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<br />O.S. DEPO.RTMBNT OF HOMELAND SECU ELEVATION CERT C �•
<br />F4derel Emergency Management Agency Exolres February 28, 2008
<br />National Flood Insurance Program Important: Read the instructions on pages 1-8.
<br />r f / SECTION A - PROPERTY INFORMATION For Insurance Company Use:
<br />AtIlk. Building esName Qpid M Adams Revocable Trust of 2002; at. al. Policy Number
<br />. Building Street Address (ind4ding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number
<br />69-1688 Puakd,Road
<br />city Kamuela V stats Hawaii ZIP Code 96743
<br />A3. Property Descripption (Lot a4d Block Numbers, Tax Parcel Numbar, Legal Deacriptlen, ate.)
<br />Lot 66, Desert
<br />Beach Lots Tax Map Key: 6-9-003: 005 (3rd Division)
<br />A4. Building Use (e.g.. RepiQential, Non -Residential, Addition, Accessory, etc.)
<br />A8. Latilude/Longaude: LAC (Qe N;
<br />r Is. 09656 "Long.N/ I brsa 4 pis. G 1440lorizontel Datum: NAD 1927 © NAD 1983
<br />A8. Attach at bast 2 photographs of the building ifthe Certificate Is being used to obtain flood Ineuronce
<br />A7. Building Diagram Number i
<br />A8. For a building with a crawl space or enclosure($), provide: A9. For a building with an attached garage, provide:
<br />a) Square footage of crawl space or enclosure(s) n/a sq It a) Square footage of attached garage . 924 sq it
<br />b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the alfa ed garage
<br />enclosure(s) walla within 1.0 foot above adjacent grade walk within 1.0 foot above adjacent grade
<br />c) Total net area of flood openings In AS.b aq In c) Total net area of flood openings in A9.b sq le
<br />SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />:I_�1i7d11
<br />Date EtfectNelRevfsed Date Zones) AO, use base flood depth)
<br />0277 C 04!02/2004 09/16/1988 AE 6.5
<br />810. Indicate the source of the Base Flood Elevation (SFE) date or base flood depth entered In Item B9.
<br />❑FIS Profile [Z]FIRMCommunity Determined QOther (Describe)
<br />B11. Indicate elevation datum used for BFE In Item B9: 0 NGVD INS [3NAVD 1989 QOther (Describe)
<br />2. Is the bulking located In a Coastal Barrier Resources System (CBRS) areaerwise Protected Area (OPA)7 Yes 0✓ No
<br />Designation Date CBRS LJOPA-
<br />ANG ELEVATION INFORMATION
<br />C1. Building elevations are based on: U Construction Drawings' LJ Building Under Construction* W Finished Construction
<br />C2.
<br />'A new Elevation Certificate will be required when construction of the building is complete.
<br />Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARAE, AR/A1-A30, AR/AH, AR/AO.
<br />below according to the bulking diagram specified In Hem AT
<br />Benchmark utilized t1SGS RM Ventral Datum Mean Sea Leval
<br />Conversion/Comments n/a
<br />Complete time CZ"
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION I
<br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by low to certify elev
<br />information. I certify that the information on this CertiOcale represents my best efforts to Interpret the date available.
<br />I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001.
<br />Check here H comments are provided on back of form.
<br />Certifiers Name Chrystal T. Yamasaki License Number LS -4331
<br />Wes Thomas Associates Company Name Wes Thomas Associates Na 4931
<br />rasa 75-5749KalawaStr t cry Kailua-Kona stale Hawaii zlPcode96740 yghrAll,V�
<br />k ID 111y 30, 2007 Telephone (808) 329-2353 July 30, 2007
<br />0 -,,a
<br />A Form 81-31, February 2008" See reverse side for continuation. Replaces all previous
<br />Check the measurement used.
<br />a) Top of bottom floor (including basement, crawl space, or enclosure floor) 8.D1 ❑� feet
<br />❑ meters (Puerto Rico only)
<br />b) Top of the next higher floor
<br />fent
<br />❑ meters (Puerto Rico only)
<br />c) Bottom of the lowest horizontal structural member (V Zones only)
<br />feet
<br />❑ meters (Puerto Rico only)
<br />d) Attached garage (top of slab)
<br />�. feel
<br />❑meters (Puerto Rico only)
<br />e) Lowest elevation of machinery or equipment servicing the building
<br />feet
<br />❑ meters (Puerto Rico only)
<br />(Describe type of equipment In Comments)
<br />I) Lowest adjacent (finished) grade (LAG)
<br />6.5 feet
<br />❑
<br />meters (Puerto Rico only)
<br />g) Highest adjacent (finished) grade (HAG)
<br />7.2 nfeet
<br />❑
<br />meters (Puerto Rico only)
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION I
<br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by low to certify elev
<br />information. I certify that the information on this CertiOcale represents my best efforts to Interpret the date available.
<br />I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001.
<br />Check here H comments are provided on back of form.
<br />Certifiers Name Chrystal T. Yamasaki License Number LS -4331
<br />Wes Thomas Associates Company Name Wes Thomas Associates Na 4931
<br />rasa 75-5749KalawaStr t cry Kailua-Kona stale Hawaii zlPcode96740 yghrAll,V�
<br />k ID 111y 30, 2007 Telephone (808) 329-2353 July 30, 2007
<br />0 -,,a
<br />A Form 81-31, February 2008" See reverse side for continuation. Replaces all previous
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