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Home My WebLink About2-1-017:005U.S. DEaARr�teNr of HDMELlWD sEcuwTY, ELEVATION CERTIFICATE OMB No. 16510-0008 B5. Suffer -+ Expires February 26 2009 F �mergenayMermgemerrtAgency B7. FIRM Panel Nair Flood insurance Program , Itnportaflt . Read the instructions on pages "A , B9; Base Flood Elevatlon(s) (Zone SECTION A -PROPERTY INFORMATION !; rFor,Irr�nsnoe"Compkny(lee-,t, Dale At Bulldin8 Owner's Name �Stetan BueMa ; r < " AO, ties base flood depth) m^<M 1 =ti +:gym •.I,, . A.1^�1��¢[ k, SnY�R�'k�� 410212004 Buildlnrp Street Addrew Qnduding Apt; Unit Suke, anNor Bldg. No) aP.O.Route and Box No. P 'Kelonlena6li AE, VE • St Clly Hilo, State HI ZIP.Code '96720%, A3: `Properly Description (Lot and Block Numbers, Tax Parcel Number, Lagal Desalp0on, etc.) ,. Lot 18, t ehle Park ResldendeLate: TMK (3) 2-1-17:5 , A4 Builth e g ResldeMlel, Non-ReekbMlal AddBbn Aceeewry eie.) ReeldeMiel , n0Use ( .. . .•. . . ___...._.. � ... w. s, ems... _ _ cruse. wu w.,. ur__�, ��.�. 1"1 u.n..„nv v u.,..wa� '. A8. Attach at least 2 photographs of the buUEinug Hthe Certlfleete b being used io'obtalri flood insuraitco. , ' A7' Baildgrg Diagram Numlxr � ?t � - ,, ( � `, Fa a building with a crawl space or endosnre(s) provide Ail. For in building with an attached garage, provide: a). Square footage of crawl space or encbsure(s) , '. . jl@S.ff , sq ft a) Square footage of attached garage Wji . , ,. aq ft b) No. of permanent flood openings In the crawl apace or b) No. of permanent flood openings In the attached. garage enclosure(s) walls wWrii t.0 foot above adjacent grade . ]¢ /�. walls MAthin 1.0 foot above adjacent grade 2 . e) Total net area of flood openings M A8b 1M eq In g 51i't' e) Total net area of flood openings In A9.b eq In "SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1.NFIPCommunllyName&CommunityNumber 82.CourdyName B3.State Hewaltt:ouniY1ti5IN Howell Hawall B4: Map/Penel Number B5. Suffer B6. FIRM Index B7. FIRM Panel B8. Flood B9; Base Flood Elevatlon(s) (Zone Dale Efte cd e/Revised Date Zone(s) AO, ties base flood depth) 0888 C 410212004 .9116M88s AE, VE • 23.0 B/0. Indwete the source of the Base Flood Elevation (SFE) date a boas flood depth entered In Item B9. ❑ FLS Profile X FIRM ❑,Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE In Item B9: X NGVD 1929 ❑ NAVD 1988 Other (Describe) Bt2. lathe building located Ina Coastal Baffler Resources System ((CBRS) area or Otherwise Protected Area (OPA)7 ❑Yes X No Designation' Date ❑ CSRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 91:, Budding elevations are based on: ❑ Construction DroxRnge• ❑Building Under Conebuction• XRfin shed Construction - •A new Elevation Certificate will be required when construction of the building Is complete. CZ Elevations -Zones At -A30'. AE, AH, A (with SFE), VE, V1430, V (with SFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete ftems C2.ay below awarding to the building diagram specified In Item A7. Benchmark Utilized 5.79 USGS WIDE T400291`Verdeal Datum ),mal ConverebNComments Local Tidel accented as sacral to NGVD 1929 In this area. Check the measurement used. a) Top of bottom floor (Including basement, crawl space, or enclosure float ig.;s, X feet ❑ meters (Puerto Rico only) b) Top of the next higher floor am X feet ❑ motors (Puerto Rico only) Q Bottom of the lowest horizontal structural member (V Zones only) zz.} X fee ❑ meters (Puerto Rico sky) d) Attached garage (top of slab)/p � X fact ❑ motors (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building J�J- X feet ❑ meters (Puerto Rico only) (Describe type of equipment In Commends) Q Lowest adjacent (finished) grade (LAG) 8.3 X fee ❑ meters (Puerto Rico any) g) Highest adjacent (finished) grade (HAG) j,2.