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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATEI OMB No. 1660-0008 I Federal Emergency Management Agency Expires February 28, 2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Policy Number RAYDEEN THOMPSON A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 66-1739 ALANEO ST. (LOT 23) City State ZIP Code KAMUELA HI 96743 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) TMK 6-6-004:126 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 20-01-31.4 Long. 155-42-20.4 Horizontal Datum: ❑ NAD 1927 Q 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 crawl 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 ft 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 N/A walls within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b WA sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name &Community Number 82. County Name T 3. State HAWAII COUNTY / 155166 HAWAII I B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevations) (Zone 0164 D Date I Effective/Revised Date Zone(s) AO, use base flood depth) 12320.3 04/02/2004 07/16/1990 A 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM ❑ Community Determined WOther (Describe) CLOMR -F G zsr f4.. o5 - o9 f .24 G 611. Indicate elevation datum used for BFE in Item 139: Q NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑■ 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 Al -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.a-g below according to the building diagram specified in Item A7. Benchmark Utilized HI DEPT OF 1NSP BM ON KAWAIHAE RD Vertical Datum NGVD 1929 Conversion/Comments a) Top of bottom floor (including basement, crawl space, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment in Comments) 0 Lowest adjacent (finished) grade (LAG) g) Highest adjacent (finished) grade (HAG) Check the measurement used. 2328. 94 W feet 2337. 94 ff feet N/A ._❑ feet 2328.65 feet 2328.94 feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) 2328 .� 1 Q feet ❑ meters (Puerto Rico only) 2328.32 Q feet ❑ 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. 0 Check here if comments are provided on back of form. Certifier's Name License Number BRUCE K. MEYERS 8336-C Title Company Name Signature FEMA FXm 81-31, F See reverse side for continuation. qn Replaces all previous editions