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IMPORTANT: In these spaces, copy the corresponding Information from Section A. For Insurance Company Use: Building Street Address (including Apt., Ung, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 66-1747 ALANEO ST. (LOT 21) City Slate ZIP Code Company NAC Number KAMUELA HI 96743 - SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) law Copy both sides of this Elevation Certificate for (1) community oftldal, (2) Insurance agent/company, and (3) building owner. Comments TMK• 6-8404124 -09 SECTION E - BUILDFNGrELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT HFE1 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, end C. For Items E1 -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 gra lowest adjacent grade (LAG). a) Top of bottom floor (Including basement, crawl space, or enclosure) Is — _ feel 1:1meters ❑above or ® below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) Is _ _ [IElafeet meters bove or below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided i Seclign.A gems 8 or 9 (see We 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is _ [n] feet L j meters LI above or LJ 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 Information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The properly owner or owners 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 best of my knowledge. Property Owners or Owners Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here If attect!menta SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Si and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and GB. G1. ❑ The Information In Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or archllectwho is authorized by law to certify elevation Information. (Indicate the source and dale 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 community -Issued BFE) or Zone AO. G3. ❑ The following Information (Items G4.-Gg.) is provided for community floodplain management purposes. G4. Permit Number I G5. Dale Permit Issued I G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G6. Elevation of as -bulk lowest floor (Including basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (In Zone AO) W q0%" rr MbOTIrpj61iC Work, _[]feet ❑ meters (PR) Datum Local Official's Name Ell1cIS reviewed Title 1l ua Flevrit;o, rerfificcll w and Community Name f��Telephone Signature I I do fs n�t recommend Date FEMA Form 81-31, February 2006 Replaces all previous editions