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• U.S.DEPARTMENT OF HONELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 A'arional Flood Insurance Program important:Read the instructions on pages 1-9. Expiration Date:July 31,2015 . , SECTION A-PROPERTY INFORMATION FOR SISURANCE CO 1 ANY USE Al. Building Owner's Name Jon Kepecs Policy Plumber A2. Building Street Address(including Apt..Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIL Number: 69-1790 PUAKO BEACH DRIVE(MAUKA STRUCTURE) City KAMUELA State HI ZIP Code 96743 A3. Property Description(Lot and Blodk Numbers,Tax Parcel Number,Legal Description,etc.) (3)6-9-005:018 A4. Building Use(e.g.,Residential.Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.19.96777 Long.-150.84900 Horizontal Datum: 0 NAD 1927 +'. NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT. Building Diagram Number 5 A8. For a building with a crawlspace or enclosure(s): A9. Fora building with an attached garage: a) Square footage of crawlspace or enclosure(s)e(s) sq ft a) Square footage of attached garage sq ft b) Number of permanent flood openings in the ciawispace b) Number of permanent flood openings in the attached garage or endosure(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 d) Engineered flood openings? 0 Yes 0 No d) Engineered flood openings? 0 Yes 0 No in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 81.NAP Community Name&Community Number B2.County Name B3.State HAWAII COUNTY-155166 i HAWAII COUNTY HAWAII 84.Map/Panel Number 135.Suffix 86.FIRM Index Date 87.FIRM Panel 88.Flood 89.Base Flood Elevation(s)(Zone 0277 C APR 02,2004 Effective/Revised Date Zone(s) AO,use base flood depth) SEPTEMBER 16,1988 VE 8 ft. X810. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89. ❑ FIS Profile ® FIRM 0 Community Determined ❑ Other/Source: 811. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 0 NAVD 1988 812. Is the buildinglocated in a Coastal Barrier Resources System0 Other/Source: (CBRS)area or Otherwise Protected Area(OPA)? 0 Yes 0 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' ® 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,ARAE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. Benchmark Utilized:PUAKO NEW Vertical Datum: NGVD 29 Indicate elevation datum used for the elevations in items a)through h)below. ®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) 31.35 ta feet 0 meters b)Top of the next higher floor NIA 0 feet 0 meters c)Bottom of the lowest horizontal structural member(V Zones only) 10.04 1.feet 0 meters d)Attached garage(top of slab) N.JA 0 feet 0 meters e)Lowest elevation of machinery or equipment servicing the budding 1,.35 ®feet 0 meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 4.00 ®feet 0 meters g)Highest adjacent(finished)grade next to building(HAG) 6.63 ®feet 0 meters h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 4.95 ®feet 0 meters 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.I certify that the information on this Certificate represents my best efforts to intermit the date evadable. 5` p I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. , , T/S x( Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a O 0 Check here if attachments. licensed land surveyor? in Yes 0 No / LICENSED ' PROFESSIONAL Certifier's Name THOMAS PATTISON License Number 10743 LAND * * SURVEYOR Title LAND SURVEYOR Company Name PATTlSON LAND SURVEYING i No.10743 Address 68-1125 NORTH KANIKU DRIVE City KAMUELA State HI ZIP Code 96743 Signature r......77. 3, '� Date 12/13/2013 Telephone 808-327-9439 yiA I 1 V 5\'''.. FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions. v