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Home My WebLink About2-4-062:063U.6, DEPA,$TMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 f Federal Emergency Management Agency I I Expires March 31, 2012 I National Flood Insurance Program Important: Read the instructions on pages 1-9. Street Address (in( o LAUNA SECTION A - PROPERTY INFORMATION L-F.or Ince sdian.Como6nv.Use... ;! uNIMOTO Suite, and/or Bldg. No.) or P.O. Route and Box No. City EI I. -O State Nt ZIP Code q&?2 A3. Property Description '- (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) IrMK. �3)2-Q�OPo2: 0&3, A4. Building Use (e.g., R�p eptlal, Nonu-Res Addition, Accessory, etc.) 51NGILE x^'111-=( RESIC`&4 :E A5. Latitude/Long Rude: Ca `�� t� Long15555 00 0`54 Horizontal Datum: ❑ NAD 1927 19 NAD 1983 A6. Attach at least 2 photographs f the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) _ sq ft a) Square footage of attached garage sq 1t b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b - —sq in c) Total net area of flood openings In A9.b _ aq in d) Engineered flood openings? ❑ Yes [INo d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name 8 Community Number 82. County Name B3. State . Hawaii County 155166 Hawaii County Hawaii Date I Effective/Revised Date Zones) AO, use base flood 155166-6190 C. 4/02/04 q. /& — 88 I AN 1 437. 3 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89. NJ FIS Profile ❑ FIRM ❑ Community Determined ❑ Other (Describe) _ B11. Indicate elevation datum used for BFE in Item B9: in NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No • Designation Date _ Cl CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction' JIQ Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations –Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item AT Use the same datum as the BFE. frA Benchmark Utilized Vertical Datum ...�vo IUq Conversion/Comments 15CAPwW LoriC. Fid# 5�0 r, 2424(9 �I5�J7R�jl G7tlot.lr Plat " leAWAILANl PWC Check the measurement used. e) Top of bottom Floor (including bas, craw sp°ace, or enclosure Floor) Z . O ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor W A _ ❑ 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) .,,,8_ 19 feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 441.0 ® feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) 0 Lowest adjacent (finished) grade next to building (LAG) '4W . 9 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 4 59 feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, Including._ ❑ feet ❑ meters (Puerto Rico only) structural support 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 information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available.) understand that any false statement maybe punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here If comments are provided on back of forth. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes 'K No Certmer's Name _rke VOf2 E5. License Number L`s _ 11858 Lie SUIZVEYI2EC .Z Company Name 1�+•1D 6oU1J1`( OF II4WAI (, WT OF FUeUC ulMiQ5 Address 101 PAUAWI bT $TE 1 City 91X State{1AWAII ZIP Code q(p"120 FEMA Form 81-31, Mar 09V See reverse side for continuation. LI. $D 0PRGSILINAL L"7. SURVEYOR N0. 11868 Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. I Porlf3maerly`eemeunw Lim 121(0 LAUWA S1 City State ZIP Code IAA LV AwA1't OR ARCHITECT CERTIFICATION _opy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. TYm of M)IPMEIJT 1SeKV"#-4C1 Bull-PthI&I (n(CWCE WAI%lE2 i Dw-Yez ALIO WATM 14EATE9 , SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items Et -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the.lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (Including basement, crawlspaee, or enclosure) is — _ ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided In Section A Items 8 and/or 9 (seepages 8-9 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building is _ _ [3 feet ❑ meters [3 above or d below the HAG. E3. Attached garage (top of slab) Is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or 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 community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify 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 community -Issued BFE) or Zone AO must sign here. The statements in Section's A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name City SECTION G - State i no iocai onicisi wno is sumorizea oy raw or Ordinance to administer the community's floodplain management ordinance can complete E and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Cherie the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law 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 community -Issued 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 Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building:_._ ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: _ _ []feet ❑ meters (PR) Datum G10. Community's design flood elevation _ _ ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name - Telephone Signature Date ❑ Check here 'd attachments FEMA Form 81-31, Mar 09 Replaces all previous editions