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Home My Public Portal AboutSecond Av_116 . FEDERAL EMERGENCY MANAGEMENT AlitNur O.M.B. No. 3067 -0077 NATIONAL FLOOD INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE EMC Project No. 04 - 0406 \Important Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION I For Insurance Company Use: BUILDING OWNER'S NAME I Policy Number E. T. Smith BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. I Company NAIC Number 116 2 nd Avenue CITY STATE ZIP CODE Tybee Island GA 31328 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 31B, Ward One, P.I.N. 1-0004-01-007 BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Residential LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type): ( # #° - ##' - # #.##" or # #— ####' °) ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME 133. STATE Chatham 135164 Chatham Georgia 34. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER 35. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zane A0, use depth of flooding) 0001 C 06/17/86 06/17/86 A8 13.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. El FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes ® No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 01. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction* ® Finished Construction `A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 6 (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.) 03. Elevations —Zones A1-A30, AE, AH. A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -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 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, to document the datum conversion. Datum Conversion/Comments Elevation reference mark used TBM Does the elevation reference mark used appear on the FIRM? ❑ Yes Z No a) Top of bottom floor (including basement or enclosure) 1121 ft.(m) j Z J b) Top of next higher floor 2001 ft(m) I; V . ( I ,, , .,. ,---,,--, ,c) Bottom of lowest horizontal structural member (V zones only) N/A . ft.(m) ttl to' r ` `� J d) Attached garage (top of slab) N/A ft(m) w F_- ► No. 2571 J e) Lowest elevation of machinery and/or equipment - v ( * 0 i3/ * servicing the building (Describe in a Comments area) 10.5ft.(m) . ', J 1) Lowest adjacent SUR ( finished) grade (LAG) 10.5 ft.(m) w m �'cy� f ' °. J g) Highest adjacent (finished) grade (HAG) 11.7 ft.(m) c J h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 0 J i) Total area of all permanent openings (flood vents) in C3.h 0 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 information. 1 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. CERTIFIER'S NAME - Michael E. Moore LICENSE NUMBER - 2571 , TITLE - Georgia Register Surveyor COMPANY NAME - EMC Engineering Services, Inc. ADDRESS 1 CITY STATE ZIP CODE 23 East Chadic Street 1 Savannah Ge 31401 SIGNATURE \( :i j ,.� DATE TELEPHONE _ 07/12/04 (912)232 -6533 FEMA Form 81 -31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the conesponcing intonation from sectwn A. BUILDING STREET ADDRESS (Indudig Apt., Unit, Suite, ar 9Idg. No.) OR P.O. ROUTE AND BOX NO. 1 Poky Number 116 2nd Avenue 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 - - - This elevation certificate was prepared for the person, persons or entity named on the certification hereon. Said certificate does not extend to any unnamed person without express recertification by the surveyor naming said person for: E. T. Smith Benchmark- Railroad Spike in Powerpole at the Southeast comer of Lovell Avenue and 2"El Street 0 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) 0 above or 0 below (check 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.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is ft.(m) in.(cm) 0 above or 0 below (check one) the highest adjacent grade. (Use natural grade, if available), E5. For Zane 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? 0 Yes 0 No 0 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 correcf to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S 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 ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. 01.0 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.) G2.0 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 (Items G4-G9) is provided for community floodplain management purposes. • G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED 07. This permit has been issued for: 0 New Construction 0 Substantial Improvement G9. 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 • • 0 Check here if attachments FEMA Form 81 -31, January 2003 Replaces all previous editions