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;' eP 29 05 03:09F Public Warks
<br />808-327-3533 P"1
<br />FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
<br />01F P 3 20()5 NATIONAL FLOOD INSURANCE PROGRAM
<br />Expires December 31, 2005
<br />ELEVATION CERTIFICATE
<br />Important: Read the instructions on pages 1 - T.
<br />SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use:
<br />BUILDING OWNER'S NAME Tho mo S 4 Ga
<br />Y bCA rq Na i i Policy Number
<br />BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or idg. No. OR P,O. ROUTE AND BOX NO Company NAiC Number
<br />0q-192 >pUa1b 6,c Dr, A -P ,2
<br />CITY [ iw n 0 Q 1 q STATE 14 T- ZIP CODE47
<br />BUILDING Ubt (e.g tzesloenual, on-resiaenhai, A(tdtt n, Acce sory, etc. Use a Comments area, a necessary.)
<br />e�g
<br />L_I NAD 1927 L( NAD 1983 SOURCE: GPS e
<br />(_,_( USG5 Quad Map LI Outer
<br />SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />B1. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER 1 82. COUNTY NAME B3. STATE
<br />Hawaii County 155166 Hawaii Colmt 7i'
<br />B10. indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
<br />U FIS Profile I' FIRM L) Community Determined IJ Other (Describe):
<br />1311- Indicate the elevation datum used for the BFE in B9: iyf NGVD 1929 I_( NAVD 1988 L.J Other (Describe):
<br />812. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? i_I Yes IX I No
<br />Designation Date:
<br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
<br />C1. Building elevations are based on: (_(Construction Drawings' LjBuilding Under Construction' Finished Construction
<br />'A new Elevation Certificate will be required when construction of the building is complete.
<br />C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see
<br />pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
<br />C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, ARIAH, ARiAO
<br />Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. H the datum is different from
<br />the datum used for the BFE in Section S. convert the datum to that used for the BFE. Show field measurements and datum conversion
<br />calculation. U e the space provided or the Comments area of Section D or Section G. as appropriate, to document the datum conversion.
<br />Datums ConversioComments
<br />m
<br />Elevation reference ark used T C(ql Does the elevation reference mark used appear on the FIRM? {_,_I Yes IyI No
<br />a) Top of bottom floor (including basement or enclosure)
<br />1� b) Top of next higher floor) � • f? � ft•(m) N m fts'�1'•-------•~.._.`r •'•;1•
<br />O c) Bottom of lowest horizontal structural member (V zones only) — ft•(m)
<br />O d) Attached garage (top of slab) ft.(m) r- JE>-' E; L.0 '41 ,I
<br />wry
<br />e) Lowest elevation of machinery and/or equipment , 1
<br />servicing the building (Describe in a Comments area.) .36 ft.(m) s !(j VE fIf, =` )
<br />f) Lowest adjacent (finished) grade (LAG) ft -(m) Z in 0.10743
<br />ft.l►n
<br />g) Highest adjacent (finished) grade (HAG) Z 5g ) i b
<br />Q h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
<br />O i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm)
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
<br />This certification is 10 be signed and sealed by a land surveyor, engineer, or architect authorized by taw to certify elevation information.
<br />I certify that the information in Sections A, S, and C on this certificate represents my best efforts to interpret the data available.
<br />! understand_ that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001•
<br />CER7IFIER'S NAME ThOm4s ia'1tI `S0 LICENSE NUMBER
<br />TITLE e$ i t em ��t t COMPANY NAME p��� ` S p V\ 0 e yn
<br />ADDRESS Sv- �y�,(j r� Q' Y > ®� CITY L A� Vuy ` �Y�Qi STATE "Ili ZIP CORE (I U-1 i Y 4D
<br />SIGNATURE V f DATEi TELEPHONE G®d _ 3`-_� C1 Li_(q
<br />FEMA Form 81-31, January 2003 See reverse side 1 conn uation. Replaces all previous editions
<br />B4, MAP AND PANEL
<br />J B5. SUFFIX
<br />I B6. FIRM INDEX
<br />B7. FIRM PANEL
<br />• B8. FLOOD
<br />B9. BASE FLOOD ELEVATION{S)
<br />NUMBER
<br />-Ig C
<br />DATE
<br />EFFECTIVEJR VISED DATE
<br />1 I0-
<br />ZONE(S)
<br />(Zone AO, use depth of fkmd(ng)
<br />I
<br />155166
<br />02
<br />4/ti:
<br />1- B
<br />F
<br />B10. indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
<br />U FIS Profile I' FIRM L) Community Determined IJ Other (Describe):
<br />1311- Indicate the elevation datum used for the BFE in B9: iyf NGVD 1929 I_( NAVD 1988 L.J Other (Describe):
<br />812. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? i_I Yes IX I No
<br />Designation Date:
<br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
<br />C1. Building elevations are based on: (_(Construction Drawings' LjBuilding Under Construction' Finished Construction
<br />'A new Elevation Certificate will be required when construction of the building is complete.
<br />C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see
<br />pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
<br />C3. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, ARIAH, ARiAO
<br />Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. H the datum is different from
<br />the datum used for the BFE in Section S. convert the datum to that used for the BFE. Show field measurements and datum conversion
<br />calculation. U e the space provided or the Comments area of Section D or Section G. as appropriate, to document the datum conversion.
<br />Datums ConversioComments
<br />m
<br />Elevation reference ark used T C(ql Does the elevation reference mark used appear on the FIRM? {_,_I Yes IyI No
<br />a) Top of bottom floor (including basement or enclosure)
<br />1� b) Top of next higher floor) � • f? � ft•(m) N m fts'�1'•-------•~.._.`r •'•;1•
<br />O c) Bottom of lowest horizontal structural member (V zones only) — ft•(m)
<br />O d) Attached garage (top of slab) ft.(m) r- JE>-' E; L.0 '41 ,I
<br />wry
<br />e) Lowest elevation of machinery and/or equipment , 1
<br />servicing the building (Describe in a Comments area.) .36 ft.(m) s !(j VE fIf, =` )
<br />f) Lowest adjacent (finished) grade (LAG) ft -(m) Z in 0.10743
<br />ft.l►n
<br />g) Highest adjacent (finished) grade (HAG) Z 5g ) i b
<br />Q h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade
<br />O i) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm)
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
<br />This certification is 10 be signed and sealed by a land surveyor, engineer, or architect authorized by taw to certify elevation information.
<br />I certify that the information in Sections A, S, and C on this certificate represents my best efforts to interpret the data available.
<br />! understand_ that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001•
<br />CER7IFIER'S NAME ThOm4s ia'1tI `S0 LICENSE NUMBER
<br />TITLE e$ i t em ��t t COMPANY NAME p��� ` S p V\ 0 e yn
<br />ADDRESS Sv- �y�,(j r� Q' Y > ®� CITY L A� Vuy ` �Y�Qi STATE "Ili ZIP CORE (I U-1 i Y 4D
<br />SIGNATURE V f DATEi TELEPHONE G®d _ 3`-_� C1 Li_(q
<br />FEMA Form 81-31, January 2003 See reverse side 1 conn uation. Replaces all previous editions
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