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2-1-003:001
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Last modified
2/25/2015 9:37:04 AM
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Date
2/26/1997
Type
Elevation Certificate
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O.M.B. NO. 3067.0077 <br />ELEVATION CERTIFICATE Expires May 31, 1996 <br />FEDERAL EMERGENCY MANAGEMENT AGENCY <br />NATIONAL FLOOD INSURANCE PROGRAM <br />ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to <br />aovide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to <br />termine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMB). <br />Instructions for completing this form can be. found on the following pages. <br />SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br />BUILDING OWNER'S NAME POLICY NUMBER <br />URASENKE FOUNDATION, HAWAII BRANCH <br />STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER <br />245. "SARATOGA ROAD -r m)= <br />OTHER DESCRIPTION (Lot and Block Numbers, etc.) <br />CITY STATE ZIP CODE <br />HONOLULU HI 96815 <br />SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br />Provide the following from the proper FiRM (See Instructions): <br />1. COMMUNITY NUMBER <br />2. PANEL NUMBER <br />3. SUFFIX <br />4. DATE OF FiRM INDEX <br />5. FiRM ZONE <br />6. BASE FLOOD ELEVATION <br />(in AO Zones, use depth) <br />1 <br />155166 <br />0880 <br />C <br />09/16/88 <br />VE <br />.12.5 <br />7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ® NGVD '29 ❑ Other (describe on back) <br />8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate <br />the community's BFE: I I I I I I .L_ I feet NGVD (or other FIRM datum -see Section B, Item 7), <br />SECTION C BUILDING ELEVATION INFORMATION <br />1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best <br />describes the subject building's reference level 1 <br />a). FIRM Zones Ai -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation <br />of LJ I I I I .H feet NGVD (or other FIRM datum -see Section B, Item 7). <br />(b). FiRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from <br />the selected diagram, is at an elevation of 1 1 l 11151.151 feet NGVD (or other FIRM datum -see Section B, Item 7). <br />(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I.L.) feet above ❑ or <br />below ❑ (check one) the highest grade adjacent to the building. <br />(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is I1.H feet above ❑ or below ❑ (check <br />one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference <br />level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown <br />3. Indicate the elevation datum system used in determining the above reference level elevations: (X NGVD '29 ❑ Other (describe <br />under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on <br />the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion <br />equation under Comments on Page 2.) <br />4. Elevation reference mark used appears on FiRM: M Yes ❑ No (See Instructions on Page 4) <br />5. The reference level elevation is based on: M actual construction ❑ construction drawings <br />(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which <br />case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate <br />will be required once construction is complete.) <br />6. The elevation of the lowest grade immediately adjacent to the building is: I { [_I 1141.151 feet NGVD (or other FIRM datum -see <br />Section B, Item 7). <br />SECTION D COMMUNITY INFORMATION <br />16 If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 <br />is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest <br />floor" as defined by the ordinance is: I ) l l i l.() feet NGVD (or other FIRM datum -see Section B, Item 7). <br />2. Date of the start of construction or substantial improvement <br />FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CON17INUATiON <br />
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