87. FIRM Panel EffectivelRevised Date 9/22/2003

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1 - U.S. DEPARTMENT OF HOMELAND SECURTY FEDERAL EMERGENCY ~~ MANAGEMENT AGENCY ELEVATON CERTFCATE OMB No National Flood nsurance Program mportant: Read the instructions on pages Expiration Date: July _ A1. Building Owner's Name JOERG G. MAlTHESSEN SECTON A - PROPERTY NFORMATON A2. Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 102 ATLANTC AVENUE City PAWLEYS SLAND State SC ZP Code A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 2A. ASSEY SUBDVSON. TMS# FOR NSURAN Policy Number: Corr lpany NAlC : Number: 1 - ANY USE A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESDENTAL A5. LatitudeLongitude: Lat. N33"26'40 Long. W79"06'47" Horizontal Datum:, NAD 1927 rn 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 5 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 3 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings i the attached garage or enclosure(s) within 1.0 foot above adjacent grade 2 within 1.O foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9. - sq in d) Engineered flood openings?, Yes No d) Engineered flood openings? kes [X No SECTON B - FLOOD NSURANCE RATE MAP (FRM) NFORMATON B1. NFlP Community Name & Community Number 82. County Name 1 13; state TOWN OF PAWLEYS SLAND GEORGETOWN 84. MaplPanel Number Suffix D B6. FRM ndex Date 12/20/ FRM Panel EffectivelRevised Date 9/22/ Flood Zone(s) VE B9. Base ~lood Elevation(s) (Zone AO, use base flood depth) 17 & 18*' 610. lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem 89., FS Profile X] FRM Community Determined, OtherSource: - B1 1. ndicate elevation datum used for BFE in tem 69: rn NGVD 1929, NAVD 1988 OtherlSource: s the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Dye! NNo Designation Date: -, CBRS OPA SECTON C - BULDNG ELEVATON NFORMATON (SURVEY REQURED) C1. Building elevations are based on:, Construction Drawings* Building Under Construction" [X Finished konstruction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARA, ARAE, ARA1-A30, ARAH, ARAO. Corhplete tems C2.a-h below according to the building diagram specified in ltem A7. n Puerto Rico only, enter meters. Benchmark Utilized: SCCC Vertical Datum: NGVD 29 lndicate elevation datum used for the elevations in items a) through h) below. NGVD 1929 NAVD 1988 OtherSource: Datum used for building elevations must be the same as that used for the BFE. Check the measuremdnt used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) [X feet deters b) Top of the next higher floor [X feet deters c) Bottom of the lowest horizontal structural member (V Zones only) [X feet, Meters d) Attached garage (top of slab) NA. feet, meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) rn feet, jeters g) Highest adjacent (finished) grade next to building (HAG) [X feet meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support NA. feet meters SECTON D - SURVEYOR ENGNEER OR ARCHTECT CERTFCATON information. certify that the information on this Certificate represents my best efforts to interpret the data available. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a [X Check here if attachments. licensed land surveyor? [X Yes, No Date 04/15/2016 Telephone FEMA Form (711 2) See reverse side for continuation. Replaces all previous editions.

2 ~ L L L - n a V. VLNS W ~ L, L MPORTANT: n these spaces, copy the corresponding information from Section A. Build~ng Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 102 ATLANTC AVENUE City PAWLEYS SLAND State SC ZP Code Company NAlC Nu SECTON D - SURVEYOR, ENGNEER, OR ARCHTECT CERTFCATON (CONTNUED) Copy both sides of thiselevation Certificate for (1) community official, (2) insurance agentlcompany, and (3) building owner. Comments B9. STRUCTURE S N VE 17 & 18. PROPERTY S ALSO N VE 19 & 21. C2. ekac UNT. FOR NSURANCE COMPANY USE Policy Number: Date SECTON E - BULDNG ELEVATON NFORMATON (SURVEY NOT REQURED) FOR ZONE A0 AND ZONE A (WTHOUT BFE) For Zones A0 and A (Without BFE), complete tems El-E5. f the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For ltems El-E4, use natural grade, if available. Check the measurement used. n Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is. feet meters above or below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is. feet [7 meters above or below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A ltems 8 andlor 9 (see pages 8-9 of nstructions), the next higher floor (elevation C2.b in the diagrams) of the building is. feet [7 meters above or below the HAG. E3. Attached garage (top of slab) is. [7 feet meters above or below the HAG. E4. Top of platform of machinery andlor equipment servicing the building is. feet [7 meters above or below the HAG. E5. Zone A0 only: f 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., SECTON F - PROPERTY OWNER (OR OWNER'S REPRESENTATVE) CERTFCATON The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE) or Zone A0 must sian here. The statements in Sections A. B, and E are correct to the best of my knowledqe. Property Owner's or Owner's Authorized Representative's Name Address City State ZP Code -- Signature T Date Telephone Comments Check here if attachments. SECTON G - COMMUNTY NFORMATON (OPTONAL) 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. Check the measurement used in ltems G-10. n Puerto Rico only, enter meters. G. [7 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 information. (ndicate 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) or Zone AO. G3. The following kformation (tems G4-G10) is provided for community floodplain management purposes. G4. Permit Number ~ G5. Date Permit ssued G6. Date Certificate Of ComplianceOccupancy ssued -- G7. This permit has been issued for: New Construction [7 Substantial mprovement G8. Elevation of as-built lowest floor (including basement) of the building:. feet meters Datum - G9. BFE or (in Zone AO) depth of flooding at the building site: -- feet [7 meters Datum - G10. Community's design flood elevation: -- feet meters Datum - Local Official's Name ~ Title Community Name ~ Telephone Signature Comments Date Check here if attachments. FEMA Form (7112) Replaces all previous editions.

3 ELEVATON CERTFCATE, page 3 BUi idi ng photographs See nstructions for ltem A6. MPORTANT: n these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 102 ATLANTC AVENUE City PAWLEYS SLAND State SC ZP Code FOR NSURANCE COMPANY USE Policy Number:, Company NAC Number: f using the Elevation Certificate to obtain NFlP flood insurance, affix at least 2 building photographs below according to the instructions for ltem A6. dentify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openiflgs or vents, as indicated in Section A8. f submitting more photographs than will fit on this page, use the Continuation Page. 1 REAR VEW ~ '! \.,,. - FEMA Form (711 2) Replaces all previous editions.

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