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I.i S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency I Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name TED 8 KATIE MOEWS Policy Number K. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC:Number; AI OPAE ROAD City PAHOA State HI ZIP Code 96778 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TMK(3) 11.068:028 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Let. N19 29.319' Long. W154 49.328Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs f the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawlspace or enclosure(s): - A9. For a building with an attached garage: a) Square footage of crawlspace or enclosures)sq ft a) Square footage of attached garage NA sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade Ng within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b N9 sq in c) Total net area of flood openings in A9.b NA sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION HAWAII COUNTY 155166 1 HAWAII COUNTY I HAWAII B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 155166.1400 C Date Elfedive/Revised Date Zone(s) AO, use base flood depth) ❑ feet ❑ meters (Puerto Rico only) 4/02/04 9/16/88 AE 13.8 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) _ 811. Indicate elevation datum used for BFE in Item 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)? ❑ Yes ® No _ DesignationDate _ ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. 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. Elevations -Zones At -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized VS GSVertical Datum Conversion/Comments Check the measurement used. a) Soo rea wn a sign ed and sealed architect authorized elevation Top of bottom floor (including basement, crawlspace, or enclosure floor) I¢.g ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor N6.- ❑ feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) NA._ ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) Ng._ ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 16Z ❑ feet ❑ meters (Puerto Rico only) (Describe type of equipment and location In Comments) 0 Lowest adjacent (finished) grade next to building (LAG) 2.92 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 5.5-5 ® feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, Including 2. L9 ® feet ❑ meters (Puerto Rico only) structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Thl rtif t'rs to be d b land uryr an !near r b law t n' sea a y a an s eyo , g ea , o a ooze It a o ce dye e information. I car* that the Information on this Certificate represents my best efforts to interpret the data avallable.l understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Check here If comments are provided on back of form. Were latitude and longitude In Section A provided by a licensed land surveyor? ❑ Yes ® No Certifiers Name RONALD D. NICKEL License Number 8846-C FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions