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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 0 • eaytaLlrmgrgency Management Agency Expires February 28. 2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name ANDREA TISCHLER Policy Number A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. HOAKA RD. Company NAIC Number City HILO State HI ZIP Code 96720 • A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) TMK(3)-2-4-054:027 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) ACCESSORY-GUEST HOUSE A5. Latitude/Longitude: Lat.N19 39'39" Long.W155 7'26" A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A7. Building Diagram Number 5 A8. For a building with a crawl space or enclosure(s),provide • A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) NA sq ft a) Square footage of attached garage NA sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade NA walls within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b NA sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION 131. NFIP Community Name&Community Number I B2.County Name HAWAII COUNTY 155166 HAWAII COUNTY State f f HAWAIIB3. B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood 69.Base Flood Elevation(s)(Zo-ne Date Effective/Revised Date Zone(s) A0,use base flood depth) I 155166-870 C 4/02/04 9-16-88 A 857.5 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. 0 FIS Profile 0 FIRM ®Community Determined 0 Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 0 NAVD 1988 B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)?Other be) ❑Yes Designation Date 0 CBRS 0 OPA ®No . SECTION C-BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* *A new Elevation Certificate will be required when construction of the building is complete. ®Finished Construction C2. Elevations-Zones A1-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 C2.a-g below according to the building diagram specified in Item A7. • Benchmark Utilized SEE COMMENT Vertical Datum Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor859.08 b) ) ®feet 0 meters(Puerto Rico only) Top of the next higher floor NA. ❑feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) NA. 0 feet d) Attached garage(top of slab) NA ❑meters(Puerto Rico only) 0 feet 0 meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 859.08 ®feet D meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) 854.8 ®feet Highest adjacent(finished) ❑meters(Puerto Rico only) g) Hi 9 grade(HAG) 854.8 ®feet 0 meters(Puerto Rico only) • 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 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. 0 Check here if comments are provided on back of form. Certifiers Name RONALD D. NICKEL Q g. License Number 8846-C `1' Title CIVIL ENGINEER Company Name RONALD NICKEL P.E. LLC iress 12-7109 KALAUNU ST City PAHOA State HI ZIP Code 96778 0 J Si re / /f�e !at7 Telephone 808-965-9911 \c' b I FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previ us P ;t, .nc