6-6-002:010 - Laserfiche WebLink

Home

77; u.S: Dt_PAAtMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION �. Building Owners Name William T. White Trust . Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. P.O. Boz 1537 HI ZIP Code 96743 OMB No. 1660-0008 Expires March 31, 2012 Use: A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TMK(3)6.6.002:010 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 19 97967 Long. -155.82875 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood Insurance. AT 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) _ sq ft a) Square footage of attached garage sq it 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 within 1.0 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.b _ sq in d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bt. NFIP Community Name 8 Community Number B2. County Name B3. State -71 155166 HAWAII I HAWAII B4. Map/Panel Number B5. Suffix B6. FIRM Index ST FIRM Panel B8. Flood B9. Base Flood Elevations) (Zone 277 C Date Effective/Revised Date Zone(s) AO, use base flood depth) d) Attached garage (top of slab) 12.6 6-5-70 9-16.88 AE 8 FEET 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) _ Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date _ ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. 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 Al -A30, AE, AH, A (with BFE), VE, VI -V30, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item AT Use the same datum as the BFE. Benchmark Utilized PUAKO NEW STATION Vertical Datum NGVD 1929 Conversion/Comments Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 12.50 ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 20.5Q ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 12.6 ❑ feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 14.76 ® feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 10.3 IS feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 10.47 ® feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including 10.43 ® feet ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATIO This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevati, information. I cert* that the information on this Certificate represents my best efforts to interpret the data avarlable.l understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 Check here if comments are provided on back of forth. Were latitude and longitude in Section A provided by a licensed land surveyor? ® Yes ❑ No Name INC. Address 73-5618 MAIAU ST. UNIT 8104 City KAILUA KONA State HI ZIP Code 96740 OOPS G. P,4A s h� LICENSED O% PROFESSIONAL * LAND } SURVEYOR No. 10743 AWA 11 U 5 P' FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions