAND 135164 • CHATHAM GA
B4. MAPAND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S)
NUMBER - 135. SUFFIX 136. FIRM INDEX DATE EFFECTNEIREVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of Reeding)
135164 0002 C 6117186 6/17/86 A8 12
510, Indicate the source of the Base Flood Elevation (BFE) data cr base flood depth entered in B9,
❑ FIS Profile E FIRM ❑ Community Determined - ❑ Other (Describe): _
511. Indicate the elevation datum used for the BFE in B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other (Deso1 ):
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No Designation Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction" E Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Buildng Diagram Number 1 (Select the building diagram most similar to the building forwhictr this certificate is being campleled - see pages 6 and 7. If no diagram
accurately represents the building, provide a sketch cr photograph.)
C3, Elevations —Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARIAE, ARIA1 -A30, AR/AH, ARRAD
Complete Items C3 -a-i below according to the buid ng 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 appropriate, to document the datum conversion.
Datum NGVD 29 Conversion/Comments
Elevation reference mark used Coes the elevation reference mark used appear on the FIRM? ❑ Yes E No .
o a) Top of bottom floor (including basement or endosure) 8. 2 ft.(m) Qi
o b) Top of next higher floor NA . _fi.(m) a ; �e Q � p1ST .9
o c) Bottom of lowest horizontal structural member (V zones only) NA , ft.(m) N
o d) Attached garage (top of slab) NA. _ft (m) E E No No r4• / tl
o e) Lowest elevation of machinery and/or equipment w Q q
servicing the buid'ing (Describe in a Comments area) 10.61t.(m) E ` 44: ° ' .
o f) Lowest adjacent {finished) grade (LAG) 7.9 ft.(m) z m Alp S LI M *, '
o g) Highest adjacent (finished) grade (HAG) 8. 2ft.(m) L ''AC ` 1TL E'( • j' ii, o h) No. of permanent openings (flood vents) within 1 ft. above aclaoent grade 0 2 i ail 0
o ) Total area of all permanent openings (flood vents) in C3. h sq. in. (sq. cm) ---'/ '
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION /
is certification is to be signed and sealed by a land surveyor, engineer, or ar chitect ai ith o r ized by lev to ce rtify elevation inrnran�
mti
Th y .. _ ... _ ..
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.
CERTIFIER'S NAME J. Whitley Reynolds LICENSE NUMBER 2249
TITLE Land Surveyor COMPANY NAME CODE
636 ADDRESS PHF E, ITE C SAVANNAH STATE 31P
S(GNATUI E / 7 77 71 / 10/13/04 9 2352-0464
FEMA For 81 - 31, January 2003 .- See reverse side for continuation. Replaces all previous editions