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Home My Public Portal AboutSeventeenth Pl_3 -'Y ELEVATION CERTIFICATE 1 OMB NO 1660 -0008 r ` u. DEPAR r u1F.NT OF HOMELAND SECuRt i i Expires February 28. 20.09 Federal Emergency Management Agency National Flood Insurance Program important: Read the instructions on pages 1 -8. SECTION A - PROPERTY INFORMATION , For Insurance Company Use Al. Building Owner's Name. Tybee Beach. LLC I Policy Number A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) of P.O. Route and Box Na . I Company NAIC Number 3 Seventeenth Place city Tybee Island, State GA ZIP Code 31328 /A3. Prop Description (Lot and Block Numbers, Tax Parcel Number, Legal Description., etc.) Pt. parcel 4, beach lot 107, ward 5 M. Building Use (e.g., Residential, Non - Residential, Addition. Accessory, etc.) rest rtlia. A5. Latitude /Longitude: Let N 31deg_59.381min long. VV 80 deg 50.907 min Horizontal Datum. ❑ NAr? 1927 Et NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number f A8. For a building with a crawl space or enclosure(s), provide Ag. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) 300 sq ft a) Square footage of attached garage sq ft h) No. of permanent flood openings in the crawl space or b) No_ of permanent flood openings in the attached enclosures) walls within 1.0 foot above adjacent grade 5 walls within 1.0 foot above adjacent grade -,._ c) Total net area of flood openings in AB.b 518. sq ..in e) Total net area of flood openings in A9.b ,- , ,• sq in SECTION B _ FLOOD ..... _ _ Lo£JEl itUSURANc>C RATE MAP (FIRM) INFORMATION 1 61. NEIP Community Name & Community Number i B2. County Name 1 B3. State { T Island 135164 , Chatham 1 GA t 64. Map /Panel Nurnber i B5. Suffix 66 FIRM index B7. FiRM Panel i 88, Flood { 69 Base Flood Elevation(s) (Zone i Data Effective /Revised Date I Zone(s) I AO, use base flood depth) 135164 0002 I C 6/17/86 6 /17/86 VS I 16 __.._ ___ -_� .- _�...___..,.._._ .__.._ _.,..__.___ ._._� _ .____.______I._ ___ _ �.._ - - -- 610. indicate the source of the Base Flood Elevation (BEE) data or base flood depth entered in Item B9. 0 FiS Profile El HEM ❑ Community Determined 0 Other (Describe). __,, 611. indicate elevation datum used for BEE in Item E9 0 NGVD 1929 0 NAVD 1988 Li Other (Describe) _____... 612. la the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? UYes 0No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl Building elevations are based on: 0 Construction Drawings" 0 Building Under Construction' 0 Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C%. Elevations - -Zones Al -A30, AE, Al-i, A (with BEE), VE, V1 -V30, V (with BEE), AR, AR /A ARiAE, AR/Al-A30, ARIAH, AR /AO. Complete Items C2.a -g below according to the building diagram specified in item A7. Benchmark Utilized local Vertical Datum NGVD 1929 Conversion /Comments - .., . Check the measurement used. a) Top of bottom floor (including basement. crawl space. or enclosure floor,_ 8.5 El feet 0 meters (Puerto Rico only) b) Top of the next higher floor 16 7 ►e feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) 16.0 ISI feet 0 meters (Puerto Rico only) dl Attached garage (top of slab) n /2.._... _ ►.< feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building ,5 7 21 feet ❑ meters (Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent (finished) grade (LAG) 8.9 !F feet 0 meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) £ 1 feet 0 meters (Puerto Rico only) 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. l certify that the information 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 US. Code, Section 1001. o s - 0 Fi a . 14-N E1 Check here if comments are provided on back of form 1 e5T t , Ceriifier's Narne J. Whiney Reynoicis License Number 2249 - 249 * CA 1i j�n �vfe. ...,.�(3 �' Title Land Surveyor Company Name Whitley Reynolds, Land Surveying C J L - s gq /utdress 636 S / hg son ,r ✓ Suia$'t' City Savannah State GA 21P Code 31405 f i c tf l -�4' . ,.' _ .._ .