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In these 1308 OMA'OMA'O PLACE City HILO State HI ZIP Code F,10 or GT: Section M both sides of this Elevation Certificate for (1) community official, (2) Insurance agendcompany, and (3) building owner. LOCATED IN THE GARAGE. NOT For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items Et -E4, use natural grade, If available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show 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, crawlspace, or enclosure) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6.9 with permanent flood openings provided In Section A Items 8 andfor 9 (see 8-9 of Inslructlone), Me next Ngher floor (elevation C2.b In the diagrams) of the building is ._ ❑feet ❑maters ❑above or below the HAG. E3. Attached garage (top of slab) 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 HAG. E5. Zone AO only: if no flood depth number Is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yea ❑ No ❑ Unknown. The local official must certify this Information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION 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 BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the beat of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Alik lure Date Telephone SECTION G - COMMUNITY INFORMATION (OPTIONAL) 'he local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A. B, C (or E), ind G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in items G8 and G9. 31. ❑ 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.) 32. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. i3. ❑ The following Information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit issued G8. Data Certificate Of CompllencalOccupancy Issued i7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement 18. Elevation of as -bulk lowest floor (including basement) of the building: _ _ ❑ feet ❑ meters (PR) Datum _ 19. BFE or (In Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters (PR) Datum 110. Community's design flood.e eva' n ❑ feet ❑ meters (PR) Datum : to lbepartment of Public Woresc-- — Local Official's Name ng'"Oering IVISIon bus reV(ewo Title Community Name Signature Comments • ❑ Check here 0 attachments EMA Form 81-31, Mar 09 Replaces all previous editions