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--------...-------------------_.-----.....--------------------+��y,->E•-( U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660.0008 Federal Emergency Management Agency Expires February 28, 2009 National Flood Insurance Program Important: Read the instructions on pages 1-6. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. BWlding Owner's Name Policy Number BARRON BERTELMANN A2. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 66-1747 ALANEO ST. (LOT 21) City State ZIP Code A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Lathude/Lorigitude: Let. 20-01-31.7 Long. 155-42-22.4 Horizontal Datum: ❑ NAD 1927 ❑Y NAD 1983 A6. Attach at least 2 photographs of the building If the Certificate Is being used to obtain flood insurance. A7. Building Diagram Number 1 A8. For a building with a crew space or enclosure(s), provide: A9. For a building with an attached garage, provide: a) Square footage of crawl space or endosure(s) WA aq It a) Square footage of attached garage 612 sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within 1.0 foot above adjacent grade WA walls within 1.0 foot above adjacent grade N/A c) Total net area of flood openings In A8.b WA eq In c) Total net area of flood openings in A9.b N/A sq In SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name 8 Community Number 82. County Name B3. Stale HAWAII COUNTY/ 155166 1 HAWAII HI 84. MaplPanel Number B5. SuffixB6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevatlon(a) (Zama 0164 D Date Effective/Revised Dale Zone(s) AO, use base flood depth) 2319._22_M feet ❑ meters (Puerto Rico only) 04/02/2004 07/16/1990 A 2314.6 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined ❑Q Other (Describe) CLOMR- I° fix, tJo 05 -09 -/r. z 4G Bill. Indicate elevation datum used for BFE in Item 89: Y❑ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) •B12. Is the building located In a Coastal Barter Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes Q No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction- Q Finished Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations -Zones At -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.& -g below according to the building diagram specified in Item A7. Benchmark Utilized HI DEPT OF TRANSP BM ON KAWAIHAE RDVertical Datum NGVD 1929 Converelon/Comments OR ARCHITECT CERTIFICATION i nis cemncaaon is to De slgnea ano seaiea oy a land surveyor, engineer, or architect authorized by law to certify elm information. I car* that the information on this Certificate represents my best eNorts to interpret the data avallab/e. I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. W Check here If comments are provided on bade of form. Certifler's Name License Number FEMA See reverse side for continuation. K. A Licensedm Professional Engineer No.8336-C tGWAIL UA."- all tI.M all previous editions Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) 2320. 221�1 feet ❑ meters (Puerto Rico only) b) Top of the next higher floor It�•❑�nn 2329 .amu feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N/A ,_❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 2319._22_M feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servldng the building 2320 .-ZL❑M feet ❑ meters (Puerto Rico only) (Describe type of equipment In Comments) 0 Lowest adjacent (finished) grade (LAG) 2319. 38 X feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 2319.59 n feet ❑ meters (Puerto Rico only) OR ARCHITECT CERTIFICATION i nis cemncaaon is to De slgnea ano seaiea oy a land surveyor, engineer, or architect authorized by law to certify elm information. I car* that the information on this Certificate represents my best eNorts to interpret the data avallab/e. I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. W Check here If comments are provided on bade of form. Certifler's Name License Number FEMA See reverse side for continuation. K. A Licensedm Professional Engineer No.8336-C tGWAIL UA."- all tI.M all previous editions