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FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL -FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME k11LI.lAM V. MLHANT>a BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX N0. 115E HIAL_0A. STREET CITY 4 ILO STATE a -I O.M.B. No. 3067-0077 Expires December 31, 2005 For Insurance Company Use: Policy Number Company NAIC Number PROPERTY DESCRIPTION Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT F, KAOMLA 1 (trtoVa tS( 1SMV1d100 , LjNIT ) . TMK 2.4-/D'19 o33 IAL- ( ##° - ##'- ##.##" or ##.#I####°) area, ZIP CODE 96-72-0 L1 NAD 1927• L1 NAD 1983 SOURCE: L_1 GPS (Type): L_1 USGS Quad Map 1_1 Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME --f-B3. STATE Hawaii County 155166 Hawaii County Hawaii B4. MAP AND PANEL 85. SUFFIX B6. FIRM INDEX B7: FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER C DATE EFFECTIVEIREVISED DATE ZONE(S) (Zone AO, use depth of flooding) I 155166 0$8D 4/02/04 16 -Sr f T- 88 A+� A-++, l B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. i_1 FIS Profile IYFIRM 1-1 Community Determined 1_1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9:1VI NGVD 1929 1_1 NAVD 1988 1_1 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes 1X I No Designation Date:uZA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings" 1-1Building Under Construction" 1_1Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number _9 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations – Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from #he'�atum used #or the BFE •in Section B, -convert-the -datum to that used forthe BFE. 'Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum - Conversion/Comments Elevation reference mark used 1° L WOOUMCAiT Does the elevation reference mark used appear 2,n the FIRM? 1_1 Yes 1 KNo ❑ a) Top of bottom floor (including basement or enclosure) A'q'8 0 fl.(m) d C3b) Top of next higher floor _ W A _ ft -(m) a �J� N' MV9q, ❑ c) Bottom of lowest horizontal structural member (V zones only)_ /,A, ft.(m) Do 'n Q LICENSED ❑ d) Attached garage (top of slab) 4-4-6 8 ft. (m) E � QPROFESSIONAL ❑ e) Lowest elevation of machinery and/or equipment d t LAND SURVEYOR servicing the building (Describe in a Comments area.) ft.(m) E ❑ f) Lowest adjacent (finished) grade (LAG) 41l-2 $ ft.(m) Na. LS -7589 ❑ g) Highest adjacent (finished) grade (HAG) 446 - ft.(m) c ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade� N ❑ 1) Total area of all permanent openings (flood vents) in C3.h A sq. in. (sq. cm) ' 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. / certify that the information in Sections A, B, and C 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. CERTIFIER'S NAME pAuL He M UrZTA Y L-?" " LICENSE NUMBER LS -158Q ICGKSGV ROSSID&_ LAOD SS box 1 l89 'O K 2O-ocT.os I�.1A01 y t AssocIha_:6 , L c, STATE �f i. ZIP CODE 01612 I TELEPHONE p�p �SQ- Qsp i FEMA Form 81-31, January 2003 `u See reverse side for continuation. Replaces all previous editions