� __L __- ...._ -. _. - ._...___.. _ ______ - _._. -___ _ _..__ ..__.._.._ .. - � .J'rp 'yam Signature/ ' /; i Date 2/23/01 Telephone 912-352-0464 f r,>✓ E �. f A / r c...1 u' um: +/a 1.2 p's � n hn these snack, copy the �0�fvnna§m*from Seu�un�� / For Insurance Company Use: e . | Address Apt.. and/or m^)mpo�Rvv��wm�m� Policy Number -~- - u Seventeenth Place _ City Tybee Island, State GA ZIP Code 31328 Company NAIC Number SECTION 'SnRv�YmR Emn|NEEFLORA��H|TE[��R�FN�ATK��y��0��U��> ------ ' --- __- ''- - - ~_~_-~ Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company. and (3) building owner. nirnei de in Sectip isTStiiT area. It does noi include elevator shaft. As shown is section Glibuilding is complete. Only cosmetic work remains. Sigtiture Date 2J23/07 . _ 0 Check here if attachments Sp/TION E BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BEE), complete Items Fl-ES. If the Certificate is intended to support a LOMA or LOMR-F request. complete Sections A, B, and C. For Items El-E4, use natural grade, if available Check the measurement used. In Puerto Rico only, enter meters. El Provide elevation information for the foll *m and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent arade (LAG) a) Top m bottom floor (including basement, crawl space, o, enclosure) /v_- Ofeet O meters O above o,O below the HAG. »> Top of bottom floor (including basement, crawl space, or enclosure) m___._ _ [] feet 0. meters 0 above or 0 below the LAG. cz For Building Diagrams 6-8 with permanent flood openings provided in Section A items 8 and/or 9 (see 8 of Instructions), the next higher floor (elevation cz.hm the diagrams) of the building is-_� 0 feet 0 meters 0 above or 0 below the HAG. E3.Atiached garage (top of slab) _ 0 feet 0 meters CI above or 0 below the HAG E4. Top of platform of machinery and/or equipment servicing the building is .. ..... ....... 0 met 0 meters 0 above or 0 below the HAG. ES. Zone AG 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? 0 Yes 0 No Unknown. The local official must certify this information in Section G. ------^- SECTION F - PROPY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION - -~--' The property owner m owner's authorized representative who completeS Sections A, B, and E for Zone A (wtthout a EFIVIA-issued or community-issued ore) or Zone AO must sgrt here. The statements in Sections A. a and are correct w the ovx Property Owner's or Ownets Authorized Representative's Name � ��``�� xddress City State ZIP Code ___--__-__--- Signature Date Telephone Comments -___ ___�.__-_-__-'-_'_---____-__--_- Check hese jf attec,hrrients SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is administer the communit ordinance can vn~x.B, and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items 08. and GB. 01 0 The Information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor engineer, or architect who is authorized by law to certify elevation tnformation. (Indicate the source and date of the elevation data in the Comments area below.) az, A community official complete Section E for a building located in Zone A (without a FEMAessued or community-issued BEE) or Zone AO. sa El The following information (Items 04. GO.) is provided for community floodplain management purposes. G4 Permit ��_ Number omoronxoIssued / GB. ow�cm�mc�eo/oompooncrmcnupa"cv|o�veo / | | __- L ______._--_�- u/ rhis permit has been iss ed for: 0 New Construction U Substantial Improvement oo, Elevation »/ as-built lowest floor (including basement) m the building' -_ -`-_- ,[]feet 0 meters (PR) Datum ____. Gn 13FF or (in Zone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum Local Official's Name ------------'--------' -----'- ----------'-------------- --- __' __ --'_-------'--'-- '-- T��6� �'---------' '--'---------'---------'' cvmmurov telephone � -__-___-_____---_' u�n"*� oat* _' _ - _- __._ ��nts _-_____' - _ Check hp.te if atteethreents 1 - '_ ' - � ' -__ __ __� _ -- -' -