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r " •, - / <br /> , <br /> U.S_ DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0004 <br /> Federal Emergency Management Agency Expires March 31,2 <br /> National Flood Insurance Program Important: Read the instructions on pages 1-9. <br /> A-PROPERTY INFORMATION <br /> 1""":"------------ <br /> SECTIONe Company Use: <br /> Al. Building Owner's Name r <br /> Hualalai Investors, LLC <br /> A2- Building Street Address(including Apt,Unit,Suite,and/or Bldg. No.)or P.O. Route and Box No. Company NAIC Number <br /> 72-100 Kaupulehu Drive, Suite 1 (Bridge Suite 7) <br /> City State ZIP Code <br /> ___ _ Kailua Kona. Hawaii 96745 <br /> A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) • <br /> TMK: (3) 7-2-010:004 4 5, 3(0,. 1,. . 5,1 3311 <br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Hotel <br /> A5. Latitude/Longitude:Lat. 19.8276° <br /> ° N Long. 155.9925 W Horizontal Datum: 0 NAD 1927 ® NAD 1: <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 <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 sq ft <br /> b) No.of permanent flood openings in the crawlspace or b) No.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 ❑ No <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION <br /> Bl. NFIP Community Name&Community Number B2.County Name 83.State <br /> hawaii County 155166 Hawaii County Hawaii <br /> B4.Map/Panel Number 55.Suffix B6.FIRM Index B7.FIRM Panel E38.Flood B9.Base Flood Elevation(s)(Zon <br /> Date Effective/Revised Date Zone(s) AO,use base flood depth) <br /> 155166478 C 4/02/04 9/16/1988 AE 9•.0 <br /> B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. <br /> 0 FIS Profile ®FIRM Community Determined 0 Other(Describe) <br /> BI1. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 0 NAVD 1988 ❑Other(Describe) <br /> B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® No <br /> Designation Date ❑CBRS ❑OPA <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) <br /> Cl. Building elevations are based on: 0 Construction Drawings' ❑ Building Under Construction' pa 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,AR/A,ARAE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h <br /> below according to the building diagram specified in Item A7. Use the same datum as the BFE <br /> Benchmark Utilized RM 65 Vertical Datum _NGVD 1929 . <br /> Conversion/Comments <br /> Check the measurement used. <br /> a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 12 8 9 feet 9meters(Puerto Rico only) <br /> b) Top of the next higher floor 22 .82 feet meters(Puerto Rico only) <br /> c) Bottom of the lowest horizontal structural member(V Zones only) Njll O feet ❑meters(Puerto Rico only) <br /> d) Attached garage(top of slab) N/A ._❑feet 0 meters(Puerto Rico only) <br /> e) Lowest elevation of machinery or equipment servicing the building 1 2_ 910 feet 0 meters(Puerto Rico only) <br /> (Describe type of equipment and location in Comments) <br /> f) Lowest adjacent(finished)grade next to building(LAG) 1 ®feet 0 meters(Puerto Rico only) <br /> . g) Highest adjacent(finished)grade next to building(HAG) 17.21XO feet ❑meters(Puerto Rico only) • • <br /> h) Lowest adjacent grade at lowest elevation of deck or stairs,including PIA _❑feet 0 meters(Puerto Rico only) <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. /certify that the information on this Certificate represents my best efforts to interpret the data available. �¢T l-p <br /> I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code, Section 1001. t� tc� <br /> ❑/"Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a LICENSED <br /> licensed land surveyor? ®Yes ❑No PROFESSIONAL <br /> * LAND <br /> Certifier's Name License Number SURVEYOR <br /> Robert K.Y. Lee L.S. 5075 <br /> Title Company Name No.5075 <br /> President Towill, Shigeoka & Associates, Inc. <br /> Address City State ZIP Code ' V,-*2153 'N. King St. , S-308, Honolulu, Hawaii 96819 ' .�'YAili),U`�' <br /> Signature ( Q 0, _ Date Telephone <br /> �-K' April 28, 2009 808-538-3857 <br /> FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions <br />