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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. Policy Number _ HOAKA RD City HILO State HI ZIP Code 96720 i SECTION D -SURVEYOR. ENGINEER. OR ARCHITECT CERTIFICATION (CONTINUEDI Mpy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments THE SFE IS BASED ON A FLOOD STUDY BY P. YOSHIMURA DATED 6193 THE ELEVATION BM IS A SURVEYOR SET SPIKE IN TP1f20 858.18 ON HOAKA RD. THE SURVEY IS DONALD JAMES MURRY 925/06 -- Signature SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El -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 Rico only, enter meters. Et. 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 space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is _ _ ❑ feel ❑ 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? ❑ Yes ❑ No ❑ Unknown. The local official must certify this Infornafion 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 FEMA4ssued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are owrect to the best of my knowledge. fiftoperty Owner's or Owner's Authorized Representative's Name Signature SECTION G - COMMUNITY The local official who is authorized by law or ordinance to administer the community and G of this Elevation Certificate. Complete the applicable ftem(s) and sign below. Code slain management ordinance can complete & the measurement used in Items G8. and G9. G1. ❑ 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.) G2. ❑ A community official completed Section E for a building located In Zone A (without a FEMA -Issued or community4ssued,BFE) or Zone AD.. G3. ❑ The following information (Items G4. -G9.) is provided for community floodplain management purposes. _ Issued G6. Date Certificate Of G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-bui8lowest floor (including basement) of the building: —_ .❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth. of Gooding at the building sitei_ ❑ feet ❑ meters (PR) Datum Local ofielars Name - Title Community Name Telephone Signature - Date ❑ Check here If attachments FEMA Forth 81-31, February 2006 Replaces all previous editions