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IU.S.DEPARIAENTOFHOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal•Emergency Management Agency Expires February 28, 2009 National Fieod Insurance Program Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use Al.. l Building owners Name Kenneth C and Dale H SUaal Policy Number A4. A5. A6. AT A8. Captain Cook, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Hawaii 3/ Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Resldentlal Latitude/Longitude: Lat. N 19 28' 07.72973" Long. W 15 54'47-03742" Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. Building Diagram Number 1 For a buildingwith a crawl 96704 -Horizontal Datum: U NAD 1927- ❑I NAD 1983 space or enclosure(s), provide: A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) n/a sq fl a) Square footage of attached garage n/a sq it 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 . walls within 1.0 foot above adjacent grade C) Total net area of flood openings In A8.b sq in c) Total net area of flood openings in A9.b sq in SECTION B - FLOOD INSURANCE RATE MAP 1FIRMI INFORMATlnnr 64. Map/Panel Number B5. Suffix no. FIRM Index B7. FIRM Panel 88. Flood 89. Base Flood Elevation(s) (Zone 1156 C Date Effective/Revised Date Zones) AO, use base flood depth) 04/02/2004 09/16/1988 AE 153 B10. Indicate the source of the Ree. Fio„d cre„tea,.., rare, ._._ __ _ , . .. .. .. yu• mnrncu m ntlra e9. EJ FIS Profile QFIRM E]Commun'ry Determined QOther (Describe) B11. Indicate elevation datum used for BFE in Item B9: Q NGVD 1929 QNAVD 1988 ❑Other (Describe) B12. Is the building located in a Coastal Barter Resources System (CBRS) arear lherwise Protected Area (OPA)? Yes Q Designation Date QCBRS "OPA No SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ..1. 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. -2. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item AT Benchmark Utilized Vertical Datum MP_an Sea I Reel Conversion/Comments n/a Check the measurement used. a) Top of bottom floor (Including basement, crawl space, or enclosure floor)1$9. Q feet Elmeters(Puerto Rico only) b) Top of the next higher floor 168.00 � feet ❑ meters (Puerto Rico only) C) Bottom of the lowest horizontal structural member (V Zones only) feet ❑meters (Puerto Rico only) d) Attached garage (top of slab) 158.86 7 feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 158.an Mfeet ❑ meters (Puerto Rico only) (Describe type of equipment in Comments) 0 Lowest adjacent (finished) grade (LAG) _15 4 V feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) _158.6 nfeet ❑ meters (Puerto Rico only) 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 on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. SPL T. Y,A Q Check here if comments are provided on back of form. �y _ Certifiers Name Chrystal T. Yamasaki License Number LS -4331 Title Name ,Wes Thomas Associates Company Wes Thomas Associates 75-5749 Kalawa Street `'ry Kailua-Kona state Hawaii ZIP Code 96740 DFebruary 11, 20Talgppnone (808) 329-2353 4331 , 2008 Form 81-31, February 2006 See reverse side for continuation. _ Replaces all previous