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Home My WebLink About2-1-020:060U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB NO.1650-0008 Federal Emergency Management Agency I Expires February 28. 20D9 National Flood Insurance Program Important: Read the instructions on pages 1-8. •I SECTION A -PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name MIL_Ogav mr-yw?' Policy Number A2. Building Street Address (including ApL. Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 10la KALAIJ1x A.O�� AVGI) c City 411 State 1+1 ZIP, Code q�"7Zo A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Descri tion, e1cJ - - I VITT i9 -A 110410 dGTTlL1At�1T LOTS Kz_&1;Ailk rncTrTMK��2 (-oao=060 A4. Building Use (e.g.. Residential, Non -Residential, Addition, Access Ty, etc.) A5. Latllude/Longhude: Lat:; jj I90 43`� 4R, i ii Long..fj tJ II;s d 4e2l, l .q rt Horizontal Datum: ❑ NAD 1927 NAD 1283 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number -_%'P_ A8. For a building with a crawl space or enclosure(s), provide: AI). • For a building with an attached garage, provide: e) Square footage of crawl space or endosure(s) - sq fl a) Square footage of attached garage sq it b) No, of permanent flood openings in the crawl space or b) No. of permanent flood•openings in the attached garage enclosure(s) wells within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade c) Total rel area of flood Openings in AB.b sq In O) Total net area of flood openings M AB.b sq In SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 61. NFIP Community Name & Communiy Number 62. County Neme B3. State Hawaii Count 155166 Hawaii county Hawaii 810. Indicate the source of the Base Flood Elevation (BRE) data or base flood depth entered In Ram 89. ❑ FIS Profile �FlRM ❑ CommunityDetermined❑ Other (Describe) UP n .� of %blic Work Ell. Indicate elevation datum used for BRE In Item B9: L� DeNGVD 1929 ❑ NAVD 1888 ❑ Other (� � Dior 812. Is the building located Ina Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area /pFA SMT 1 Yes eV eWBd •, Designation Date til 4 ❑ CBRS ❑ OPA rT-e-a/!Ievat CerS rt" ICafe and 1 �f recomma�+Ae SECTION C -BUILDING ELEVATION INFORMATION (SURVE D ) Cl. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construstiotfinal aw~Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations -Zones A7-,430, AE, AH, A (with BFE), VE, Vt-V30, V (with BRE), AR, AR/A, ARAE, AR/A7-A30, AR/ �O. Complete items C2.ag below according to t�I e� Quildin d rem �d�,a A7. � Benchmark Wlized ISM OSU 1 rl�Icli lL 9 YLAAT Veriics ConverslonlComments' Check the a) Top of bottom floor (Including basement, crawl space, or enclosure Loon) u/'6' ❑ feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 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) 1 1 ,$[�i 'feel ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building __j(V—• = [{'feet ❑ meters (Puerto Rico only) (Describe type of equipment In Comments) f) Lowest adjacent (finished) grade (LAG) I O . 8 afeet ❑ meters (Puerto Rico only) g) Highest adjacent (Lnished) grade (HAG) I I _E_ 1set ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to Oertlfy ele Information. 1 oerilly that the Information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine orimpdsonment under 18 U.S. Code, Section 1001 Check here R comments are provided on back of form. Title "0 4URV(;y0 • Address�tROv Im 6 11 �A ouoen�s/e NuumAbeer L5 ,T- S 91 y Name prlV� 77 1AUKKA Y Associ&7t,s Ito State sll ZIP Code t Date IG+ P,f-,ht6R Telepho'nl M 159,ggj U�41ONA�L FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions B4. Map/Panel Number B5. Suffix B6. FIRM Index 67. FIRM Panel. Flood B9. Base Flood Elevation(s) (Zone 1551660885 0885-0 Date I 4/02/04 Efladlve/Revised Date 1 t6-d6p,19$ Zone(s) >A6 AOuse base flood depth) is'1 810. Indicate the source of the Base Flood Elevation (BRE) data or base flood depth entered In Ram 89. ❑ FIS Profile �FlRM ❑ CommunityDetermined❑ Other (Describe) UP n .