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Home My WebLink About2-5-024:012U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal, Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program Important: Read the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION IT60neurepcefi ompany,Use Al. Building Owner's Name FLORA B SOLOMON y Polloy Number , Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. `C NTMOM NAIL Number:, r City HILO State HI ZIP Code 96720 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 12-A, AINAKO SUBDIVISION, SERIES 2, FILE PLAN 427, TAX MAP KEY(3) 2-5-024:012 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 1912-30 N Long. 155-07-26W Horizontal Datum: ❑ NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building If the Certificate Is being used to obtain flood insurance. A7. Building Diagram Number Q A8. For a building with a crawlepace 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 560 eq It b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings In the stteched garage enctosure(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 _ eq in c) Total net area of flood openings In A9.b _ eq In d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 131. NFIP Community Name 6 Community Number 82. County Name 7B3. State HAWAII COUNTY 155166 1 HAWAII COUNTY I HAWAII B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone ® feet 155166 0859-D Date Effective/Revised Date Zone(s) AO, use base flood depth) 1 c) Bottom of the lowest horizontal structural member (V Zones only) NIA ._ 2 -APR -04 16 -SEP -09 A 654 655 AS B10. Indicate the source of the Bess Flood Elevation (BFE) data or base flood depth entered in Rem B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) _ 811. Indicate elevation datum used for BFE In Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) _ B12. Is the building located Ina Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No ft Designaflon Date _ ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction' ® 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, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AD. Complete.items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized P 1 NAIL 411 KAPAA ST Vertical Datum _ ConversionlComments i nis cemncaaon is to De signea ane seaiea Dy a lana surveyor, engineer, or architect authorized by low 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 form. Were latitude and longitude In Section A provided by a licensed land surveyor? IS Yes ❑ No Cenlfler's Name PAUL H MURRAY LPLS License Number LS -7589 PLACE Lr.,ENSED PROFESSIONAL Nt4D- SURVEYOR No. LS -7589 , FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions Check the measurement used. a) Top of bottom floor (Including basement, crawlspace, or enclosure floor) §§L-. 15 ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor t '_.$it_ ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) NIA ._ ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 655 AS ® feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 655 .gg_ ® feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) - 653 .5 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (flnished) grade next to building (HAG) 654 . ® feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, Including 10_. 1 ® feet ❑ meters (Puerto Rico only) structural support SECTION D - SURVEYOR ENGINEER. OR ARCHITECT CERTIFICATION i nis cemncaaon is to De signea ane seaiea Dy a lana surveyor, engineer, or architect authorized by low 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 form. Were latitude and longitude In Section A provided by a licensed land surveyor? IS Yes ❑ No Cenlfler's Name PAUL H MURRAY LPLS License Number LS -7589 PLACE Lr.,ENSED PROFESSIONAL Nt4D- SURVEYOR No. LS -7589 , FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding Information from Section A. for Insurance ComparrylUse x`, ,; Building Street Address (Including Apt., Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. Policy Number 167 KAPAA STREET City HILO State HI ZIPCode 96720 [.Compat)y,.,..,-CNum7tat;4t SECTION D - SURVEYOR. ENGINEER. OR ARCHITECT CERTIFICATION (CONTINUEDI Wy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner. STORAGE ROOM IN THE GARAGE. SECTION E - BUILDING ELEVA"ON INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) 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, end C. For hems E1 -E4, use natural grade, If available. Check the measurement used. In Puerto Rk:o only, enter meters. Et. 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, crewispace, or enclosure) Is _— ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (Including basement, craMspace, 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 (see pages 8.9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is — _ ❑ feet ❑ meters ❑ above or ❑ 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. F - The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-lesued or community -Issued BFE) or Zone AO must sign here. The statements in Sections A, A and E are coned to the hest of my knowledge. Authorized Signature Date Telephone ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check 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 date 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-buiit 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 flo%geva�ortment Of Public Works—•— ❑ feet ❑ meters (PR) Datum Local Official's Name Tide Community Name IEK recommends Telephone Signature LJ does not recommend Date By �%jti L2y ®tee Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions :� S W' a S % in A 4 � r