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rr—LJCrWL + a r.v-- NATIONAL FLOOD INSURANCE PROGRAM U. M. rvo. ovo r trv+ + Expires July 31, 2002 ELEVATION CERTIFICATE Im ortant: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: OWNER'S NAME Johnny Tamaye ILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. Company MAIC Number 28 Puako Road Y STATE ZIP CODE Kamuela, Hawaii 96743 OPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal,eta) Puako Beach Lots — Lot 67 TMK: 3)6-9 03:06 ILDING USE (e.g., Residential, Non-residential, Addition, Accessory, eta Use Comments section if necessary.) RESIDENTIAL TITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (rype): or ❑ NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ❑ Other. -LOCAL F.I.R.M. LEVELS SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2. COUNTY NAME M. STATE !%71("C I HAWAII I HAWAII i4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX 1 87. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTNIE/REVISED DATE ZONE(S) (Zone AO, use depth o(flooding) 0277 C 415%—R) _ 9-16-88 AE 6.0 1. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile [9 FIRM ❑ Community Determined ❑ Other (Describe): Indicate the elevation datum used fbr the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): !. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes dNo Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' ® Finished Construction fw Elevation Certificate will be required when construction of the building is complete. ng Diagram Number (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.) Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE,- AR/A1-A30, AR/AH, AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the 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 LEVELED FROM Elevation reference mark used VL /1- Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No ❑ a) Top of bottom floor (Including basement or enclosure) 17 3 fL(m) 1i ❑ b) Top of next higher floor ❑ c)_ Bottom of lowest horizontal structural member (V zones only) _-A(m) o Q ❑ d) Attached garage (top of slab) (BELOW) 6 $ft.(m) ❑ e) Lowest elevation of machinery and/or equipment a servicing the building. ❑ f) Lowest adjacent grade (LAG) _6 Lft.(m) z No.❑ Highest adjacent rade HAG fL m 4968 g) s ) 9 (HAG) �•LO ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade �'A (I, U SQ,. ❑ i) Total area of all permanent openings (flood vents) in C3h _sq. in. (sq. an) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION 'his 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. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. :ERTIFIER'S NAME Donald C. McIntosh LICENSE NUMBER 4966 Haws i i :MA Form 81-31, AUG 99 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS