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HomeMy Public PortalAboutSecond Av_1116 O.M.B. NO. 3067 -0077 ELEVATION CERTIFICATE Expirof May 31, 1946 FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PIIOGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood Insurance purchase requirement. This form is used only to provide elevation Information necessary to ensure compliance with applicable community Iloodplaln management ordinances, to determine the proper insurance premium rate, and /or to support a request for ra Letter of Map Amendment or Revision (LOMA at LOMR). Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER STREET ADDRESS (Including Apt., Unil Sul le and/or Bldg. Number) On P.O. ROUTE AND BOX NUMBER COMPANY NAIL NUMBER / //4 51 co Ni) * EA.1 01 NER DESCRIPTION (Lot and Block Numbors, etc.) CITY STATE ZIP CODE 7 I3 C Ati 6 4, ; SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1, COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX 5. F'nM ZONE 5. BASE FLOOD ELEVATION (In AO Zones, use depth) _•) 6 y ©c °z c c //7/8 6 g 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BF): ,54,NGVb UOthnr (describe on back) 6. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, Indicate the community's BFE:UUJ_U.0 feet NGVD (or other FIRM datum -see Section t3, Item 7), SECTION C BUILDING ELEVATION INFORMATION i, Using the Elevation Certificate Instructions, Indicate the diagram number from the diagrams tound on t'ageS 5 and 6 that best describes the subject building's reference level _f . 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I 1 1 11_17 .M feet NGVD (or other FIRM datum -see Section B, Item 7). (b). FIRM Zones V1 - V30, VE, and V (with BFE). The bottom of the lowest horizontal structural rneniber of the reference level from the selected diagram, is at an elevation of I I 1 I I IAA feet NGVD (or other FIRM datum-see Section B, Item 7). (c). FIRM Zone A (without BFE). The Moor used as the relerence level from the selected diagram Is I_ I .0 feet above U or below Ill (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram Is I I i.0 feet above U or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number Is available, Is the building's lowest floor (reference level) elevated In accordance with the community's Iloodplaln management ordinance? U Yes U No U Unknown 3. indicate the elevation datum system used In determining the above reference level elevations: 1g NGVD '29 U Other (describe under Comments on Page 2). (NOTE: if the elevation datum used In measuring the elevations Is different than thal used on the FIRM (see Section 13, Item 71, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Continents on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes jr.ANo (See Instructions on Page d) 5. The reference level elevation Is based on: IS-actual construction U construction drawings (NOTE: Use of construction drawings is only valid If the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post - construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade Immediately adjacent to the building is: l I 1 I I ?1.0 .feel NGVD (or other F1RM datum -see Section B, Item 7). • SECTION D COMMUNITY INFORMATION 1. II the community official responsible for verifying building elevations specifies that the reference level indicated In Section C, Item 1 is not the "lowest floor" as defined in the community's Iloodplaln management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance Is: 1 I I 1 1 J,Li feet NGVD (or other FIRM datum -see Section B, Item 7). 2. Data of the start of construction or substonlial improvetneril • FEMA Form 81 -31, MAY 93 REPLACES All i REVIoUS EDITIONS SEE REVERSE SIDE FOR CONiINUATiON SECTION E CERTIFICATION This certification Is to be sighed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation Information when the elevation Information for Zones A1 AE, Al I, A (wilh,BFE),V1 V30,VE, and V (with BFE) Is required. Community officials who are authorized by local law or ordinance to provide floodplain management Information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level (Ham ams 6, 7 and 8 - Distinguishing f=eatures -If the certifier is unable to certify to breakaway /non- breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), Men list the Feature(s) nol included 10 the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. 1 certify that Me information in Sections 8 and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Bert B. Barrett, Sr. Ga. #1239 CERTIrIER'S NAME LICENSE NUMBER (or Allix Seal) -R._ L. S. — Barrett Land _ Surve_yin l — — - - -- 111 LE COMPANY NAME P. 0. Box 10091 Savannah, Ga. 31412 ADDITES � CITY STATE ZiP 2 -6 / G 67 tZ'd ry3k 1 -912 - £397 — 5460 SIGNAT(JnE A lE f NONE Copies should be made of this Certificate for: 1) community official, 2) Insurance agent /company, and 3) building owner. COMMENTS: ON WITH ON PILES, SLAB BASEMENT PIEES, on COLUMNS A V 1� rl A A V Jt ZONES ZONES 1!° ZONES ZONES ZONES - I I ~ hEEEI EI7CE f r1Er Et1ENC - BASE LEVEL fi - GEFEGENCE I yy 77rr'' --�' LEVEL rEVEI I Tl� I r LOCID EL // EVATION i ��-- I y v.� i �_,r 1 _ti a,W aI 1 3`I v eASE EASE N. TIEEENENCE ILDOU ELEVANGN Gram ' J,r IEVEL ELEVANON �NEEEniii A DJACENT Al LEVEL ONAOE j I.1 ,I!. i A D.IACEIIr ,rat , , e{ GNADE The diagrams above illustrate the points at which the elevations should be pleasured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the relerence level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.