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4f QJ6V 77t4` FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION rrvcn a rwmc !�A/CG WCA-r fTi REE riDDRESvc-S (Including Apt., Unit, Suite, ES( ffTION (Lot and Block Numbers, Tax I —. —.. r / I �S.LC .. .O. ROUTE AND BOX NO. STATE O.M.B. No. 3067-0077 Expires December 31, 2005 For Insurance Company Use: ( till°- #p - p#.prP or pp.plYppp°) �r IJ NAD 1927 �L'_I NAD 1983 SOURCE: L_I GPS (Type): LI USGS Quad Map LJ Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION County I Hawaii B4. MAP AND PANEL I B5. SUFFIXFIRM B6.6 INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATIONS) NUMBER 155166 0�2 ' E DATE EFFECTIVE/REVISED DATE ZONE S) (Zone AO, use depth of flooding) 02 95 OG •- 02 � S Z. 00" .+v. Cole ore source or nie nese Flood Elevation (nrn) data or base flood depth entered In B9. LI FIS Profile JX FIRM LI community Determined LI Other (Describe): B11. Indicate the elevation datum used for the BFE in B9:A NGVD 1929 LI NAVD 1988 1-1 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? LI Yes IX I No Designation Dale: _ SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REOUIREDt Building elevations are based on: LlConstruction Drawings- LlBuilding Under Construction* LlFinished Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR/AH, AR/AO Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum Cnnversinn/Cnmmcnte Elevation reference mark used -0(�Ya be" Mw't-Does the elevation reference mark used app O a)Top of bottom floor (including basement or enclosure) 13 _ . fl.(m) 15 ' Cl b) Top of next higher floor2'� _ . 3(O fl.(m) A O c) Bottom of lowest horizontal structural member (V zones only) ,1.Q ft.(m) o ❑ d)Attached garage (top of slab) , O ft.(m) w g ❑ e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area.) I % ft.(m) 8 R ❑ f) Lowest adjacent (finished) grade (LAG) ft.(m) z N O g) Highest adjacent (finished) grade (HAG) ft.(m) O h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade O 1) Total area of all permanent openings (flood vents) in C3.h M sq. In. (s cm) at on the FIRM? Ll Yes El No O�Pg G. Pq J, PROFESSIONAL SZ * LAND * 1„ SURVEYOR / ' Z No. 10743 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the date available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code. Section 1001. FEMA Form 81-31, January 2003 See reverse side Vor continuation. Replaces all previous