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U.S. DEPARTMENT OF HOMELAND SECURITY
<br />Federal Emergency Management Agency
<br />National Flood Insurance Program
<br />ELEVATION CERTIFICATE
<br />Important: Read the instructions on pages 1-8.
<br />OMB No. 1660-0008
<br />EXDires February 28. 2009
<br />SECTION A - PROPERTY INFORMATION For Insurance Company Use:
<br />Al. Building Owner's Name Cecich Family 1986 Trust Policy Number
<br />Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number
<br />TJ -5572 Kuakini Hwy, #38
<br />City Kailua Kona State HI ZIP Code 96740
<br />A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
<br />Lot 27 of Kona Bay Estates (File Plan 1813) TMK: 7-5-005: 038 (3id Division) PROJ#14872.2
<br />A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
<br />A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983
<br />A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
<br />AT Building Diagram Number 1
<br />A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide:
<br />a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft
<br />b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage
<br />enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade
<br />c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
<br />SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />B1. NFIP Community Name & Community Number B2. County Name B3. State
<br />HAWAII 155166 1 HAWAII I HAWAII
<br />B4. Map/Panel Number
<br />B5. Suffix
<br />B6. FIRM Index
<br />B7. FIRM Panel
<br />B8. Flood
<br />B9. Base Flood Elevation(s) (Zone
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />Date
<br />Effective/Revised Date
<br />Zone(s)
<br />AO, use base flood depth)
<br />0694
<br />C
<br />APRIL 2, 2004
<br />SEPT 16, 1988
<br />AE
<br />10
<br />B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
<br />❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe)
<br />1311. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
<br />B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes ®No
<br />Designation Date ❑ CBRS ❑ OPA
<br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
<br />C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' ® Finished Construction
<br />'A new Elevation Certificate will be required when construction of the building is complete.
<br />C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g
<br />below according to the building diagram specified in Item A7.
<br />Benchmark Utilized USGS VERTICAL BM AT PIER Vertical Datum MSL
<br />Conversion/Comments Converted from MLLW to MSL
<br />a) Top of bottom floor (including basement, crawl space, or enclosure floor) -
<br />b) Top of the next higher floor
<br />c) Bottom of the lowest horizontal structural member (V Zones only)
<br />d) Attached garage (top of slab)
<br />e) Lowest elevation of machinery or equipment servicing the building
<br />(Describe type of equipment in Comments)
<br />0 Lowest adjacent (finished) grade (LAG)
<br />g) Highest adjacent (finished) grade (HAG)
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
<br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
<br />information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
<br />I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. PL T. yq
<br />❑ Check here if comments are provided on back of form.
<br />Q LtC��1 9y
<br />Certifier's Name CHRYSTAL THOMAS YAMASAKI, LPLS License Number LS -4331 U PROFId
<br />Title LICENSED LAND SURVEYOR Company Name WES THOMAS ASSOCIATES 7fr 1�1
<br />,ress 75-5749 KALAWA STREET City KAILUA KONA State HI ZIP Code 96740-1817on
<br />�W_A
<br />Date 04/0 /2006 Telephone 808-329-2353
<br />FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
<br />Check the measurement used.
<br />14.24
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />25.12
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />❑ feet
<br />❑ meters (Puerto Rico only)
<br />13.31
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />13.90
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />13.22
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />13.85
<br />® feet
<br />❑ meters (Puerto Rico only)
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
<br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
<br />information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
<br />I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. PL T. yq
<br />❑ Check here if comments are provided on back of form.
<br />Q LtC��1 9y
<br />Certifier's Name CHRYSTAL THOMAS YAMASAKI, LPLS License Number LS -4331 U PROFId
<br />Title LICENSED LAND SURVEYOR Company Name WES THOMAS ASSOCIATES 7fr 1�1
<br />,ress 75-5749 KALAWA STREET City KAILUA KONA State HI ZIP Code 96740-1817on
<br />�W_A
<br />Date 04/0 /2006 Telephone 808-329-2353
<br />FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
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