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U.S. DEPARTMENT OF HOMELAND SECURITY <br />k Federal Emergency Management Agency <br />National Flood Insurance Program <br />• Al. Building Owners Name <br />& <br />Randall M. & De nice H. S <br />• <br />ELEVATION CERTIFICATE <br />Important: Read the Instructions on pages 1-9. <br />Suite, and/or Bldg. No.) or <br />OMB No. 1660-0008 <br />Expires March 31, 2012 <br />Tax Man Key: 3rd Div. 2-5-05: 129 <br />A4. Building Use (e.g., Residential, Non -Residential, AddMon, Accessory, etc.) Residential i <br />� <br />A8. Lsdtude/Longitude: Let. 19.6861 Long. 155.1399. Horizontal. Datum_: NAD 1927. J„z❑ NAD 1983 <br />A8. Attach at least 2 photographs of the building If the Certificate Is being used to obtain flood Insurance. ' <br />A7. Building Diagram Number5 <br />A8. For a building with a crewlspace or enclosure(s): A9. For a building with an attached garage: <br />a) Square footage of crawlapeoe, or enciosure(s) N/A aq it e) Square footage of attached garage N/A. eq 1t <br />b) No. of permanent flood openings In the crawlspace or b) No. of permanent flood openings In the site garage <br />enclosure(s) within 1.0 foot above adjacent grade N A within 1.0 foot above adjacent grade N A <br />c) Total net area of flood openings In AB.b -YLA_ sq In c) Total net area of flood openings In A9.b N eq In <br />d) Engineered flood openings? - ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ff No . <br />IIZf-1IIJ-1Z[01� <br />81. NFIP Community Name & Community Number B2. County Name B3. Stets <br />155166 Hawaii Hawaii <br />B4. MaplPanel Number <br />B5. Suffix <br />Be. FIRM Index <br />B7. FIRM Panel <br />B8. Flood <br />s9. Base Flood Elevetion(a) (Zone <br />below according to the building diagram specified in Item A7. Use the same datum as the BFE. <br />_ Date <br />104ZO2/200412Z17/2009AE.1.110.0- <br />Effective/Revised Date <br />Zone(s) - <br />AO, use base flood depth) <br />B <br />D <br />Check the measurement used. <br />a) Top of bottom floor pncluding basement, crawlspace, or enclosure floor) <br />b) Top of the next higher floor <br />1 105. 13 feet <br />N A <br />B1 u. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9. <br />❑ FIS Profile ® FIRM Community Determined ❑ Other (Describe) <br />811. Indicate elevation datum used for SFE in Item 89: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) <br />B12. Is the building located Ina Coastal Barter Resources System (CBRS) area or Otherwise Protected Area (DPA)? ❑ Yes �`i] No <br />Designation Date ❑ CBRS ❑ OPA <br />C1. Building elevations are based on: ❑ Construction Drawings- ❑ Building Under Constnmdion• <br />®.Finished Construction <br />•A new Elevation Certificate will be required when construction of the building Is complete. <br />C2. Elevations - Zones At -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), <br />AR, ARIA, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete hems C2.a-h <br />below according to the building diagram specified in Item A7. Use the same datum as the BFE. <br />BenchmarkLMI[zed VSGS BM "1123" re -set 1971 <br />VerUcelDatum <br />NGVD 1929 <br />Conversion/Comments N/A <br />Check the measurement used. <br />a) Top of bottom floor pncluding basement, crawlspace, or enclosure floor) <br />b) Top of the next higher floor <br />1 105. 13 feet <br />N A <br />metemgpuerto Rico only) <br />,_ feet <br />meters (Puerto Rico only) <br />c) Bottom of the lowest horizontal structural member (V Zones only) <br />N /A _❑ feet <br />❑ meleB (Puerto Rice only) <br />d) Attached garage (top of slab) <br />N A _❑ feel <br />❑ meters (Puerto Rice only) <br />e) Lowest elevation of machinery or equipment servicing the building <br />1 . 101 . _Q.5E feel <br />❑ meters (Puerto Rico only) <br />. (Describe type of equipment and location In Comments) <br />0 Lowest adjacent (finished) grade next to building (LAG) <br />1,101 . 55p feet <br />❑ meters (Puerto Rico only) <br />g) Highest adjacent (finished) grade next to building (HAG) <br />1,102 , 58❑x feet <br />❑ meters (Puerto Rice only) <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including <br />1,102 . 4 5❑x feet <br />❑meters (Puerto Rico only) . <br />c ms cerunceson is to oe signeo ano seareo Dy a rano surveyor, engineer, or architect authorized by law to certify elevatli <br />Information. I certify that the Information on this CertNkate represents my best efforts to Interpret the data available. <br />I understand that any false statement maybe punishable by fine orlmprlsonment under 18 U.S. Code, Section 1001. <br />❑x Check here if comments are provided on back of form. Were latitude and longitude in Section A Rrovided by a <br />licensed land surveyor? ®Yes U No <br />President. P.E. <br />FEMA Form <br />Inc. <br />935-6827 <br />reverse side for continuation. <br />T. �M <br />usl:r�,�ED <br />� PROF�{S�tONAL <br />ENGINEER <br />NO. 5105-C <br />Replaces all previous editions <br />