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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
<br />Federal Emergency Management Agency
<br />National Flood Insurance Program Important: Read the instructions on pages 1-8.
<br />SECTION A - PROPERTY INFORMATION
<br />Al. Building Owner's Name DOUGLAS & JOHNENE DEASY
<br />. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
<br />HI LOU
<br />City PAHOA State HI ZIP Code 96778
<br />OMB No. 1660-0008
<br />Expires February 28.2009
<br />For Insurance Comoanv Use:
<br />A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL
<br />A5. Latltude/Longitude: Lat. N19 29.355' Long. W154 49.289' Horizontal Datum: ❑ NAD 1927 ® NAD 1983
<br />A6. Attach at least 2 photographs of the building if the CertKcate Is being used to obtain flood insurance.
<br />AT Building Diagram Number D
<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) NA sq It a) Square footage of attached garage NA sq 1t
<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 NA walls within 1.0 foot above adjacent grade NA
<br />c) Total net area of flood openings In A8.b NA sq in c) Total net area of flood openings in A9.b NE sq in
<br />SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />HAWAII COUNTY 155166 1 HAWAII COUNTY I HAWAII
<br />155166.1400 I C I 4 02/04 I Effeetiv916-88 d Date ZoAnE(s) I AO, use base
<br />7ood
<br />B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
<br />❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Descdbe)
<br />811. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
<br />612. Is the building located Ina Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)9 ❑Yes ®No
<br />Ih Designation Date _ ❑ CBRS ❑ OPA
<br />IV SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REOUIREDI
<br />Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction
<br />'A new Elevation Certificate will be required when construction of the building is complete.
<br />C2. Elevations —Zones At -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR/AH, ARIAD. Complete Items C2.a-g
<br />below according to the building diagram specified In Item A7.
<br />Benchmark Utilized USGS Vertical Datum
<br />Conversion/Comments
<br />a) Top of bottom floor (including basement, crawl space, or enclosure floor)_
<br />b) Top of the next higher floor
<br />C) Bottom of the lowest horizontal structural member (V Zones only)
<br />d) Attached garage (top of slab)
<br />e) Lowest elevation of machinery or equipment servicing the building
<br />(Describe type of equipment in Comments)
<br />1) Lowest adjacent (finished) grade (LAG)
<br />g) Highest adjacent (finished) grade (HAG)
<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 date available.
<br />I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �,r,w� •,,,.
<br />® Check here if comments are provided on back of forth. +rel C r �'•%,,
<br />Certifiers Name RONALD D. NICKEL License Number 8846-C
<br />Title CIVIL ENGINEER Company Name RONALD NICKEL P.E. LLC &- ; ✓�
<br />dress 12-7109 KALAUNU ST City PAHOA State HI ZIP Code 96778
<br />Slgnatu ate Telephone 808-965-9911
<br />FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous
<br />Check the measurement used.
<br />feet
<br />❑ meters
<br />(Puerto
<br />Rico only)
<br />6._
<br />❑ feet
<br />❑ meters
<br />(Puerto
<br />Rico only)
<br />NA._
<br />❑ feet
<br />❑ meters
<br />(Puerto
<br />Rico only)
<br />NA. _
<br />❑ feet
<br />❑ meters
<br />(Puerto
<br />Rioo only)
<br />IN
<br />® feet
<br />❑ meters
<br />(Puerto
<br />Rico only)
<br />5.23
<br />® feet
<br />❑ meters
<br />(Puerto
<br />Rico only)
<br />¢.2'
<br />® feet
<br />❑ meters
<br />(Puerto
<br />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. I certify that the information on this Certificate represents my best efforts to interpret the date available.
<br />I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �,r,w� •,,,.
<br />® Check here if comments are provided on back of forth. +rel C r �'•%,,
<br />Certifiers Name RONALD D. NICKEL License Number 8846-C
<br />Title CIVIL ENGINEER Company Name RONALD NICKEL P.E. LLC &- ; ✓�
<br />dress 12-7109 KALAUNU ST City PAHOA State HI ZIP Code 96778
<br />Slgnatu ate Telephone 808-965-9911
<br />FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous
<br />
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