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Home My Public Portal AboutSixth Av_1412 Z0 ' H aSE 2,82,2, ZS£ E b6 t... or, ....,.._. a ," FEDERAL EMERGENCY MANAGEMENT AGENCY O. M.S. 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 1 For Insurance Company Use: 1 BUILDING OWNERS NAME I Policy Number BILL MCLAUGHLIN BUILDING STREET ADDRESS (including Apt, Unit, Suite, andfor Bldg. No) OR P.O. ROUTE AND BOX NO. I Company NATO Number 1412 SIXTH AVENUE CRY STATE ZIP CODE TYBEE ISLAND, GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 289, WARD NO 4 BUILDING USE (e.g., Residential, Nan - residential, Addition, Accessory, etc Use a Comments area, if necessary.) RES LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: El GPS (Type): ( #6e - ##' -##.#1F or #tt.#+ ###) ID NAD 1927 ❑ NAD 1983 0 USGS Quad Map 0 Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 91. NFIP COMMUNITY NAME & COMMUNITY NUMBER BZ COUNTY' NAME B3 STATE TYBEE ISLAND 135164 CHATHAM GA 134. MAP AND PANEL 1 87. FIRM PANEL B9. BASE FLOOD ELEVATICN(S) NUMBER 85. SUFFIX 96. FIRM INDEX DATE EFFECTIVEfl EVISEDDATE B6. FLOOD Z0N S) (Zone AO, use depth o'tboig) 135164 0002 C 6/17/86 617/86 A8 13 B10, Indicate the source of the Base Flood Elevation (BFE) data orbasefiood depth entered in B9. 0 FIS Profile ® FIRM 0 Community Determined 0 Other (Describe): B11. Indicate the elevator datum used for the BFE in 139:0 NGVD 1929 0 NAVD 1988 0 O:t'er (Describe): _ 912. Is the building rocatedin a Coastal Barrier Resources System (CBRS) area or Othervrise Protected Area (OPA)? 0 Yes Z No Designation Dale SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on 0 CanstrucGon Drawings* 0 Building Under Const n* ►2 Finished Construction *A new Elevation Cerificate will be required when construction of the build ng is complete. C2. Building Diagram Number 8 (Select the building diagram most similar to the bilking for which this certificate is being completed - see pages 6 and 7. If no dagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones Al A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, ARIAH, AR/A0 Complete Items C3. -a4 below according to the building dagram specified in item C2. State the datum used. If the datum is Efferent from the datum used for the BF E 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, todocurnentihe datum conversion, Datum NGVD 29 Conversion /Comments Elevation reference mark used Does the elevation reference mark used appear on the FIRM? 0 Yes ►:1 No o a) Top of bottom floor (induding basement or enclosure) 7. 71t(m) �` f o b)Top of next higherfloor 16.1 film) . w '; E ms ` o c) Bottom of lowest halzontal structural member (V zones only) NA . _ft.(m) 8 o N G .0 o d) Attached garage (top of slab) 7. 7 fl.(m) a e) Lewes: elevation of machinery and/or equipment v g ` *. �.2 iFi. l I servicing the binding (Describe In a Comments area) 15.8 it(m) E ro • ,' v o f) Lowest adjacent (finished) grade (LAG) 7.4ft(m) ; o g) Highest adjacent (finished) grade (HAG) 7. 6 it.(m) u4 j 0-;i o h) No. of permanent openings (f,cad vents) within 1 ft. above adjacent grade 3 4 I 0 r o i) Total area of all permanent openings (flood vents) in C3.h 1559 sq. in. (sq. cm) J / r SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION / This cert'if'ication is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information In Sections A, 13, and C on this certificate represents my best efforts to interpret the data available. 1 understand that env fa/se statement maybe 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 �--n ADDRESS / CITY STATE ZIP CODE • 636 STEPHE,DlSON A E, SUITV .— SAVANNAH GA 31405 SIGNAT E / ,/ — 5/1E5 912 - 352-0464 FEM 81 -31, tstgry 2003 -./ See reverse side for continuation. Replaces all previous editions I'd LBLL 2SE ZL6 SpTauRa{ Rat4114p1 C Ebo:LD SO DT un[ Z0 °d %S6 LBLL ZS2 ET 22 80 500E- 0T –Nflf IMPORTANT: In these spaces, copy the corresponding information from Section A. I Fur Insurance company Use BUILDING STREET ADDRESS (Inducing Apt, Unit Suite, and/or Bkfg. No) OR Pe. ROUTE AND BOX NO. I Poky Number 1412 SIXTH AVENUE CITY STATE 2IP CODE I Compsny NAIC Number TYBEE ISLAND, GA 31328 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy bosh sides of this Elevation Certificate for (1) community official, (2) insurance agentloarrpany, and (3) building owner. COMMENTS C3.e) = A/C PAD 0 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 rnJsl be completed. El. Building Diagram Number _(Select the building diagram most similar to the bu1cflng for which this certificate is being completed –see pages 6 and 7. lino diagram accurately represents the building, provide asketch or photograph) E2. The top of the bottom floor (including basemert or enclosure) of the building is ft.(m) _ in.(am) ❑ above or ❑ below (cheD< one) the highest adjacent grade. (Use natural grad, if available), E3, For Building Diagrams 6-8 with openings (see page7), the next higher floor or elevated floor (elevation b) eT the building is fl.(m) _in.(cm) above the highest adjacent grade. Complete ilerns C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is ^ ft.(m) _in.(cn) ❑ above or ❑ below (check one) the highest adjacent grade, (Use natural grad, if available). E5. For Zone AO ony: If no flood depth number is available, is the lop of the bottom floor elevated in accordance with the communityrs floodplain management ordnance? ❑ Yes ❑ No ❑ Unknown, The local official must certify this informafion 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 FBA-issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E ere correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVES NAME ADDRESS CITY STATE ZIP CODE SIGNATURE DATE TELEPHONE COMMENTS ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local offidal who is authorized by law or ordinance to adm nister the community's fioodplaln management ordnance can complete Sections A, B, C (or E), and G of Elevation Certificate. Complete the applicable item(s) and sign below. G1, ❑ 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 autho'tzzed by state or local law to certify elevation information. (Indicefe the source and date of the elevation data in the Comments area below.) G2. 0 A community official completed Section E for a balding located in Zone A (v.ilhouout a FEMA - Issued or community-issued BFE) or Zone AO. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT1SSSUED 166. DATE CERTIFICATE OF COMPLIANCE/DCCLPANCYISSUED G7. This permit has been issued for ❑ New Construction ❑ Substantial tmprovemenl G8, Elevation of as -built lowest floor (including basement) of the building is: — it(m) Datum: G9. BFE or (in Zone AO) depth of flooring at the building site is: _. ft.(m) Datum: LOCAL OFFICIALS NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS ❑Check here if attachments FEMA Form 81 -31, January 2003 Replaces all previous editions 2 °d LBLL 2SC 21G spiouRa? Raia.Tyr'1 r efs0 =L0 SO Ot unr