HomeMy Public PortalAboutSecond Av_1514 - DERAL EMERGENCY MANAGEMENT AGE' ',Y O.M.B. No 3067 - 0077
- NATIONAL FLOOD INSURANCE PROGRA. Expires July 31, 2002
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 -7.
SECTION A - PROPERTY OWNER INFORMATION 1 For lrsurance Company Use,
BUILDING OWNER'S NAME I Policy Number
CURTIS J. & CINDY H. HANKS
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. f Company NAIL- Number:':
1514 SECOND AVENUE
CITY STATE ZIP CODE -
TYBEE ISLAND GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) •
LOT34 -B, WARD 4, TYBEE ISLAND .
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.)
RESIDENTIAL .
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##' -##' - ##.##" or ##.#lei## ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other:
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
BI. NFIP COMMUNITY NAME & COMMUNITY NUMBER 1 B2. COUNTY NAME I B3. STATE
CITY OF TYBEE ISLAND - 135164 CHATHAM I GA
84. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S),
NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO, use depth of flooding)
I 135164-0002 C 6/17186 6/1786 AB 13
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other (Describe):
811. Indicate the elevation datum used for the BFE in 89: E NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): _
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA) ?❑ Yes E No
Designation DateN /A
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. Building 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 A1-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 C3a -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 appropriate, to document the datum conversion
Datum NGVD 1929 Conversion /Comments NONE
Elevation reference mark used LOCAL Does the elevation reference mark used appear on the FIRM? ❑ Yes E No
❑ a) Top of bottom floor (including basement or enclosure) 10.21 ft.(m) T
❑ b) Top of next higher floor NONE . ft.(m) N ^0
❑ c) Bottom of lowest horizontal structural member (V zones only)N /A . ft.(m) o . N N.
(')' 6( >
❑ d) Attached garage (top of slab) NONE. _ ft.(m) 2 N
❑ e) Lowest elevation of machinery and /or equipment w 4
servicing the building 10 . 21ft.(m)
❑ f) Lowest adjacent grade (LAG) 8 . 4 ft.(m) z.
❑ g) Highest adjacent grade (HAG) 9. 0 ft.(m) c
❑ h) No, of permanent openings (flood vents) within 1 ft. above adjacent grade N/A t
❑ i) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm) _
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 may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. _
CERTIFIER'S NAME BERT B. BARRETT, JR. LICENSE NUMBER 2225
n -
TITLE PRESIDENT / / J1 n COMPANY NAME BERT BARRETT, JR. LAND SURVEYING, P.C.
ADDRESS / / / / / / / CITY STATE ZIP CODE
145 RIJNNPR ROAM / / / V SAVANNNIAH r:A 314.1f1 _
SIGNATURE I �,,4,} C DATE TELEPHONE
P G J• //! 1? /?? /n1 a12.Rg7_rir- i _
1 — / t" i It _
s 1 U
writ v, i r11 I . . �ra��� ...,Ny uie L:VI I capvuuUIy inrormation rrom section A. I For insurance Company Use:
BUILDING STREET ADDRESS (Including Apt., Unit, F and /or Bldg. No.) OR P.O. ROUTE AND BOX NO, Polley Number -
1514 SECOND AVENUE
CITY STATE ZIP CODE I Company NAIC 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) building owner.
COMMENTS -
❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
or Zone AO and Zone A (without BFE), complete Items El through E4. if the Elevation Certificate is intended for use as supporting
nformation for a LOMA or LOMR -F, Section C must be completed.
El. Building Diagram Number _(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.)
E2. The top of the bottom floor (including basement or enclosure) of the building is — ft.(m) _in.(cm) ❑ above or ❑ below (check one)
the highest adjacent grade.
E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is
ft.(m) _ in.(cm) above the highest adjacent grade.
E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's
floodplain management ordinance? ❑ Yes ❑ No ❑ 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, and E for Zone A (without a FEMA- issued or
community- issued BFE) or Zone AO must sign here.
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 A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below.
31. ❑ The information in Section C was taken from other documentation 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. (Indicate the source and date of the
elevation data in the Comments area below.)
32. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or
Zone AO.
33. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes.
G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE /OCCUPANCY
ISSUED
37. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
38. Elevation of as -built lowest floor (including basement) of the building is: ft.(m) Datum:
39. BFE or (in Zone AO) depth of flooding at the building site is: ft.(m) Datum:
LOCAL OFFICIAL'S NAME TITLE
COMMUNITY NAME TELEPHONE
•
SIGNATURE DATE
COMMENTS — . .. ..__....
❑ Check here if attachments