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FED k_. _AL EMERGENCY MANAGEMENT AGENCY v.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 Insurance Company Use:
BUILDING OWNERS NAME I Policy Number
RIC HOGAN 11
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number
923 -A HWY 80
CITY STATE ZIP CODE
TYBEE ISLAND GA 31328
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 3-A, BREWER'S LANDIING
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.)
RES
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( ##O -##' - ##.##" or #14.#01011r) ❑ NAD 1927 ❑ NAD 1983 0 USGS Quad Map ❑ Other. _
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bt. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME B3. STATE
TYKE ISLAND 130030 CHATHAM GA
B4. MAP AND PANEL B7. FIRM PANEL 69, BASE FLOOD ELEVATION(S)
NUMBER B5. SUFFIX 86. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of flooding)
1300300120 C 5/19/87 5/19/87 AE 12
910. 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):
B11, Indicate the elevation datum used for the BFE in 99: ® 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 Date
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
01. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Constnucton* E Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
02. Building Diagram Number 7 (Select the building diagram most similar to 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 A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARIAE, AWA1 A30, AR/AH, AR/A0
Complete Items C3. -a-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 9, 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 29 ConversionlComments
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑ Yes E No •
o a) Top of bottom floor (including basement or enclosure) 9. 1 ft.(m) v 4.
- 4 R
o bj Top of next higher floor 19.2 ft.(m) (.2 ,0 STE al
o c) Bottom of lowest horizontal structural member (V zones only) NA . _ t.(m) 2 o Q* O
o d) Attached garage (top of slab) 8. 9 ft.(m) 12 4.
o e) Lowest elevation of machinery and/or equipment w B , c.- ' . servicing the building (Describe in a Comments area) 13.0 ft.(m) E w '� < o y0 i o f) lowest adjacent (finished) grade (LAG) 8.0 ft.(m) z m \ ` e�, / AV
o g) Highest adjacent (finished) grade (HAG) 9, 0 ft.(m) N t / � f ►`
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 4 mi / -- _
o 1) Total area of all permanent openings (flood vents) in 03.h 599 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 i916rmation.
I certify that the information in Sections A, 8, 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.
CERTIFIERS NAME J. Whitley Reynolds LICENSE NUMBER 2249
TITLE Land Surveyor COMPANY NAME
_l) ./7
ADDRESS ) S' U C / SY STATE P CODE
636 STEPH ON A )N E, S SAVANNAH GA 31
VANNAH GA 31405
SIGNAT E ,f /� DATE TELEPHONE
/7 7/14/04 912-352-0464
r // _// l �- —
FEMA Foy -31, January 2003 See reverse side for continuation. Replaces all previous editions
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rorInsurance Company Use:
BUILDING STREET ADDRESS (Induding Apt, Unit, S` Al/or Bldg. No.) OR P.O. ROUTE AND BOX NO. L Policy Number
923 - A HWY 80
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
C3,e) = A/C PAD
❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (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.(m) _in.(cm) [] above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available),
E3. For Buikflng 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,i on front of form.
E4. The lop of the platform of machinery and/or equipment servicing the building is _ ft,(m) ___in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use
natural grade, if available).
ES. 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, C (Items C3,h and C3.i only), and E forZoneA (without a FEMA- issued or community-
issued BFE) or Zone A0 must sign here. The statements in Sections A, B, C, and E are correct to the best ofmyknowledge.
PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME
ADDRESS CITY STATE ZIP CODE
SIGNATURE DATE TELEPHONE
COMMENTS
0 Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordnance to administer the communitVs floodplain management ordinance can complete Sections A, 8, C (or E), and G of this Elevation
Certificate. Complete the applicable item(s) and sign below,
01. ❑ 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.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) orZone AO.
G3. ❑ The following information (Items G4 -G9) is provided for community 800dplain management purposes.
G4. PERMIT NUMBER ( G5. DATE PERMIT ISSUED 06. DATE CERTIFICATE OF COMPLIANCEJOCCUPANCY ISSUED
07, This permit has been issued for ❑ New Construction 0 Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: __. _ft.(m) Datum:
09, 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 all previous editions
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