Laserfiche WebLink
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 <br /> FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date:July 31, 2015 <br /> Natiunal Flood Insurance Program IMPORTANT:Follow the instructions on pages 1-9. <br /> SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br /> Al. Building Owner's Name Kinzer Family Trust Policy Number: <br /> A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P0.Route and Box No. Company NAIC Number: <br /> 64-640 MANA ROAD <br /> City KAMUELA State HI ZIP Code 96743 <br /> A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) <br /> (3)6-4-018-084 <br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) <br /> A5. Latitude/Longitude: Lat. 20(MAR Long. -155 63268 Horizontal Datum: ❑NAD 1927 0 NAD 1983 <br /> A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. <br /> A7. Building Diagram Number 5 <br /> A8. For a building with a crawlspace or enclosure(s): A9.For a building with an attached garage: <br /> a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage 500 sq ft <br /> b) No.of permanent flood openings in the crawlspace or b) Number of permanent flood openings in the attached garage <br /> enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade <br /> c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in <br /> d) Engineered flood openings? ❑Yes 0 No d) Engineered flood openings? ❑Yes 0 No <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION <br /> B1. NFIP Community Name&Community Number B2.County Name 63. State <br /> HAWAII COUNTY- 155166 HAWAII COUNTY HAWAII <br /> B4. Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel Effective/ B8. Flood Zone(s) 69.Base Flood Elevation(s)(Zone <br /> Revised Date A0,use base flood depth) <br /> 0167C C APR 02,2004 September 16, 1988 X 2843 <br /> B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9: <br /> ❑FIS Profile x❑FIRM 0 Community Determined 0 Other/Source: <br /> B11.Indicate elevation datum used for BFE in Item B9: x❑NGVD 1929 D NAVD 1988 0 Other/Source: <br /> B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes 0 No <br /> Designation Date: / / 0 CBRS 0 OPA <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) <br /> Cl. Building elevations are based on: ❑Construction Drawings* 0 Building Under Construction* 0 Finished Construction <br /> *A new Elevation Certificate will be required when construction of the building is complete. <br /> C2. 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/A0.Complete Items <br /> C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters. <br /> Benchmark Utilized:RM 8 Vertical Datum:2804.82' <br /> Indicate elevation datum used for the elevations in items a)through h)below. ❑x NGVD 1929 0 NAVD 1988 0 Other/Source: <br /> Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. <br /> a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 2842 2 ❑x feet D meters <br /> b) Top of the next higher floor <br /> ❑feet ❑meters <br /> c) Bottom of the lowest horizontal structural member(V Zones only) 0 feet 0 meters <br /> d) Attached garage(top of slab) 2840 3 ❑x feet ❑meters <br /> e) Lowest elevation of machinery or equipment servicing the building 2841 2 Qx feet 0 meters <br /> (Describe type of equipment and location in Comments) <br /> f) Lowest adjacent(finished)grade next to building(LAG) 2839. 3 Lj feet ❑meters <br /> g) Highest adjacent(finished)grade next to building(HAG) 2840.2 ❑x feet 0 meters <br /> h) Lowest adjacent grade at lowest elevation of deck or stairs, including 2839.5 li feet 0 meters <br /> structural support <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 <br /> information.I certify that the information on this Certificate represents my best efforts to interpret the data available. <br /> I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. F� <br /> El Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a <br /> gCheck here if attachments. licensed land surveyor? 0Yes ❑No <br /> 15. <br /> ,cEN �,.D �`� <br /> Certifiers Name License Number PROFt I4NAL <br /> Roger Dean Fleenor LS 7276 MAL <br /> Title Company Name * \ S1 )/E R <br /> Owner Roger Dean Fleenor LPLS LLC \o. 7276 <br /> Address City State ZIP Code <br /> n. PO Box 383414 �//� Waikoloa HI 96738 'S' P. <br /> Signature ., Date Telephone �r''A I I, �S <br /> 3-13-2014 808-880-9441 <br /> FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions. <br /> 1' <br />