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Home My Public Portal AboutSecond Av_1404 F 'RAL EMERGENCY MANAGEMENT AGENCY I _fl .(m) No. 3067 -0077 CE �.. ..ATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE 09 -2 2 -�S 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 RONALD BROWN BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NAIC Number 1404 SECOND AVENUE CITY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 48,A, WARD 4 BUILDING USE (e g Residential. Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RES LATITUDE/LONGITUDE ONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type): ( #� - ##' - ##.##" or ## #°) 0 NAD 1927 0 NAD 1983 0 USGS Quad Map 0 Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP COMMUNITY NAME & COMMUNTY NUMBER B2. COUNTY NAVE B3. STATE TYBEE ISLAND 135164 CHATHAM GA B4. MAP AND PANEL ' 57. FIRM PANEL B9. BASE ROOD ELEVATIONS) ) NUI+h3ER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (ZoneAO, usedeph of flooring) ) 135164 0002 C 6!17185 6)17)86 A8 13 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Prof le ® FIRM 0 Community Determined 0 Cther ( Describe}: B11 Indreate the elevation datum used for the BFE h B9: ® NGVD 1929 0 NAVD 1988 ❑ Other (Describe): B12. Is the building Ixaled in a Coastal Ranier Resources System (CBRS) area or Otherwise Protected Area (CPA)? 0 Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building etevatons are based on: 0 Construction Drawings` 0 Building Under Construdion` ►4 Finished Construction 'A new Elevaton Certificate will be required when construction of the building is complete. C2. Building Diagram Number E (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 anc 7. If nc diagram accurate'y represents the building, provide a sketch or photograph.) C3. Elevations — ZonesA1 -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), A R, AR /A, AR/AE, AR/A1-A30, AR/AH, AR/AO 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 Inc BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calcalation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion Datum NGVD 29 ConversiontCorrrnents Eevation reference mark used Does the elevation reference mark used appear on the FIRM? 0 Yes ® No o a) Top of bottom floor (including basernent or enclosure) 17. 4 ft(m) ro ' f ' b) Top of and higher floor NA , . m V� ,+ � >Ct sE a o c) Bottom of lowest hoizontai structural member (V zones only) NA . ft(m) y e c d) Attached garage (top of slab) fyA, _ ft. E ( ` , o e) Loxest elevation of machinery and/or equipment W o. servicing the building (Describe in a Comments area) 16.7 ft(m) t ` f;" o f) Lowest adjacent (finished) grade ;tAG) 7.4 ft (m) z ° \ :, t∎` 0. su ' a`% o g) Highest adjacent (finished) grade (HAG) 7. & ft(m) \` , ' !i!E`{ o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade D _ . . 0 o t) Total area of all permanent openings (flood vent) in C3 h sq. in. (sq. ar) / 9 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed anc sealed by a land surveyor, engineer, or architect authorized by taw to certify elevation information. I certify Mat the information in Sections A, B, 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. CERTIFIERS NAME J. WHITLEY REYNOLDS LICENSE NUMBER 2249 TITLE LAND SURVEYOR COMPANY NAME ADDRESS CITY STATE ZIP CODE 636 STEPHEN C SAVANNAH GA 31405 SIGNAT U7 jZ f 9/22/0v 2- 352 -0464 FEMA Fm 81 -31, January 2003 See reverse si continuation. Replaces al previous editions 1 d LBLL 2SE 218 splouRa? RaIQTLIM r est —leo SO 22 dos IMPORTANT: In these spaces, copy the corre' ding information from Section A. ` For Insurance Company Use: yy vJJ BUILCING STREET ADDRESS (lndud'rng Apt, Unn, Sui>°, analu, oidg. No.) OR P.O. ROUTE AND BOX NO. I Pofiry Number 1404 SECOND AVENUE CITY STATE ZIP CODE I Company NA1C Number TYBEE ISLAND, GA 31328 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both s.ces of this Elevation Certificate for (1) community official, (2) insurance agent /company, and (3) binding 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 Zone A (without BFE), complete Items El through E4, if the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number _(Select the building diagram most adder to the ouilding for which this certificate is being completed — seepages 6 and 7 If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) he highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floc- or elevated floor (elevation b) of the building is ft.(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and 03.i on front of form. E4. The top of the platform of machinery andior eyrx pment servicing the buildng is _ ft.(m) _i1.(crn) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, it available) E5. For Zone AO only: If no flood depth number is available, is the top of the bottom fioar elevated in accordance with the community's floodpiain management ordnance? ❑ ves ❑ No 0 Unknown. The local official must certify this information in Section 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 C3.1 only), and E for Zone (without a FENA issued or community- issued BFE) cr Zone A0 must sign here The statements in Sections A, a C, and E are corf to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S 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 or ordinance to administer the community's floodplain management ordinance can complete Sections P., B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below, G1 ❑ Theinformaaon in Section C was taken from otherdrumentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indcate the source and date of the elevation data in the Comments area beow.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA - issued or community-issued BFE ) or Zone A0. G3. ❑ The following information (Items G4 -G9) is provided for community floociplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCFJOCJJPANCY ISSUED G7. Th s permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the bolding is: _ . _ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: — _ ft.(m) Datum: LOCAL OFFICLAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑ Check here f attachments FEMA Form 81-31, January 2003 Replaces all previous editions Z'd LBLL as ZTG spjouRay RaigTy11 r eSt' :BO 50 ZZ daS