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Home My WebLink About6-6-004:130............... U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION OERTIFICATE OMB No. 16604008 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: Al. Building Owners Name Policy Number ROCHELLE FEATHERAN A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 66-1725 ALANEO ST. (LOT 27) City State ZIP Code KAMUELA HI 96743 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, eta.) TMK: 6-6-004:130 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitudell-ongflude: Lat. 2001-29.9 Long. 165-42-17.5 Horizontal Datum: ❑ NAD 1927 Q NAD 1983 A6. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood Insurance. A7. Building Diagram Number1 A8. For a building with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) WA sq ft a) Square footage of attached garage 912 sq ft b) No. of permanent flood openings In Bre crawl apace or b) No. of permanent flood openings In the attached garage enclosure(s) walls within 1.0 foot above adjacent grade WA walls within 1.0 foot above adjacent grade NIA e) Total rot area of flood openings In Aa.b . WA sq In c) Total net area of flood openings In A9.b WA act In SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B7. NFIP Community Name ti CommunityNumber B2. County Name B3. State HAWAII COUNTY / 155166 1 1 HAWAII HI 84. Map/Panel Number B5. Suffix Be. FIRM Index B7. FIRM Panel B8. Flood 89. Base Flood Elevatldn(s) (Zone 0164 D Date I Effective/Revised Date Zone(s) AO, use base flood depth) 2341.. as 11 feet ❑ meters (Puerto Rioo only) 04/02/2004 07/16/1990 A 2334.6 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ❑ FIRM []Community Determined OOther (Describe) CLOMR' F C�z',c rel o. O$�Oi � l foL4G BI 11. Indicate elevation datum used for BFE in Item 89: W NGVD 1929 ❑ NAVD 19M ❑ Other (Describe) B12. Is the building located In a Coastal Barter Resources System (CBRS) area or Otherwise Protected Area (OPA)7 ❑ Yes ® No • Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings- ❑ Building Under Construction- Q 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, V1430, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.ag below according dthe IDEPTv1A3�BI BenClunazFM ONKAWAHAE RD Verecel Datum NGVD 1929 Conversion/Comments I ms cennlcauon Is to as signed and sealed Dy a lana surveyor, engineer, or arenitect authdnzea by law to certify elevation Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) b) Top of the next higher floor 2341. 80 feet feet ❑ meters (Puerto Rico only) ❑ meters Rico c) Bottom of the lowest horizontal structural member (V Zones only) WA -_❑ feet (Puerto only) ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 2341 .Q feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 2341.. as 11 feet ❑ meters (Puerto Rioo only) (Describe type of equipment in Comments) - 0 Lowest adjacent (finished) grade (LAG) 2340.97 X feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade (HAG) 2341. , 6 n feel ❑ meters (Puerto Rico only) I ms cennlcauon Is to as signed and sealed Dy a lana surveyor, engineer, or arenitect authdnzea by law to certify elevation Information. I codify that the information on this Certificate represents my best efforts to interpret the data available. - I understand that any false statement may be punishable by tine or Imprisonment under 18 U.S. Code, Section 1001. ® Check here if comments are provided on back of form. K. Licensed Professional * Engineer No.8336-C UaP. Certifiers Name License Number BRUCE K. MEYERS 8336-C Title Company Name CIVIL ENGINEER OKAHARA 8 ASSOCIATES INC Address City State ZIP Code 200 KOHO HILO Help 96720O, Signature 08-11-09 808 9615527 FEMA FoA 81-31, February 2006 See reverse side for continuation. Replaces all previous editions For Insurance Company Use: ALANEO ST. ccry State ZIP Code Company NAIL Number KAMUELA HI 96743 Copy both sides of this Elevation Certificate for (1) community official, (2) Insurance agent/company, and (3) building owner. TMK: 6.6-004130 ITEM C2.e - 50 GAL ELECTRIC WATER HEATER RELIANCE 606 SERIES CCU I I n c - =W1s 1Mo.csavRnvey INrUNINA I IVN SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zo s AO and A (without SFE), complete Items Ei-E5. If the Certificate is Intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items Et -E4, use natural grade, d avaflable. Check the measurement used. In Puerto Rico 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 pnduding basement, crawl space, or enclosure) Is _ ❑ feet ❑ meters ❑ above orbelow the HAG. b) Top of bottom floor (including basement, crawl apace, or enclosure) Is _ _ ❑feet 11 meters ❑above Of ®he1WM ti18 LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided In Sedigp/1 Items 8 for 9 (see ggga 8 of Instructions), the next higher floor (elevation C2.b In the diagrams) of the building Is . _ ❑feet LJ maters LJ above or LJ 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 She 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 communllys floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local offldal must certify this Infomhation in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, 8, and E for Zone A (without a FEMA -Issued or communfly-lesued SFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to Me best of my bawledge. _Property Owners or Owners Authorized Representative's Name _Address City State ZIP Code Signature Data Telephone Comments . G - h ne hocak omaal Wro hs aumonzeo Dy mw or ordinance to adnunister the community's floodplain management ordinance can complete Sections A. B, C (or E), and G of this Elevation Certificate. Complete the applicable Item(s) and sign below. Check the measurement used In Items G8. and G9. Gt. ❑ The Information In Sedion 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 dale 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 FEMAAssued or community -Issued 8FE) or Zone AO. G3. ❑ The following information (Items G4. -G9.) is provided for community floodplain management purposes. G4. Permit Number G7. This permit has been Issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -bulk lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum Gg. SIZE or (In Zone AO) ddpWf ( uIWVP6f((c Woks ❑ feet ❑ meters (PR) Datum Local Official's Name Jhluumillv_ Title communcry Name Telephone [., recommends Date Comments Dclto 4/6404 ❑ Check here 11 attachments FEMA Form 81-31, February 2006 Replaces all previous editions