$ X fee ❑ meters (Puerto Rico only) `y SECTION D - SURVEYOR, ENGINEER OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation inforindom I eerily that the information on this Certificate represents my best efforts to Interpret the dale available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. L. L. i"Check here If comments are provided on track of form. QPNUU 1�� CoMees Name Daniel Berg License Number LS 11245 L rrwrrr,.�eine7alAL L NDoc PO Box 577 CRY Hilo State HI ZIP Code 86721 y tVo• 11245 P' Signature .Date 23 January 2009 Telephone 8089594360 9h'AIi, V S• Ent•. 4/aa/Sol0 ` ]A Form 81-31, February006 See reverse side for continuation. Replaces all previous editions In these spaces, copy the City Hilo StateHI ZIP Code '.98720: ,CorrtFerry NAINumber r r - .N A NJ, SECTION D - SURVEYOR ENGINEER. OR ARCHITECT CERTIFICATION (CONTINUED) ' both aides of this Elevation Certificate for (1) community official: (2) Insurance agentfoompalry. and (3) bulkl ft owner. . menta:' 1) Structure referred to hereon Is situated entirely within the AE Hood zone. 2) Local (Hilo) Tidal Datum Is taken as Identical to NGVD29 on Howafi Island. 3) Equipment semMM the building as referenced In item 02. e) Is Electric Meter Box on bulMing face. E - BUILDING ELEVATION INFOR For Zones AO and A (without BFO, complete Items El -E5. If the CartNicate Is Intended to support a LOMA or LOMR-F request, complete Sections A, B. and C. For hems E7 -E4, use'natural grade, If available. Check the measurement used. In Puerto Ria only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade (WAG) and the lowest adjacent grade (LAO). a) Top of bottom floor (Including basement, crawl space, or enclosure) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) to ❑ feet ❑ meters ❑ above or ❑ below the LA0. E2. For Building Diagrams 6.8 with permanent flood openings provided In Section A hems 8 andfor 9.(see 8 of Instructions), the next hlgher floor - (elevation C2b In the diagrams) of the bWMhq Is _ _ ❑ feet ❑ maters ❑ above or U below the NAG. E3. Attached garage (top of slab) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery andfor equipment servicing the building Is _._ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, Is the top of the bottom floor elevated In accordance with the ammunWe floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must car* this information In Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or cemmunity4esued BFE) or Zone AO must sign here. The statements in Sections A S, and E are correct to the beat of my knowfedge. Property Owner's or Owner's Authorized Representative's Name City Side ZIP Code Signature Date Telephone or and G of this Elevation Certificate: lana to administer the eommunitys floodplain management ordinance an complete & applicable item(s) and sign below. Check the measurement used M Items 08. and 09. G1. ❑ The Information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or amlihect who Is authorized by low to certify elevation Information. (Indicate the source and date of the elevation data In the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or cemmun"Lied BFE) or Zone AO. G3. ❑ The following Information (items G4.G9.)Is provided for community floodplain management purposes. G4. Permit Number I G5. Date Permit Issued I G6. Date Certificate Of ComoOanoe/Oocuoanev Issued 07. This permit has been Issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as-bula lowest floor (including basement) of the building: _ _ j] feet ❑ meters (PR) Datum Gil. BFE or (in Zone AO) depth kf&p*ao ~ePubnc fir._ ❑ feet ❑ meters (PR) Datum Local Offidars Name - Title "", •"„” JQ recommends '"`' Signature U cloes not recommend Date menta ey_fiY�h ��-1�c �owc—o FEMA Form 81-31, February 2005 Replaces all previous Front Yew, Jan. 23,2009 RAt� .' L{r f !(L .._ �� 1,t�'��. {E � �..