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,—-- www nivvvmivw6 nwvrvwrn ELEVATION CERTIFICATE Read the instructions on paces 1.7. Expires July 31, 2002 SECTION A - PROPERTY OWNER INFORMATION 1_ Forir..wrance'GornoanvUse: Hiram Simeona BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 1070 Kalanianaole Street CITY STATE ZIP CODE Hilo HI 96720 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 16A Keaukaha Tract I, Increment 2, Tax Map Key: 30 Div..2-120:61 buiwrrvu ubt te.g., mesraenua, mm Hesiuenua, rwaruon, Accessory, etc. use a uomments area, rr necessary./ Residential LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: GPS (Type): ( #r-## -##.##' or ##.#####) ® NAD 1927 ❑ NAD 1983 ❑ USGS Quad Map ® Other: USGS SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 131. IPCOMMUNITY I NAME & COMMUNI 1 Y NUN�ER B2�I COU BHa STATE �j 84. MAP AND PANEL B5. SUFFIX Datum ConversiorJCorrvnents 87. FIRM PANEL Elevation reference mark used USGS Does the elevation reference mark used appear on the FIRM? B9. BASE FLOOD ELEVATION(S) NUMBER b) Top of next higher floor B6. FIRM INDEX DATE EFFECTIVEIREVISED LATE 88. FLOOD ZONE(S) (Zone A0, use depth of fl Wng) 155166 0885 C 04/OM 09116)88 AE 15.8 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® FIRM ❑ Comr wlty Determined ❑ Other (Descnve): B11. Indicate the elevation datum used for the BFE in B9% NGVD 1929 ❑ NAVD 1988 ❑ Outer (Describe): B12. is the biking located in a Coastal Banner Resources System (CBRS) area or Oth&-w1se Protected Area PPA)? ❑ Yes ®No Designation Date SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. 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 Building Diagram Number 1(Select the building diagram most similar to the buildng for which this certificate is being completed - see pages 6 and 7. 1 no diagram accurately represents the building, provide a sketch or photograph..) Elevations - Zones At -A30, AE, AH, A (with BFE), VE, V1 430, V (with BFE), AR, ARIA, ARAE, ARIAI AX ARIAH, ARIAO Complete items C3. -a4 below according to the building diagram specified in item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE Shaw field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum ConversiorJCorrvnents Elevation reference mark used USGS Does the elevation reference mark used appear on the FIRM? a) Top of bottom floor (inducing basement or enclosure) 20. it(m) b) Top of next higher floor WA . _fL(m) c) Bottom of lowest horizontal structural member (V zones only) N/A. __t(m) d) Attached garage (top of slab) 19. 8 ft(m) e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) 19.8 fL(m) f) bDwest adjacent(finished) grade (LAG) 19.3 f4(m) g) Highest adaow t (finished) grade (HAG) 19. 2A(m) ❑ Yes %No 9 T. LICENSED PROFESSIONAL ENGINEER NO. 5105-0 Q; \9 / h) No. ef permanent openings (flood vents) within 1 ft above adjacent grade ) Total area of all Wmanent openings (flood vents) h C3.h sq. in. (sq. an) E x pi r e s 7 o 8 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 certify elevation information. l certify that the information in Sections A, A and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement maybepunishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIERS NAME David T. Imata LICENSE NUMBER 5105 C TITLEVice President COMPANY NAME Imata & Associates, Inc. ADDRESS /'—'1 CITY STATE ZJP CODE Hilo HI 96720-2606 DATE TELEPHONE 08/02/07 (808) 935-6827 FEMA Form 81-31, JUL 00 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS --P'l L- 2 - t •- czc . e --G)