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Kamuela F-T*i(r1T. Ifbrrneli on from Seatlon A. For kWMncs l.ompen or P.O. Route and Box No. ' Polity mbar as AI ZIP Code Company NAlC NUMIN 96743 Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agenVoompeny, and (3) building owner. cOmnenleThe subject property fall upon the boundary of the X & AE flood zones It is this surveyors opinion that the subject property falls within zone X and flood zrp AE falls southerly and across the stream. 12-03-2009 1-111A IL` 441AVA11•L`II` ;[.]:l`/_IL•],f(=1r1XIA111.i1 For Zones AO and A (without SFE), complete Items E7 -E5. H the Certificate Is intended to support a LOMA or LOMR-F request, complete Seclbrm A, B. end C. For Items E1 -E4, use natural grade, H available. (heck the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate bootee to slaw 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 cravdspace, or enclosure) Is _ _ ❑feet ❑meters ❑above or r}�-fbelow the FAG. b) Top of bottom floor (Including basement crawlspece. or endow") Is _ _ ❑feet ❑meters ❑above or the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provitJed (E Secll" Items B rr /or 9 (see ggges &9 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is u feet LJ meters �J above or LJ below the HAG. E3. Attached garage (Dip of slab) Is _ ❑ feat ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building Is _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only. If no flood depth number Is available, Is the top of the bottom Noor elevated In accordance with the community'e floodplain management ordinance? ❑ Yes ❑ No ❑ Unkrrown. The local official must oertiN this Information In Section G. 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 SFE) or Zone AO must sign here. The statements In Seetlons A, B, and E are comed to the best of my knowledge. Properly Owner's or Owner's Authorized Representative's Name rase city State 23P Code Signetare Date Telephone or and G of thta Elevation Certificate. applicable Item(s) and sign below. Check management ordinance can complete S measurement used In Items G9 and G9. Gt. ❑ 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. (Indicate the source and date of the elevation data In the Comments area below.) G2. ❑ A community official completed Section E fora building located In Zone A (without a FEMA -Issued or community -Issued SFE) orZone AO. G3. ❑ The following Information (Items G4 -G9) Is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit Issued I GS. Date CeMcate Of CompliencefOocupanky Issued G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement GS. Elevation of as -built lowest floor (Including basement) of the building ❑ feet ❑ meters (PR) Datum G9. BFE or (In Zone AO) depth of flooding at the building site ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Community Name Telephone Signature FEMA Forth 81-31, Mar 09 Replaces all previous editions