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Home My WebLink About2-1-017:067U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1860-0008 Federal Emergency Management Agency I Expires February 28. 2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A - PROPERTY INFORMATION For Insurance Company Use: . Building Stri Klose Street TMK (including Apt., Unit, Suite, and/or Bldg. HI ZIP Code or P.O. Route and Box No. A4. Building Use (e.g., Residential, Non•Reeldential, Addition, Accessory, etc.) Residential A8. Letitude/Longltuds: Let. SM43'61.1a Long. W166.01120.7" Horizontal Datum: ❑ NAD 1927 ® NAD 1S83 A8. Attach at least 2 photographs of the building H the Certificate is being used to obtain flood Insurance. A7. Building Diagram Number ji AS. For a building with a crawl space or endosure(e), provide A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) eq ft a) Square footage of attached garage eq ft b) No.enc of permanent flood openings in the crawl apace d b) No. of permanent flood openings In the attached garage ental net (s) walla within 1.0 foot above adjacent grade wells within 1.0 That above adjacent grade c) Total net area of flood openings In Ae.b _ eq in c) Total net area of flood openings In A9.b eq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Bt. NFIP Community Name 8 Community Number B2. County Name S3, State Hawai1,1661661 Hawaii Hawaii B4. Map/Panel Number Be. Suffix Be. FIRM Index 87. FIRM Panel Be. Flood Be. Base Flood Elevations) (Zone 0686 Date Effect!"lRevleed Date Zone(s) AO, use base flood depth) C January 6,1970 September 16,1966 AE,x 22.3 FT. u,aa:aw um auu,ca w am Dose rwoa eievaaon (eFe) data or base flood depth entered in Item B9.4 ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) _ 811. Indicate elevation datum used for BFE in Item Be: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located Ina Coastal Barrier Resources System ((CBRS) area or Otherwise Protected Area (OPA)7 ❑Yes ®No Designation Date ❑ CBRS ❑ OPA L SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construetlon' ® 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, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete Rome C2.a-g below according to the building diagram specified In Item A7. The Deporhnent of Public Works Benchmark Utilized 6.79 USGS (PID:T000291 Vertical Datum Local Tidal Engineering Division has reviewed ConversbNCommente Local Tidal accepted as equal to NOVO 29 datum In this areae ythn EI t,CheckeasBr%9t.04J erfifieate and recommen s e) Top of bottom floor (including basement, crawl apace, w enclosure floor)_ 3�1 .0 ®feet ❑re (P��4 q {�„mmend b) Top or the next higher flow ,Z@.0 ❑feet ❑(pus o cpnc) Bottom of the lowest horizontal structural member (V Zones only) ))$.22 ® feet ❑(fh�hiifi'tibnly) d) Attached garage (top of slab) IMA.— ❑ feet ❑ meters (Puerto Rica only) e) Lowest elevation of machinery or equipment servicing the building. 9ig.]Z ® feet ❑ r (PueRo Rico only) (Describe type of equipment in Comments) ^�� 0 Lowest adjacent (finished) grade (LAG) 31.Q$ ® feet ❑eters (Puerto Rio only g) Highest adjacent (finished) grade (HAG) -�,� ® feet ❑ �gro„en,. jgg „n1W 5 0 2n SECTION D - SURVEYOR ENGINEER. OR ARCHITECT CERTIFICATION ,,ea W. uuuauu„ W w ua shgnea ano seahea Dy a [Ono surveyor, engineer, or architect authorized by law to certify elet I nformation. I certify that the intormation on this Certificate represents my beat efforts to interpret the data available. / understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑ Check here If comments are provided on back of form. Cerfifier's Name Richard Sunden License Number 12746 Tide Land Surveyor Company Name The Independent Hawaii Surveyors ass PO Box 077 City Hilo State HI ZIP Code 96720 FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use: Building gtreat Address (Including Apt., Unit, Suite, amllor Bldg, No.) or P.O. Route and Box No. 2316oea Street - M —0 Z7 6 Policy Number Cay Hilo State NI ZIP Code 66720 II1111111111ppy both sides of this Elevation Certificate for (1) community official, (2) insurance agem/cemparry, and (3) building owner. ' For Zones AO and A (without BFE), complete hems E1 -E5. If the Certificate Is Intended to support a LOMA or LOMR-F request, complete Sections A. B, and C. For Items El -E4, use natural grade, If available. Check the measurement used. In Puerto Rice 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, crawl apace, w enclosure) Is _ _ ❑ feet ❑ metere' b) Top of bottom flow ) le feet misters ❑ above or bele(including basement, crawl space, or enclosure ❑ above or ❑ be tow the LAG, the HAG. E2. For Building Diagrams " with permanent flood openings -- ❑❑ Provided In Section A hems 8 endlw 8 (eee tie 8 of Instructors), the next higher floor (elevation C2b In the diagrams) Is of the building is ❑fast ❑ meters ❑ above w I_j below the HAG, E3. Attached garage (top of slab) ts ❑ fast ❑ maters ❑ above or ❑ below the HAG., E4. Top of platform of machinery andlor equipment servicing the building is __._ ❑ feat E5. Zone AO only: N no flood depth number Is available, Is the top of the bottom floor elevated In accordance with the vroom ❑ below fl � HAG. ordinance? ❑ Yes ❑ No ❑ Unknown. The local ofcial must community's floodplain management certify this Information in Section O. OLUTION F - The Property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or communtty4seued BFE) or Zone AO must sign here. The stafements in Sections A, S, and E are comed to the beat of my knowledge. Property Owncee or Owners Authorized Representative's Name State ZIP Code Comments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official whole authorized by la;;or ordinance to administer the communitys floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complefe the applicable hem(s) and sign below. Check the measurement used In Items G8. and G8. 01. ❑ 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 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 boated In Zone A (without a FEMA -Issued or community -Issued BFE) or Zone AO, G3. ❑ The following Information (hems G4. -G8.) is provided for community floodplaln management purposes. 04. Permit Number 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 -bush lowest floor (Including basement) of the building: _ _ feet ❑ meters (PR) Datum GB. BFE or (in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters (PR) Datum Local Officiers Name Tihe Community Name Telephone Signature Check here h etLchmems 'EMA Form 81.31, February 2006 Replaces all previous editions Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 2S Woes Street 7M-- Oi -7 ; ot,'7 ity Hilo State HI ZIP Code 99720 Company NAIC Number It submitting more photographs than will fit on ,the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, H required, "Right Side View" and "Left Side View." 0 Building Photographs See Instructions for Item A8. 71nsurance Company Use: Wing Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. rKloea Street7�fi y HiloState HI ZIP Code ee72o Numbe sing the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item Ata. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. Front View 0