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U.S�I)EPARTMENTOFHOMELANDSECURITY ELEVATION CERTIFICATE OMB No.18eo-coca
<br />Federal Emergency Management Agency Expires March 31, 2012
<br />National Flood Insurance Program Important: Read the Instructions on pages 1-9.
<br />SECTION A- PROPERTY INFORMATION a",ForlTiburelice?Gtli�pairy}Uee');;
<br />• Al. Building Owners Name WAIKOLOA BC LLCrPy�o,l.iayZl�uiiitre7T u ,". , , j .
<br />A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. *DorylpanYpNA1CANumber�,- , krr, a, ,rs,
<br />( 89-1081 KU UALI'I PLACE
<br />J Clry WAIKOLOA State HI ZIP Code 95738
<br />f A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
<br />3A-9.007:015
<br />A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) NON-RESIDENTIAL
<br />A5. Latitude/Longfude: Let., 19 5W48" Long. 155.5318" Horizontal Datum: ® NAD 1927 ❑ NAD 1983
<br />AS. Attach at least 2 photographs of the building if the Certificate Is being used to obtain flood Insurance.
<br />J A7. Building Diagram Number 5
<br />.1' AS. For a building with a crowlspace or onclmrs(e):),a,,/•h , Ail. For a building with an attached garage: /A
<br />e) Square footage of crawlspeos or endosure(s) _ sq ft a) Square footage of attached garage sq ft
<br />b) No. of permanent flood openings In the crowlspeae or b) No. of permanent flood openings Ir tea eltaehed garage
<br />enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade _
<br />c) Total net area of flood openings In AB.b _ sq in C) Total net area of flood openings In A9.b _ , sq In
<br />d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes [],,No
<br />SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />J B1. NFIP Community Name tL Community Number82. County Name - 83. State
<br />HAWAII COUNTY 155165 =COUNTY HAWAII
<br />11,
<br />V B10.
<br />B4. Map/Psnel Number
<br />J
<br />85. Suffix
<br />Be. FIRM Index
<br />87. FIRM Panel88.
<br />Ficod
<br />89. Be" Flood Elevations) (Zone
<br />155168
<br />0257C
<br />Date
<br />I
<br />EftectivelRevlaed Dote
<br />Zones)
<br />AO, use base flood depth)
<br />Lowest elevation of machinery or equipment servicing the building
<br />;.1Q
<br />4/02/04
<br />9M&1988
<br />, VE
<br />8.0-
<br />.0
<br />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 />Indicate elevation datum used for BFE in Item B9: I@ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) _
<br />Is the building located in a Coastal Bonier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
<br />Designation Date _ ❑ CBRS ❑ OPA
<br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
<br />4'Cl. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction" ® Finished Construction
<br />'A new Elevation Certificate will be required when Construction of the building Is complete.
<br />./ C2. Elevagons - Zonas Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (wkh BFE), AR, AR/A, ARAE, AR/A1-130, AR/AH, AR/AO. Complete Items C2.adt
<br />below according to the building diagram specified In Item AT Lisa the same datum as the BFE. _
<br />Benchmark Utilized B.M. 3 (M KAWAIHAE HARBORVerticel Datum NGVD 1928 ..
<br />Conversion/Comments USGS BENCHMARK
<br />J a)
<br />Top of bottom floor (Including basement, crawlepaos, or enclosure floor) 2.21
<br />b)
<br />Top of the next higher floor
<br />® feet
<br />✓ c)
<br />Bottom of the lowest horizontal structural member (V Zones only)
<br />@1
<br />d)
<br />Attached garage (top of slab)
<br />j1.9
<br />- e)
<br />Lowest elevation of machinery or equipment servicing the building
<br />;.1Q
<br />(Describe type of equipment and location In Comments)
<br />0
<br />Lowest adjacent (finished) grade next to building (LAG)
<br />g.Q
<br />g)
<br />Highest adjacent (finished) grade next to building (HAG)
<br />9.9
<br />h)
<br />Lowest adjacent grade at lowest elevation of deck or stairs, Including
<br />0.2
<br />Check the measurement used.
<br />. '. ®feet
<br />❑ meters (Puerto Rico only)
<br />❑ feet
<br />❑ meters (Puerto Rico only)
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />❑ feet
<br />❑ meters (Puerto Rico only)
<br />® feet
<br />❑ motors (Puerto Rico only)
<br />® feet ❑ meters (Puerto Rico only)
<br />® feet ❑ meters (Puerto Rico only)
<br />® feel ❑ meters (Puerto Rico only)
<br />OR ARCHITECT CERTIFICATION
<br />1 mil Certiticatidn is to be Signed and healed by a land 9urveybr, engineer, or SWIReCt authorized by law to Comfy elevation
<br />information. 1 certify that the information on this Certificate represents my best efforts to Interpret the date eva4able.1
<br />understand that any false statement maybe punishable by line orimprlsonmerd under 18 U.S. Code, Section 1001.0
<br />Check here If comments are provided on back of form. Were latitude and longitude in Section A provided by a
<br />licensed land surveyor! ® Yes ❑ No
<br />Certitlees Name THOMAS G. PATTISON License Number 10743
<br />Title LAND SURVEYOR Company Name PATTISON LAND SURVEYING INC
<br />Address 68-1125 N. KANIKU DRIVE UNIT 906 CIty KAMUELA State HI
<br />J A
<br />Signature- f �- Date 6-20.2012 Telephone 80&327-9439
<br />YA i=
<br />No 1074,3
<br />, Mer 09 See reverse side for continuation. Replaces all previous editions
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