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°.BIPAR1s1ENTOF1Ir]11ELA1m8EOURfTY ELEVATION CERTIFICATE PL/gEAAI. ENEROENCv,MAN11aEMENT AGENCY OMB No. 1660.0008 xarloraf f7oad lnsurancr?nrgram Impoitant Read the inti ftc ions on pages 1-8.. ExpirationDete: July31, 2015 SECTION A PROPERTY INFORMATION molt,INSIJRANCE COMPANY,'USI Al. Binding Owner's Name Jon Kepecs , - PotcyNtenber at , A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. - •,Company NAK; Number , 89.1790 PUAKO BEACH DRIVE (MP M STRUCTURE) City.KAMUEIA .. State Ml 23P Code 98743 -. A3. Property Description (Lot and Block Numbers, Tax Parcel Number, tergal Description, stc.) (3)6-9-005:018 A4.. Building Use (e.g., Residential. Non -Residential, Addition, Accessory, eft.) Seaklindial A5. LatibidelLonpaude:. LaL 19.96777 Long. -150.84800 Horizontal Datum: ❑ HAD 1927 ® NAD 1983 A8. Attach at least 2 photographs of the building if the CertBcals is being used to obtain flood insurance. A7. Bidding Diagram Number 5- AS. For a buldi ng with a aaa4spsoe or enclosure(s): A9. Fora building with an attached garage: a) Square footage of orewispace or enclosure(s) eq It 9) Square footage of attached garage sqft b) Number of pamharieite0od operdngs in tle aealBpow b) Number of permanent flood gpernmgs in the altodwd garage or enclosure(s) within 1.0 foot above l4werd grade within 1.0 foot above acyaowt grade c) Total not area of flood openings in A8.baq in c) Total net area of food openings In A9.b i in d) Engineered food Opp ❑ Yes E3 No d) Engineered flood opening? 13 Yes ❑ NomOpp"? 181. NFIP Community Name LHAWAII COUNTY -165166 8 Community Number I._ HAWAII COUNTY -- - HAWA82. County Name 83. II L84. MeplPanel Number I 85. Suft B8. FIRM index Date I 67. FIRM Panel 08. Flood 89. Sese Flood Elevaton(s) (Zone 02'77 C - APR 02,.2004 wed Data Zore(s) AO, use hese Send depth) SEPTEMBER 18. 1989 VE aft. 810. Indicate the source tithe Base Flood Elevation (BFE) dale or ban flood depth entered in Item 89. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ ONhec/Source: _ 811. Indices elevation datum used fix SFE in Item 89: ® NGVD 1929 ❑ - NAVD 1908 ❑ 011ner/5ouroe: 612. Is the building located in a Coastal Barrier Resources System ICBM) area or Otherwise Protected Area (OPA)? ❑ Yes ❑ No Designation Date: _ ❑ CBRS ❑ OPA. SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings. ❑ Building Under Construction* ® Finished Construction 'A new Elevation Certificate wig be required when construction of the building is complete. C2. Elevations -Zones Al-". AE, AH, A (with SFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, ARIAO. Complete Items C2.041 below according to the building diagram specified in Rom A7. In Puerto Rico only, enter meters. Benchmark 111IIIzed: PUAKO NEW Vertical Datum: NGVD 29 Indicate elevation datum used for the elevations in items a) through h) below. ® NGVD 1929 O NAVD 1986 O Other/Source: Datum used for building elevations mustbe to same as that used for the SFE. Check the nessiveme t used a) Top of bottom floor (Including basement, crevdspece, or enclosure Roo0 U. -M ® het ❑ meters b) Top of the nand higher floor Nag ❑ fast ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) 1¢9¢ ® het ❑ meters d) Attached garage (top of slab) N -A - ❑ feet j] meters e) lowest elevation of machinery Or equipnert servicing the building LL.-` ® het ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (fnishod) grade next to building (LAG) 4.99 ® het ❑ meters g) Highest adjacent (finished) grade next to braiding (HAG) ¢.663 ® feet ❑ meters h) Lowest ad)acent grade at lowest elevation of deck or stabs, including structural support 4.9b ® feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect authodzed by law to certify elevation ird60ma0011, f car* that Me hnbmeaorr on ads CeAYkefe MPMSerds my bestefforfa to interpret the data available. _ I understand that any f iss statement may be punishable by fine or Bryxisonrnent under 16 U.S. Code, Section 1001.; M'pS G. PqT Check here tconmlems are provided on back of form. Were Witude and lengflude in Section A provided by a Check here If attachments. licensed land surveyor? ® Yes ❑ NoO P LICENS Ep y Certifiers Name THOMAS PATTISON License Number 10743 * L�AN10 Title LAND SURVEYOR Company Name PATTISON LAND SURVEYING SURVE147R -- No. 10743 Address 88-1125 TH KANIKU DRIVE Cay KAMUFIA State HI ZIP Cade 96743 _ ti Signature -"- iDate 12/13/2013 Telephone 808-327-9439 \\l+e it FEMA Form 086.0-33 (7112) See reverse side for continuation. Replaces all previous editions.