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Home My Public Portal AboutVan Horn_82-A FJr31-2005 1448 C551 P.04/05 FEDERAL EMERGENCY MANAGEMENT AGENCY M.B. No. 3067 .0077 NATIONAL FLOOD INSURANCE PROGRAM + O. Expires Dccernbcr 31, 2005 ELEVATION CERTIFICATE Irvrpo r t Read the Inetruc1Ions on Pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION 1-FolAreSurerieCtiteriserv. Use_ • BUILDING OWNER'S NAME � �,: � L',iSJil444lilti TI+E guift-r)' C OuP. $ t G ; ' ' BUILDING ST Rtv� ESS (Including Apt, Unit, Sidle, and/or Bldg. No,) OR P.O. ROUTE AND BOX NO. I i ry t P: ° CITY STATE ZIP CODE G I T 1 r • OF TY8e6E / 5 e.43.6.s C.ee cafe cp i4- _ S f 3 zt3 PROPERTY DESCRIPTION (Lot and Black Numbers, Tax Percet Number, Legal Description, etc.) 4.7 17' -,d. VAJ ar IL e.e.PT.a Ar_4w ,A:7485" SG42EVEsVW.1. =Zs BUILDING USE (e.g., Residential, Non - residential, Addetionn, Accessory, et. Use Comments utee If neee cry,) 1 2 .Eb toier. 1 '1' : 4. t,. LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE L GPS (Type): ( ftil "- VC - ##,#%' or f4, *NNW ) LJ HAD 1927 LJ NAD 1963 L USGS Quad Map a Other: SEC 1ION B -FLOOD INSURANCE RATE MAP (AXM) tNFLNUAAt ION Bt . NFIP COMMVNY NAME & COMMUNITY NUMBER 82. COUNTY NAME, B3. STATE I R IA CA op Nees (e Tba.,s. j .v es 3 1 G ,44T7 5 a. iCDEcvacare., 84. MAP AND PANEL 85. SUFFIX B6, FIRM INDEX 87, FIRM PANEL 88. FLOOD B9. BASE FLOOD ELEVATIONS) NUMBER BATE EFFECTIVEIREVISEDDATE ZONES 15514,4 Uaol C. 040 17- gds oG -n- a4 A E c 4 4 810. lndlcata tta source of the Base Flood Elevation (BFE) data or base flood depth entered in BB. )....J FIS Profile IA FIRM 11 Community Determined 1 Other (Deectlbe): B11. Indicate the elevation datum used for the BFE in B9: L NGVD 1929 L( NAVD 1988 LJ Other (Describe)• B12. Is the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 LJ Yes 11 No Dealgnation Date: SECTION C • BUILDING ELEVATION INFOHMAIIUN ISURVEl REQUIRED) C1. Building elevations area based on: Ueanstruction Drawings' LJBulding Under Constnlction• XIFinished Construction `A new Elevation Cerlfficate will be required when oonatniction of the building is complete. C2. Building Diagram Number (o (Select die building elegrsm mast similar to the building for which this certificate Is being completed • see pages 6 and 7. If no diagram acametely represents the building, provide a sketch or photngreph.) C3. Elevatane - Zones A1-A30, AE, Ate, A (with BFE). VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30. AR/AH, AR/AO Complete Items C3.a -I below according to the bultding diagram apedtied 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 ce provided or the Comments area of Section D or Suction G, as appropriate, to document the datum conversion. Datum/ 4WD JD ft�1 Conversion/Comments 4.'4a4%4 V- Elevation reference mark used Does the elevation reference mark used appear on the F Yes No Qa) Top of bottom floor (Including basement or enclosure) 1 5 . A. ft.(m) If �U n Qb) Top of next higher floor 2 2 ../... ft(m) C O C? � / (] c) Bottom of lowest horizantal structural member (V zones only) I A ^ es.- ft m (m) ° , ' Q ❑d)Attached garage (top of alab) t 5 . 5 ft,(m) Z * • >> [le) Lowest elevation of machinery and/or equipment Iu' \ tvo 2743_ -1 servicing the building (Desalbe In a Comments area' I . N , , ft(m) - r �9, r • ci f) Lowest adjacent (finished) grade (LAG) t Z , . S fb.(m) 1 ` y e (] g) Highest adjacent (finished) grade (HAG) I ;-- • M.It4M) 1 1.. 4, SU V �� O Q h) No. of permanent openings (flood vents) within 1 it above adjacent grads i �f FS M. 4( EjG I) Total area of at permanent openings (flood vents) in C3.h 645 try In. (aq. cm) g 04 , • z SECTION 0 • SURVEYOR, EfelllINEER, ORARCHCtECT folE,RTIFICAbtJ . This certification 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 Section. A, 13, and 0 en ibis certificate represents my best effort, to interpret the data available. I understand that any false testament may be punishable by line or imprisonment under 18 U.S. Code, Section 1081. CERTIFIER'S NAME LICENSE NUMBER JAMES M. KEATON GA. 2743 TITLE COMPANY NAME REGISTERED LAND SURVEYOR CUAT1tANI SURVEYING SERVICES, INC. ADDRESS CITY STATE ZIP CODE P. 0. BOX 61649 SAVANNAH GEORGIA 31420 . SIGNATURE A DATE TELEPHONE , set 5 AOC, 3/. 