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9.1
<br /> U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
<br /> Federal Emergency Management Agency Expires February 28.2009
<br /> National Flood Insurance Program Important: Read the instructions or pages 1-8.
<br /> SECTION A-PROPERTY INFORMATION For Insurance Company Use:
<br /> Al. uilding Owner's Name Policy Number
<br /> L,a %t-Pi► I O -33-T i _S ( L.L.
<br /> A2. uilding Street Address(includin Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Company NAIC Number
<br /> 7Z-100 U t�tt�l 'G�2, 5-Ur 4k-E,.-- te
<br /> mats Z�421
<br /> cityState P Code
<br /> A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
<br /> -C- 1Vk. (t 7-2-lc' 4- 1---,-,- S , 3-P),4-8' "
<br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) lam -[' L3�T t�Ej
<br /> A5. Latitude/Longitude:Lat.N-14.`a.- Long. VJ ('SS Q 9jSt'c' Horizontal Datum: 0 NAD 1927 N\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 1
<br /> A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide:
<br /> a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft
<br /> b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage
<br /> enclosure(s)walls within 1.0 foot above adjacent grade walls 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 /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
<br /> B1.NFIP Community Name&Community Number B2.County Name B3.State
<br /> Hawaii County 155166 Hawaii County Hawaii
<br /> 84.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
<br /> Date Effective/Revised Date Zone(s) AO,use base flood depth)
<br /> 1551664/6. 478"6 4/02/04 1l0b1 l 9„a8 A.E. 1.p
<br /> B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
<br /> p FIS Profile [FIRM ❑Community Determined ❑Other(Describe)
<br /> B11. Indicate elevation datum used for BFE in Item B9: 1,4 NGVD 1929 0 NAVD 1988 ❑Other(Describe)
<br /> B12. Is the building located in a Coastal Barrier Resources System(CBRS)area orOtherwise Protected Area(OPA)? ID Yes ® No
<br /> ❑ ❑
<br /> Designation Date CBRS OPA
<br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
<br /> Cl. Building elevations are based on: ❑Construction Drawings* ❑ Building Under Construction* 4 Finished Construction
<br /> *A new Elevation Certificate will be required when construction of the building is complete.
<br /> C2. Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g
<br /> below according to the building diagram specified in Item 1 A7. CCC���Z
<br /> Benchmark Utilized ,� ‘01:,'‘01:,' T Vertical Datum vP 1 ( .
<br /> Conversion/Comments A
<br /> •
<br /> Check the measurement used.
<br /> a) Top of bottom floor(including basement,crawl space,or enclosure floor) 12...(isfeet ❑meters(Puerto Rico only)
<br /> b) Top of the next higher floor Z2 .9c feet ❑meters(Puerto Rico only)
<br /> c) Bottom of the lowest horizontal structural member(V Zones only) feet ❑meters(Puerto Rico only)
<br /> d) Attached garage(top of slab) _❑feet ❑meters(Puerto Rico only)
<br /> e) Lowest elevation of machinery or equipment servicing the building (2,, .IS[151 feet ❑meters(Puerto Rico only)
<br /> (Describe type of equipment in Comments)
<br /> f) Lowest adjacent(finished)grade(LAG) _____11_. .111feet ❑meters(Puerto Rico only)
<br /> g) Highest adjacent(finished)grade(HAG) C2.. :4 feet ❑meters(Puerto Rico only)
<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. /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. o�� R. L9 a®
<br /> 16‘Check here if comments are provided on back of form. ' � te,Q
<br /> ' RE94TERED
<br /> Cee/rtifier s Namer ,� t ",C License Number * PROESSIONA[
<br /> Tit e �-f �{jaate
<br /> gany No. 54 /
<br /> 44_24. cikvZIP,Op �.� /; /
<br /> .Jignature a_-• ( !I Date elephone All, 0• ,
<br /> FEMA Form ' 1, February 2006 See reverse side for continuation. Replaces all previous editions
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