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IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building gtreat Address (Including Apt., Unit, Suite, amllor Bldg, No.) or P.O. Route and Box No. 2316oea Street - M —0 Z7 6 Policy Number Cay Hilo State NI ZIP Code 66720 II1111111111ppy both sides of this Elevation Certificate for (1) community official, (2) insurance agem/cemparry, and (3) building owner. ' For Zones AO and A (without BFE), complete hems E1 -E5. If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A. B, and C. For Items El -E4, use natural grade, If available. Check the measurement used. In Puerto Rice only, enter meters. E1. 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, crawl apace, w enclosure) Is _ _ ❑ feet ❑ metere' b) Top of bottom flow ) le feet misters ❑ above or bele(including basement, crawl space, or enclosure ❑ above or ❑ be tow the LAG, the HAG. E2. For Building Diagrams " with permanent flood openings -- ❑❑ Provided In Section A hems 8 endlw 8 (eee tie 8 of Instructors), the next higher floor (elevation C2b In the diagrams) Is of the building is ❑fast ❑ meters ❑ above w I_j below the HAG, E3. Attached garage (top of slab) ts ❑ fast ❑ maters ❑ above or ❑ below the HAG., E4. Top of platform of machinery andlor equipment servicing the building is __._ ❑ feat E5. Zone AO only: N no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the vroom ❑ below fl � HAG. ordinance? ❑ Yes ❑ No ❑ Unknown. The local ofcial must community's floodplain management certify this Information in Section O. OLUTION F - The Property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or communtty4seued BFE) or Zone AO must sign here. The stafements in Sections A, S, and E are comed to the beat of my knowledge. Property Owncee or Owners Authorized Representative's Name State ZIP Code Comments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official whole authorized by la;;or ordinance to administer the communitys floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complefe the applicable hem(s) and sign below. Check the measurement used In Items G8. and G8. 01. ❑ 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 low 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 boated In Zone A (without a FEMA -Issued or community -Issued BFE) or Zone AO, G3. ❑ The following Information (hems G4. -G8.) is provided for community floodplaln management purposes. 04. Permit Number G5. Date Permit Issued I G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -bush lowest floor (Including basement) of the building: _ _ feet ❑ meters (PR) Datum GB. BFE or (in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters (PR) Datum Local Officiers Name Tihe Community Name Telephone Signature Check here h etLchmems 'EMA Form 81.31, February 2006 Replaces all previous editions