HomeMy WebLinkAbout2-4-006:180 ResidentialU �F"IRTMENTOF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 16604)008
Fade a Emergency Management Agency Expires March 31, 2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A - PROPERTY INFORMATION For biBarano6C9inp61Al. ti
Al. Building Owner's Name Gary & Laurie Ann Tavares gPk>Oq Number ^ ,
A2. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number',?,
340 Hooks Road
City Hilo State HI ZIP Code 96720
A3. Pp
'perty Description (Lot and Block Numbers, Tax Paroel Number, Legal Description, ate.)
TMK:3 Mv.2.1-008:180
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, ate.) Residential
A8. Latitude/Longituds: Lat. 19.882404 Long. 155.122217Horizontal Datum: ❑ HAD 1927 ® NAD 1983
AS. Attach at best 2 photographs of the building H the Certificate to being used to obtain flood insurance.
A7. Building Diagram Number IS
AS. For a building with a crawlspeoe or anclosure(s): A9. For a building with an attached garage:
a) Square footage of croMepace or enclosures) M aq It a) Square footage of attached garage J= eq R
b) No. of permanent flood openings In the crawlspeoe or b) No. of permenerd flood.openings Init eiattoohed garage
enclosures) within 1.0 toot above adjacent gratia WA � within 1.0 foot above adjacent grade Q
c) Total net area of flood openings In A@b ; WA eq in c) Total not area of flood openings In. A9.b 1918 eq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? "" ❑'Yes "® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
HAWAIICOUNTY "155108 . F' HAWAII _ HAWAII'
84. Map/Panel Number85.
Suflbk
Bit. FIRM Index
B7. FIRM Panel
Be. Flood
89. Base Flood'Elevation(s) (Zone
. 155188 0870 &155188
C
Date
Effective/Revised Date
Zone(s)
AO, use,bese flood depth)
0890
9/18/1988
A
..' .'� �: •955: . • .
B10. Indicate the source of the Base Flood Elevation (SFE) date or base flood depth entered in Item 89. -
❑ FIS Profile ❑ FIRM ❑ Community Determined ® Other (Describe) Elevation Certificate Recon by CMF Enalneers (9/1 all 31
811. Indicate elevation datum used for BFE in Item 89: ® NGVD 1929 ❑ NAVO 1988 ❑ Other (Describe) _
812. Is the building located Ina Coastal Border Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevation& are based on: ❑ Construction DrvMngs- ❑ Building Under Construction* ® Finished Construction
•A new Elevation Certificate will be required when construction of the building Is complete.
C2. Elevations -Zones At -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO. Complata Items C2.a-h
below according to the building diagram specified In Item A7. Use the some datum as the BFE.
Benchmark Utilized PI Sotke Vertical Datum NMM192B
Conversion/Comments See Section D comments.
Check the measurement used.
a) Top of bottom floor (Including basement, crawlspeoe, or enclosure floor) QQQ.4 ® feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor $Z1.4 ® feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ meters (Puerto Rico only)
d) Attached garage (top of slab) ¢¢j.@ ® feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building ¢!)Q.$ ® feet ❑ meters (Puerto Rico only)
(Describe type of equipment and location In Comments)
f) Lowest adjacent (finished) grade next to building (LAG) W-0 ® feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade next to building (HAG) AN -1 ® feet ❑ meters (Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs, Including NZ.4 ® fast ❑ meters (Puerto Rico only)
structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
i nis cerunceuon is to oe signea ana aearea by a uma surveyor, engineer, or arenaect aknnonzea by iaw to terry eievauon
Information. I cert y that the Information on this CerNBcete represents my best efforts to Interpret the data availab/e.l
understand that any false statement maybe punishable by fine orlmprtsonment under 18 U.S. Code, Section 1001.❑
Check here It comments are provided on back of form. Were latitude and longitude In Section A provided by a
licensed land surveyor? ® Yea ❑ No
CerOflels Name Wayne A. Subica Jr. License Number 13717
Tab Lend Surveyor Company Name Imata & Assoc., Inc.
A. Sti .
�Q. P1 Ar. " qv
LID 9
PRO $�ONAL
It'AtV
A SURVEYOR N
No 13717
y'�wnu.uSP
FEMA Form 81-3 , Mar 09 a See reverse side for continuatlon. Replaces all previous edi9ons