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Home My Public Portal AboutSecond Ter_5 TB ci ` /ehb GOGG GSY. G LD cEDERAL 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 I For Inn rance Company Use: BUILDING OWNERS NAME 1 Policy Nurnber FIDELITY CONSTRUCTION, INC. BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company NA1C Number 5SECONDTERRACE I. CITY STATE ZIP CODE TYBEE ISLAND, GA 31326 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc) LOT 7 OF A SUBDIVISION OF LOTS 19 & 20, WARD NO. 1 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) RES LATiTUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( ## ° - #tr ##.##" or ##.#4##$P) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B • FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 1 B2. COUNTY NAME 83. STATE TYBEE ISLAND 135164 CHATHAM GA 84. MAP AND PANEL B7, ';IRM PANEL I B9. BASE FLOOD ELEVATION(S) . NUMBER 85, SU FFIX es. ERA INDEX DATE EFFECTIVEiREViSED DATE B& FLOOD ZONE(S) (Zone A0, use deph of tioadingl 1351640001 C 6/17186 6/17/86 A8 / 16 B10. Indicate the source of the Base Flood Elevation (BFI data or base food depth entered in 89. 0 AS Profile ® FIRM ❑ Community Determined ❑ Other (Describe):, 811. I nchcate the elevation datum used for the BFE in B9: )13 NGVD 1929 0 NOD 1988 ❑ Other (Describe): - B12, Is the building located in a Coastal Barris Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes 1.4 No Designation Date SECTION C • BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Buiding Under Constnictionk Z Finished Construction *A new Elevation Certificate will be required when construction of the building is complete, C2. Building Diagram Number 7 (Select the building diagram most simtarto the building forwhich 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 (w th BFE), VE, V1 - V30, V (with BFE), AR AR/A, AR/AE, AR/A1 - A30, AR/AH, AR/A0 Complete Items C3. - below amording to the building dagram specified in Item C2. Statethe datum used. If the datum Is dfferent from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum oonversion calcuhation. Use the space provided or the Comments area of Sedion 0 or Section G, as appropriate, to document the datum conversion. Datum NGVD 29 Conversion/Comments Elevation reference mark used Does the elevation reference mark used elopes on the FIRM? ❑ Yes IM No o a) Top ofboftorn floor (including basement orendosure) 12. 8 ft.(m) • o b) Top of next higher floor 21.2 ft.(m) 7 4 700:::/ � o c) Bottom of Lov t horizontal structural member (V zones only) NA , ft(m) o o g� o d) Attxhed garage (top of slab) NA, ft.(m) E i 1 w m : ,k' o e) Loruest elevation of machinery and/or equipment servicing the building (Describe to a Comments area) 20 3 t (m) � , v / o f) Lowest a�}aceni (finished) grade (LAG) 11 , 8 ft, (m) �� r o g) Highest adjacent (finished) grade (I-3AG) 12 4 ft.(m) . � o h No. of nnanent openings (flood vents within lit above ad' fit - �' EN . j� F pe ) k' grade 3 8 f z . . o i) Total area of all permanent openings (flood vents) in C3.h 898 sq. In. (sq. cm) ilf SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION '1 This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized oy law to certify elevation informatoor✓. 1 certify that the information in Sections A, 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, CERTIFIERS NAME 1, WHITLEY REYNOLDS LICENSE NUMBER 2249 TITLE LAND SURVEYOR COMPANY NAME ,-- . CITY STATE ZIP CODE 636STEEP NAV II C _,ir SAVANNAH GA 31406 StGNATU // /' ./..._________.----- 1 A 2J�05 912-352-0464 7 7 FEh1A For7.6ll - 31, January 2003 See reverse side for continuation. Replaces all previous editions 1 -d /_R /. /. ?ci RIG spTouRa -i Faros -m r eT+,:Rfl qt7 In on z0 °d Z.S6 LBZL ZS= ETE 6S :BO S00E- 60 – DAG IMPORTANT: In these spaces, copy the cone° °ending information from Section A. Forinsurance Company Use BUILDING STREET ADDRESS (IndUding Apt, Unit, Suite, a ,kdg, No.) OR P.O. ROUTE AND BOX NO. I Policy Number 5 SECOND TERRACE CITY STATE ZIP CODE 1 company NAlc Number TY BEE ISLAND, GA 31328 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED} Copy both sides of this Elevation Certificate for (1) community'Adel, (2) Insurance agentkempany, and (3) building owner. COMMENTS C3.e) = AIC PAD ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONEA(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 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.(rn) _ in,(cm) ❑ above or ❑ below (died( 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 building is — ft(m) _In.(cm) above the highest adjacent grade, Complete items C3.h and C3.1 on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is ft.(m) _In.(cm) ❑ above or ❑ below (cheat one) the highest al acent grade. (Use natural grade, if available). E5. For Zone AO only if no food depth number is available, is thetop of the bottom floor elevated in accordance with the oommunityvs toodplain 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, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA - issued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and Eare correct to the best ofrny 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 ordnance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation CPrtt sate. Complete the applicable itern(s) and sign below. Gf , ❑ The infomtation in Section C was taken from other doarrnentation 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.) 02. ❑ A community official completed Section E for a building located in Zone A (without a FEMA issued or community-issued BFE) or Zone AO. G3_ ❑ The following information (hems 04 -09) is provided for cornmurity floodplain management purposes. G4. PERMIT NUt BER G5. DATE PERMIT ISSUED ` G6, DATE CERTIFICATE OF COVPLIANCEJ0CCUJPANCY ISSUED G7. This pemrt has been issued tor:. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as - built lowest floor ('Including basement) of the building is: ft. (m) Datum: G9. 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 FEMA Form 81 -31, January 2003 Replaces alt previous editions 2 • POr~ 7TH SDTOUa>r ADTZTUm r UT 4. :nn cn n n man