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FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077 <br /> NATIONAL FLOOD INSURANCE PROGRAM Expires July 31,2002 <br /> ELEVATION CERTIFICATE <br /> Important: Read the instructions on pages 1 -7. s , <br /> SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: <br /> BUILDING OWNER'S NAME Policy Number <br /> Andrew R. Riga .• <br /> 'r <br /> BUILDING STREET ADDRESS(Including Apt,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number <br /> 33 Kaulike Street <br /> CITY STATE ZIP CODE •1 <br /> Hilo HI 96720 <br /> PROPERTY DESCRIPTION(Lot and Block Numbers.Tax Parcel Number.Legal Description.etc.) <br /> Lot 36, Waiakea. Heights Subdivision, Unit 1, Tax Map Key: 3rd Div. 2-4-37: 73 <br /> BUILDING USE(e.g..Residential.Non-residential.Addition,Accessory.etc. Use Comments section if necessary.) <br /> Residential <br /> LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: LJ GPS(Type) -' <br /> ( ##'-##'-##.##' or ##.####e) LJ NAD 1927 I__.1 NAD 1983 (J USGS Quad Map LJ Other. <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION • <br /> B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE <br /> Ita4AA„lal i 155166 Hawaii HI <br /> wt.MAP AND PANEL B5. SUFFIX l B6.FIRM INDEX 87.FIRM PANEL B8.FLOOD B9.BASE FLOOD ELEVATION(S) <br /> NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) <br /> 155166 0890 _ C Sept. 16, 1988 Sept. 16, 1988 AH 616.0 <br /> B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. <br /> Lj FIS Profile L XJ FIRM I I Community Determined L Other(Describe): <br /> B11. Indicate the elevation datum used for the BFE in B9: IJ NGVD 1929 j I NAVD 1988 U Other(Describe): <br /> B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? Lj Yes IX I No <br /> Designation Date: <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) <br /> Cl. Building elevations are based on: IJConstruction Drawings' ' j JBuilding Under Construction' j.JFinished Construction <br /> 'A new Elevation Certificate will be required when construction of the building is complete. <br /> C2. Building Diagram Number 5 (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 A1-A30, AE,AH,A(with BEE),VE,V1-V30,V(with BFE),AR,AR/A,ARAE,AR/A1-A30,AR/AH,AR/AO <br /> Complete Items C3a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from <br /> the datum used for the BFE in Section B,convert the datum to that used for the BFE. Show field measurements and datum conversion <br /> calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion. <br /> Datum MSL Conversion/Comments <br /> Elevation reference mark used COUNTY BM Does the elevation reference mark used appear on the FIRM? (_I Yes Ix I No <br /> O a)Top of bottom floor(including basement or enclosure) 616 . 89 ft.(m) <br /> O b)Top of next higher floor N/A _ft.(m) h 0M1 <br /> O c) Bottom of lowest horizontal structural member(V zones only) 615 58 ft(m) ���� M,�T�G <br /> O d)Attached garage(top of slab) 614 • 44 ft.(m) E a �O LICENSED <br /> O e)Lowest elevation of machinery and/or equipment °1-„ PROFESSIONAL \� <br /> servicing the building N/A _ft.(m) E U LAND SURVEYOR <br /> D f)Lowest adjacent grade(LAG) 611 • 2 ft.(m) v N No.4328 <br /> g)Highest adjacent grade(HAG) 613 • 9 ft.(m) <br /> O h) No.of permanent openings(flood vents)within 1 ft. above adjacent grade 0 <br /> O i)Total area of all permanent openings(flood vents)in C3h 0 sq. in.(sq. cm) y✓All, )' <br /> SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION <br /> This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. <br /> I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. <br /> '•(nderstand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. <br /> ..RTIFIER'S NAME LICENSE NUMBER <br /> Clyde K. Matsunaqa 4328 <br /> TITLE COMPANY NAME <br /> Licensed Professional Land Surveyor Imata & Associates, Inc. <br /> ADDRESS CITY STATE ZIP CODE <br /> 171 Kapiolani Street Hilo HI 96720 <br /> SIGNATU "</„. .�Q �� DATE 06/27/00 TELEPHONE (808) 935-6827 <br />