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s. U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 P Expires March 31,2012 Federal Emergency Management Agency - National Flood Insurance Program Important: Read the instructions on pages 1-9, SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Policy Number Kelly Sheahan A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 69-1757 PUAKO BEACH DRIVE City State ZIP Code KAMUELA HI 96743 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) (3)6-9-004-032 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Residential A5. Latitude/Longitude:Lat. 19.96755 Long. -155.84620 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 crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosures) sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawispace or b) No.of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in d) Engineered flood openings? 0 Yes 0 No d) Engineered flood openings? 0 Yes 0 No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NFIP Community Name&Community Number 82.County Name 83.State HAWAII COUNTY-155166 HAWAII COUNTY HAWAII ! B4.Map/Panel Number 85.Suffix I B6.FIRM Index B7.FIRM Panel 88.Flood 89.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 0277 C APR 02,2004 SEPTEMBER 16,1988 AE 6.2 810. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. 0 FIS Profile 0 FIRM 0 Community Determined ❑Other(Describe) 811. Indicate elevation datum used for BFE in Item B9:Q NGVD 1929 0 NAVD 1988 0 Other(Describe) 812. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes Q No Designation Date 0 CBRS 0 CPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: 0 Construction Drawing? 0 Building Under Construction' Q 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/AO. Complete Items C2.a-r below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized RM 32 Vertical Datum 6.59 feet Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 8.57 0 feet 0 meters(Puerto Rico only) b) Top of the next higher floor 17.45 Q feet 0 meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) -0 feet 0 meters(Puerto Rico only) d) Attached garage(top of slab) 7.24 Q feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 9.07 Q feet 0 meters(Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 6.77 0 feet meters(Puerto Rico only) g) Highest adjacent(finished)grade next to building(HAG) 9.44 xQ feet 0 meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs,including 7.37 x❑feet fl meters(Puerto Rico only) structural support 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. f certify that the information on this Certificate represents my best efforts to interpret the data available. t understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 100 f. r❑Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a (71115. ti licensed land surveyor? OYes 0 N Cr LICENSEDENSED 13 PROFESSIONAL Certifiers Name License Number LAND Roger Dean Fleenor LS 7276 * SURVEYOR * Title Company Name No. 7276 Owner Roger Dean Fleenor LPLS LLC Address City State ZIP Code 414 c '. 59-255 Olomana Road Kamuela Hawaii 96743 WA ii, ‘1::-'' Signature I' /- Date Telephone dP i G,. 9-9-2011 808-880-9441 FEMA Form 81 -31,Mar 09 See reverse side for continuation. Replaces all previous editions