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IMPORTANT: In these spaces, copy the cormarponding Information hem Seddon A. ':,For Irreuranoe Company Use:. i'. fduitdino Saeet Address (including Apt., Unit, Suite, ar for Bldg. NO.) or P.O. Route and Box No: .Policy Number 1262 KALANIANAOLE AVENUE City HILO State HI ZIP Code 96720 Compafy NAIL Num . SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community of ldal, (2) Insurance agenticompany, and (3) building owner. . Comments REM A7: DIAGRAM 4 IS THE MOST APPLICABLE. THE STRUCTURE IS SPLIT LEVEL, HOWEVER, THE LOWEST FLOOR IS SLAB ON GRADE AND THE OTHER TWO LEVELS ARE POST AND PIER. THE BOTTOM FLOOR ELEVATION IS 13.3 -FT, THE NEXT LEVEL IS 15.0 -FT AND THE THIRD LEVEL IS 17.4 -FT. ITEM C2: THE BENCH MARK REFERENCED IS A COM TRAVERSEUSED IN THE KALANIANAOLE SEWER IMPROVEMENT PROJECT. ITEM C2-R?RE�.OWESSIiggnnas ea ST MACHINERY SERVICING THE STRUCTURE 18 A WATER HEATER LOCATED ON THE LOWEST FLOOR LEVEL. t JZlf� Date 11JULY-20 CUILWINk, 6GCYaLO "V1'UHMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items Et -E5. If the Certificate Is intended to support a LOMA or LOMR•F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade. It available. Check ft measurement used. in Puerto Rioo only, enter meters, Et. 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 (WG). e) Top of bottom floor (Including basement aawlspece, or enclosure) is ❑ feet ❑ meters ❑ above or below the HAG. b) Top of bottom Poor (Including basement, omwlsp rce, or enolosl Is ❑feat D meters [I above or [I below the LAG. E2. For Building Diagrams 8-B with permanent flood openings provided in Seatlon A Items 8 endlor g (se , ages" of Insauctbns), the next higher floor (elevation C2.b in the diagrams) of the building Is _ — ❑ feet [Imeters [Iabove or LJ below the HAG. E3.. Attached garage (top of slab) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery andfor equipment servicing the building Is _ ❑ feet ❑ meters ❑ above or ❑ below me HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bosom floor elevated in accordance with the community's ffoodplaln management ordinance? ❑ Yee ❑ No ❑ Unknown. The local official must certify this information In Section 0. SECTION F - PROPERTY OWNER (OR OWNERS REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A. B. and E for Zone A (without s FEMA -issued or community -issued BFE) or Zone AO moat sign here. The statements in Sections A, B, and E are correct to the beat of my knowledge - sprees e e Name . Address City State ZIP Code Signature Date Telephone — • Comments — fl Check here a edachmema SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local offiesil who is authorized by law or Ordinance to administer the community's floodislain management ordinance can complete Sections A, S, C (or E), and G of thle Elevation Certificate.. Complete the applicable Item(s) and sign below, Check the measurement used In beets GS and G9. - Gt. ❑ The Information in Section C was taken flom other documentation that has been signed and sealed by o licensed surveyor, engineer, or architect who Is authorized by law to tartly 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 FEMA4seued or community-lesued BFE) or Zone AO. G3. ❑ The following information (Items 04 -GO) Is provided forcommunity floodplain management purpose. 04;Pwmft Number _---` -- G5: Date Parma Issued O6. Dste Ce' fVK to Of CompeancNOcoupancy Inuad G7. This permit has been issued for: ❑ New Construction - ❑ Substantial Improvement - Gil. Elevation of ss -butt lowest floor onoluding basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (In Zone AO) depth of floodingat the building site: _ _- '❑ feet ❑ meters (PR) Datum _ G1O. Community's design flood elevation - ❑ feet ❑ meters (PR) Datum Local Offldefe Nnme Title -- Community Name - Telephone Signature Date Comments —'-- -- 11 Check here if aaachmenls 40 FEMA Form 81-31, Mer 09 _ '..Replaces all previous editions.