2001 (912) 303 -.0302 ' A Form 81 -31. .lnrn Ian. 9nns CCC ommocc Qlryc Eno nn►rr•.u.,w•ri r... .+. ... .... .... E d SEEO TIC zT6 Aoo3 Baal d8 :E0 SO TE 2nd PLC-31-20E35 14:49 CS51 . ��., ,... P. 05/09 VVI,.},g4.y VS6. l 9 UILDING STREET ADDRESS (Including Apt. Ur>1l. Suite, and/or No.) Oft P.O. ROUTE AND BOX NO. iPpj Nufiber Att. NB ih.t' 4C+A. 4E CITY STATE ZIP CODE ;C`dr?}fs9r�j� NAtC•Number CITY 4?= - rysEe /S4.A.•.tr� bAk.c 3r3ZA • I ;. r r O SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) c S Copy this C...3 Eievation Certificate tor oera.e4..rear�.A.1a� rS official, O# ?aF agent/company, r1 .h building &A.m. A n A raft COMMENTS EN4..0Sur4e 1F11gt. Imo! tT'ri."/�t -.E Iad+V6d2. A. 40 STAIR. 1..c) ..1 - E vs C.3b 44. 7,10 4 r1 Atert..r Fr...Oo(d . 1 N th Goa, Di rCa AS 44. POPs. tae . r Rous ., c.0ie ac ex.rr keg. ,6,wt easVATot A,r Et..15..1/• tit. 0,. TT C ie. is 4,4 CA Or7+Oe s At 4k, �e1,0 i� afk3 I „ 1_1 Check here if attachments �S�CTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO ANO ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items Ei. through E4. Ir the Elevation Certificate is intended for use as supporting information fora LOMA or LOMR -F, Section C must be completed. El Bvilding Diagram Number (Select the building dtegrem mast similar to the building for which this certificate Is being completed - see pages S 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 ( I j ft.(m) I 1 iin.(cm) 1_1 above or (_l below (check one) the highest adjacent grade. (Use nature% grade, If available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of i • • ',ling is 1___1_1 ft.(m) Ij ebove the highest adtacenl grade. E4, The too of the platform of machinery and/or equipment servicing the building Is i B. (m) . ...ye or 1_.1 below (check one) the highest adjacent grade. (Use natural grade. It available.) • ES. For Zone AO only: It no hood depth number is avaiiabte, is the lop of the bottom floor elevated in accordance with the community's 400dptain management Ordinance? 1_,J Ws j�j No (J Unknown. The local official must certify this information in Section G, SECTION F - PROPERTY OWNER (OR OWNER'S REPREsENCAnNE1 CERTIFICATION The property owner or owner's authorized representative who completes Sections A, 8, C (Items C3.h and C3.1 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 E are correct to the best of my knowledge, PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENIATIV'S NAME ADDRESS CITY STATE Z[P CODE SIGNATURE DATE TELEPHONE COMMENTS C A..) 'cif here if attachments SECTION G - CONWIUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, 8, G (or E), and 0 of this Elevation Certificate. Complete the applicable item(s) and sign below. 61. 1_1 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 dale of the elevation data in the Comments area below.) 62. i -1 A community official completed Section E for a building located in Zone A (without a FEMA - Issued or community - Issued 8FE) or Zone AO, G3, i_1 The following intormation (Items G4 - G9) is provided for community 1oodptatn menagernent purposes. 64. PERMIT NUMBER G5. DATE PERMIT ISSUED GS, DATE CER IFiCACE OF' COMPi_iANCE /OCCUPANCY ISSUED G7. This permit has been Issued for: L I New Construction Li Substantial Improvement GS. Elevation of as -built lowest floor (Including basement) of the building Is: � ft,(m)Datum: G9. BF E ar (in Zone AO) depth of flooding at the building site 1s: __ ft.(rn)Datum: LOCAL OFFICIAL'S NAME COMMUNITY NAME TELEPHONE SIGNATURE D ATE COMMENTS TOTAL P.05 ty •oi SECO - I 'C -2T6 '>1003 R9Ji 01 62 :CO SO to 2nu