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U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood insurance Program IMPORTANT:Follow the instructions on pages 1-9. Expiration Date:July 31, 2015 SECTION A-PROPERTY INFORMATION FOR PtSURANCE COMPANY USE Al. Building Owner's Name SCOTT GRAINGER Policy Number: A2. Building Street Address(including._Apt.,Unit,Suite,and/or Bldg.No.)or PO.Route and Box No. Company NAC Number: 69-1773 PUAKO BEACH DRIVE City KAMUELA State HI ZIP Code 96743 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) (3)6-9-004-036 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat. 19 96717 Long. -155.84725 Horizontal Datum: 0 NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1A A8. For a building with a crawispace or enclosure(s): A9.For a building with an attached garage: a) Square footage of crawispace or enclosure(s) sq ft a) Square footage of attached garage 360 sq ft b) No.of permanent flood openings in the crawlspace or b) Number of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade L c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b 360 sq in d) Engineered flood openings? ❑Yes 0 No d) Engineered flood openings? 0 Yes 0 No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1. MAWAUme&5Co1m(tiunity Number 82.County Name B3.State HAWAII COUNTY HAWAII B4. Map/Panel Number B5.Suffix B6.FIRM Index Date 87.FIRM Panel Effective/ 88.Rood Zone(s) 89.Base Rood Elevation(s)(Zone Revised Date AO,use base flood depth) 0277 C APR 02,2004 SEPTEMBER 16, 1988 AO 2 FEET B10.Indicate the source of the Base Rood Elevation(BFE)data or base flood depth entered in Item B9: ❑FIS Profile 0 FIRM ❑Community Determined 0 Other/Source: 811.Indicate elevation datum used for BFE in Item B9: 3 NGVD 1929 0 NAVD 1988 0 Other/Source: B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑x No Designation Date: / / 0 CBRS 0 OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* ❑x Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. 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/A0.Complete Items C2.a-h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. Benchmark Utilized:LOCAL BENCHMARK"PUAKO NEW' Vertical Datum:NGVD 1929 Indicate elevation datum used for the elevations in items a)through h)below. 0 NGVD 1929 0 NAVD 1988 0 Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 15 03 ❑x feet 0 meters b) Top of the next higher floor 25 13 0 feet 0 meters c) Bottom of the lowest horizontal structural member(V Zones only) 13 20 0 feet 0 meters d) Attached garage(top of slab) 11 .30 0 feet 0 meters e) Lowest elevation of machinery or equipment servicing the building 447. 13.50 0 feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building8 09 (LAG)) 0 feet 0 meters g) Highest adjacent(finished)grade next to building(HAG) 10,26 ❑x feet 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including 10.04 0 feet 0 meters structural support SECTION 0-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.I 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 'is G. /320;T 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a / 0 Check here if attachments. licensed land surveyor? 0 Yes 0 No A.(' LICEt, �� Certifier's Name 1 c,n e Number * Nfit L 4S DONAL 2 THOMAS G.PATTISON SUpt,�v OR *Title VICE PRESIDENT PAaIOmeAND SURVEYING INC v0743 Address Cit State ZIP Code ./3 68-1125)IORT.44•NIKU DRIVE UNIT 906 KA\ � MUELA HI 96743 1 Signature )7/ Date Telephone /1 U S.P ..,raw.- 10/04/2013 808-327-9439 FEMA Form 086.0-33(7/12) See reverse side for continuation. Replaces all previous editions. r