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ELEVATION CERTIFICATE, pap 2 IMPORTANT: In these spaces, copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.I Policy Number. W1703 Puako Beach Road City Waikoios State HI ZIP Code 98738 1 Company NAIC Number. SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenUwmpany, and (3) building owner. Comments ' Per Section C. Item C2.e. Lowest equipment is an aerobic pump servicing a 1000 gallon aerobic: septi: tank. Its bottom eivatron Is 7.80. The lowest elevatl" of other egipmem In the area are Elev. 11.85, a Trot water pump, Elev. 7.70, a hot water tank, Elev. 9.15, a 1000 gallon aerobic septic tank. Also, attached is a specification of lowered doors at the utility equipment room. SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zeros AO and A (without SFE), compleM Items Et -E5. N 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, N available. Check the measurement used. In Puerto Rico only, enter meters. Et. Provide elevation information for the following and check the appropriate boxes to show whether the ekwsWn is above or below the highest adlacent grade (FAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement. crawlspece, or enclosure) is ❑ feet ❑ mekrs ❑ above or ❑ below the FAG. b) Top of bottom Noor (including basement, dawrlepam, or enclosure) Is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Bu9Nng Diagrams 8-9 with permanent flood openings provided in Section A Nems 8 and/or 9 (see p#s 8-4 of Instructions), the next higher Icor (elevation C2.b In the diagrams) of the building is ❑ feet ❑ meters ❑ above or p below Me HAG. E3. Attached garage (top of slob) Is ❑ feet ❑ 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 FAG. ES. Zone AO only: It no food depth number Is available, to the top of the bottom floor elevated In aocoMenoe with the community's floodplain management ordinenae7 ❑ Yes ❑ No ❑ Unknown. The local official must oertify this Information in Section G. The property owner or owner's autlwnzed representative who completes Sections A. B. and E for Zone A (without a FEMAassued or commumfy-Issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are torted to the best of my knowledge. Property Owners or Owners Authorhed Representative's Name Kevin McMillen Address PO Box 2494 City Kellus Kona State HI ZIP Code 98745 Signature ]/ _ . \t'. \.- , fj in Date 12!07113 Telephone 0083284833 Comments The local official Who Is eNtlonied by law or ordinance to sammrstar no communny'a twooptsin management oxamanf a Can complete rremctts A, 0. 4 (or t), ane C of this Elevation Certificate. Complete the applicable dem(s) and sign below. Check the measurement used in hems G"10. In Puerto Rim only, ender melers. G1. ❑ The intormaWn 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 for a building located in Zone A (without a FEMA-Inued ormmmuntty-Issued BFE) or Zone AO. G3. ❑ The folowing information (Items G4 -G10) is provided for community floodplain management purposes. Penni Number G7. This permit has been Issued for. ❑ New Construction ❑ Substantial Improvement Go. Elevation of as -but@ lowest floor (including basement) ofthe building: ❑ fast ❑ meters Datum G9. BFE or(In Zone AO) depth of flooding at the bubdhV she: ❑ feet ❑ meters Datum G10. Community's designa"flon,rtmant of Public Works ❑ The 0 maters Datum Local Official's Name EtI9rnee:n9 'vision has reviewed This e,ifficute and Community Name Pf.Rccr7in�E^^'a Telephone Signature [J do3s rot recommend Data Comments :ncl O tprovsa ; 400�± FEMA Form 086-0.33 (f i�j °•� ..� Replaces all previous edkbns. V1 o zou