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2-4-037:054
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Last modified
6/17/2014 9:08:29 AM
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Date
12/1/1999
Type
Elevation Certificate
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L <br />ELEVATION- CERTIFICATE O.M.B. No. 3067-007/ <br />FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 <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 pro- <br />vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine <br />the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not <br />required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. <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 />K.N.T. Partners <br />STREET ADDRESS (Including Apt.. Unit. Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER <br />COMPANY NAIC NUMBER <br />OTHER DESCRIPTION (Lot and Block Numbers, etc.) <br />Lot 17, Waiakea Heights. Subdivision; Unit 1, TMK: 3rd Div. 2-4-37: 54- <br />CITY STATE ZIP CODE <br />Hilo HI 96720 <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 AD <br />use depth) <br />155166 <br />0890 <br />C <br />Sept. 16, 1988 <br />_ AH ; <br />YY _. <br />60fi <br />7. Indicate the elevation datum system used on the FIRM for Base Flood Elevatiolis (BFE): NNGVD '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 .0 feet NGVD (or other FIRM datum—see Section B, Item 7). <br />SECTION C BUILDING ELEVATION INFORMATION'"4 <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 5 <br />2(a.). FIRM Zones Ai -A30, AE, AH, and A (with BFE). The top of the-referericedevel floor from the selected diagram is at an elevation <br />of ! 1 161 O! 71 AJ feet NGVD (or other FIRM datum—see Section B, Item 7): <br />(b). FIRM Zones V1 -V30, 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 UJJ_1 J.JJ,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 L11.0 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 UJ.IJ 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: ® 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: ❑ Yes I—IX_ No (See Instructions on Page 4) <br />5. The reference level elevation is based on: X❑ 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: 1 1 16101(9J feet NGVD (or other FIRM datum -see <br />Section B, Item 7). <br />SECTION D COMMUNITY INFORMATION <br />1. 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 ! ! I 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, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION <br />
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