� of %blic Work Ell. Indicate elevation datum used for BRE In Item B9: L� DeNGVD 1929 ❑ NAVD 1888 ❑ Other (� � Dior 812. Is the building located Ina Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area /pFA SMT 1 Yes eV eWBd •, Designation Date til 4 ❑ CBRS ❑ OPA rT-e-a/!Ievat CerS rt" ICafe and 1 �f recomma�+Ae SECTION C -BUILDING ELEVATION INFORMATION (SURVE D ) Cl. Building elevations are based on: ❑ Construction Drawings" ❑ Building Under Construstiotfinal aw~Construction 'A new Elevation Certificate will be required when construction of the building Is complete. C2. Elevations -Zones A7-,430, AE, AH, A (with BFE), VE, Vt-V30, V (with BRE), AR, AR/A, ARAE, AR/A7-A30, AR/ �O. Complete items C2.ag below according to t�I e� Quildin d rem �d�,a A7. � Benchmark Wlized ISM OSU 1 rl�Icli lL 9 YLAAT Veriics ConverslonlComments' Check the a) Top of bottom floor (Including basement, crawl space, or enclosure Loon) u/'6' ❑ feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 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) 1 1 ,$[�i 'feel ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building __j(V—• = [{'feet ❑ meters (Puerto Rico only) (Describe type of equipment In Comments) f) Lowest adjacent (finished) grade (LAG) I O . 8 afeet ❑ meters (Puerto Rico only) g) Highest adjacent (Lnished) grade (HAG) I I _E_ 1set ❑ meters (Puerto Rico only) 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 Oertlfy ele Information. 1 oerilly that the Information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine orimpdsonment under 18 U.S. Code, Section 1001 Check here R comments are provided on back of form. Title "0 4URV(;y0 • Address�tROv Im 6 11 �A ouoen�s/e NuumAbeer L5 ,T- S 91 y Name prlV� 77 1AUKKA Y Associ&7t,s Ito State sll ZIP Code t Date IG+ P,f-,ht6R Telepho'nl M 159,ggj U�41ONA�L FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In those spaces, copy the corresponding Information from Section A. For Insurance Company Use: Building Street p dress (including Apt., A O L6 r Blep.�,j P.O. Route and Box Z- -o ; Ob'a Pala Number city -41 L.p - i� State ) q6 Z p ZIP Code Company NAIL Number Allis, SECTION D -SURVEYOR ENGINEER OR ARCHITECT CERTIFICATION (CONTINUED) MW Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenVcompany, and (3) building owner. Comments `fir I nh If•r-r nniuhrs-.%T r'n w.u..... �, _ .-.... - - —• _ - ks I `r- — SECTION - E •BUILDING ELEVATION N (SURVEY NOT REQUIRED) FOR ZONE AO AND 20NE A 11MTNOtn' 9FEh For Zones AO and A (without BFE), complete Items E7 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, S. and C. For Items E7 -E4, use natural grade, H 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 fie highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement crawl space, or enclosure) M _ feet El meters 11 above or ®Debw the FLAG. b) Top of bottom floor (Including basement, crawl space, or enclosure) is __ _ ❑ feet ❑ meters ❑ above w below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provider/ in Secllgp,A Items 8 V*or g (see pale 8 of Instructions), the next higher floor (elevation C2b in the diagrams) of the building is ❑feet LJ meters UJ above or U 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 _ ❑ feel ❑ 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 commuNtys floodplain management ordinance? ❑ Yea ❑ 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 communhydasued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A. B. —C(" E), and G of this Elevation Cenifimte. Complete the applicable hem(s) and sign below. Check the measurement used In Items G8. and GO. 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 cenify 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 FEMAdssued or commituri issued BFE) or Zone AO. G3. ❑ The following Information (Items 04.-Gg.) Is provided for community.floodptsln management purposes. G4. Permit Number G5. Date Permit Issued GB. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G6. 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 she: ❑ feet ❑ meters (PR) Datum Official's Name Community Name Telephone Signature Date ❑ Check hereif attachment, FEMA Form 81-31, February 2006 Replaces all previous editions