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U.S.bEPARTMENT OF HOMELAND SECURITY <br />Federal Emergency Management Agency <br />National Flood Insurance Program <br />Building Street Address (including Apt., Unit, <br />.LANE <br />ELEVATION CERTIFICATE <br />Important: Read the instructions on pages 1-8. <br />OMB No. 1660-0008 <br />Expires February 28 2009 <br />SECTION A - PROPERTY INFORMATION I For Insurance Comoanv Use: <br />and/or Bldg. No.) or P.O. Route and Box No. <br />A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) <br />A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) REIDENTIAL <br />A5. Latitude/Long@ude: Lat. N19 30.060' Long. W154 48.121Horizontal Datum: ❑ NAD 1927 ® NAD 1983 <br />A8. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. <br />A7. Building Diagram Number 5 <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) Ng sq ft a) Square footage of attached garage NA sq ft <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 - N/A walls within 1.0 foot above adjacent grade N6 <br />c) Total net area of flood openings In AS.b N/A sq in c) Total net area of flood openings in A9.b N6 sq in <br />SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br />B1. NFIP Community Name 8 Community Number 82. County Name B3. State <br />HAWAII COUNTY 155166 1 HAWAII COUNTY HAWAII <br />B4. Map/Panel Number <br />B5. Suffix <br />B6. FIRM Index <br />B7. FIRM Panel <br />B8. Flood <br />B9. Base Flood Elevation(s) (Zone <br />/A._ <br />❑ feet <br />Date <br />Effective/Revised Date <br />Zone(s) <br />AO, use base flood depth) <br />155166-1400 <br />C <br />4/02/04 <br />9/16/88 <br />AE <br />15.5 <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 (Describe) _ <br />B11. Indicate elevation datum used for BFE in Item B9: ® NGVD:1929 ❑ NAVD 1988 ❑ Other (Describe) <br />B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑Yea ®No <br />Designation Date _ ❑ CBRS ❑ OPA <br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <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 Al -A30, AE, AH, A (with BFE), VE, Vt-V30, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g <br />below according to the building diagram specified in Item AT <br />Benchmark Utilized SURVEYOR SET Vertical Datum C_G_A LEVE <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 />a) Lowest elevation of machinery or equipment servicing the building <br />(Describe type of equipment in Comments) <br />f) Lowest adjacent (finished) grade (LAG) <br />g) Highest adjacent (finished) grade (HAG) <br />Check the measurement used. <br />19.2 <br />® feet <br />N/A._ <br />❑ feet <br />WA._ <br />❑ feet <br />/A._ <br />❑ feet <br />19.2 <br />® feet <br />❑ meters (Puerto Rico only) <br />❑ meters (Puerto Rico only) <br />❑ meters (Puerto Rico only) <br />❑ meters (Puerto Rico only) <br />❑ meters (Puerto Rico only) <br />8.85 ® feet ❑ meters (Puerto Rico only) <br />8.44 ® feet ❑ meters (Puerto 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 data available. <br />l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. <br />® Check here if comments are provided on back of forth. <br />Certifier's Name RONALD D. NICKEL License Number 8846-C <br />G <br />FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions <br />