My WebLink
|
Help
|
About
|
Sign Out
Home
4-5-006:067
PublicDocuments
>
Public Works
>
Engineering Division
>
99_Archive
>
01_Forms
>
Floodplain Management
>
Elevation Certificates
>
Completed Elevation Certificates
>
Zone 4 Elevation Certificates
>
4-5-006:067
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/21/2014 9:18:36 AM
Creation date
7/21/2014 9:17:39 AM
Metadata
Fields
Template:
Document Description
Date
6/9/2014
Type
Elevation Certificate
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
2
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
U.S.r1Pl1RTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE <br /> FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 <br /> ,National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31,2015 <br /> SECTION A-PROPERTY INFORMATION " <br /> Al. Building Owner's Name Ronald L.Thiel and Barbara L.Franklin <br /> A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. <br /> 45-3438 Mamane Street <br /> City Honokaa State HI ZIP Code 96727 <br /> A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description.etc.) <br /> (3)4-5-006:067 <br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential <br /> A5. Latitude/Longitude:Lat.20.07796 Long.-155.46400 Horizontal Datum: 0 NAD 1927 ® 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 6 <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 endosure(s) 87 sq ft a) Square footage of attached garage WA sq ft <br /> b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage <br /> or enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade N/A <br /> c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b N/A sq in <br /> d) Engineered flood openings? 0 Yes ® No d) Engineered flood openings? 0 Yes 0 No <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION <br /> B1.NFIP Community Name&Community Number C B2.County Name B3.State <br /> Hawaii County-155166 i Hawaii County Hawaii <br /> B4.Map/Panel Number 85.Suffix B6.FIRM Index Date B7. FIRM Panel I 88. Flood 1 89.Base Flood Elevation(s)(Zone <br /> 0205 C April 2,2004 Effective/Revised Date Zone(s) I AO,use base flood depth) <br /> i September 16, 1988 AH 1092.0 <br /> B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89. <br /> ❑ FIS Profile ® FIRM 0 Community Determined 0 Other/Source: <br /> BI 1. Indicate elevation datum used for BFE in item 89: ® NGVD 1929 0 NAVD 1988 0 Other/Source: <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: 0 CBRS 0 OPA <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) <br /> Cl. Building elevations are based on: 0 Construction Drawings' 0 Building Under Construction' ® 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 In Puerto Rico only,enter meters. <br /> Benchmark Utilized:Tr."Hula Moon" Vertical Datum: NGVD 1929 <br /> Indicate elevation datum used for the elevations in items a)through h)below. ®NGVD 1929 0 NAVD 1988 0 Other/Source: <br /> Datum used for building elevations must be the same as that used for the BFE. <br /> Check the measurement used <br /> a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 1100.1 ®feet 0 meters <br /> b)Top of the next higher floor 1105.3 ®feet 0 meters <br /> c) Bottom of the lowest horizontal structural member(V Zones only) N/A. 0 feet 0 meters <br /> d)Attached garage(top of slab) N/A. 0 feet 0 meters <br /> e)Lowest elevation of machinery or equipment servicing the building 1100.1 ®feet 0 meters <br /> (Describe type of equipment and location in Comments) <br /> f) Lowest adjacent(finished)grade next to building(LAG) 1099.4 ®feet 0 meters <br /> g) Highest adjacent(finished)grade next to building(HAG) 1103.5 ®feet 0 meters <br /> h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 1100.1 ®feet 0 meters <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.I certify that the information on this Certificate represents my best efforts to interpret the data available. OQl g•JAC <br /> l understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. fitSo <br /> Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a !.v LIQgt'1 . <br /> 0 Check here if attachments. licensed land surveyor? 0 Yes DD No PROF- ()NAL�MA <br /> Certifier's Name Trevor B Jackson License Number LS-11858 * • <br /> Title Land Surveyor Company Name No.19858 <br /> Address P.O.Box 872 City Pahoa State HI ZIP Code 96778 <br /> A�'AI1,U 5 <br /> SignaturetiV%.--44J Date /d Telephone 808-640-6057 <br /> FEMA Form 086-0-33(7112) See reverse side for continuation. Replaces all previous editions. <br />
The URL can be used to link to this page
Your browser does not support the video tag.