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2-2-043:082
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Last modified
6/24/2014 1:43:51 PM
Creation date
4/14/2014 1:18:09 PM
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Date
9/5/1995
Type
Elevation Certificate
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` ELEVATION CERTIFICATE <br />" - r FEDERAL EMERGENCY MANAGEMENT AGENCY <br />NATIONAL FLOOD INSURANCE PROGRAM <br />ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to <br />provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to <br />determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). <br />Instructions for completing this form can be found on the following pages. <br />SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br />BUILDING OWNER'S NAME POLICY NUMBER <br />Kaimi and Stacy Chung <br />STREET ADDRESS (including Apt.. Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER <br />P. 0. Box 4414 <br />OTHER DESCRIPTION (Lot and Block Numbers,. etc.) <br />TMK No.: 2-2-43:82 <br />CITY STATE ZIP CODE <br />Hilo, Hawaii 96720 <br />SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br />Provide the following from the proper FIRM (See Instructions): <br />i. COMMUNITY NUMBER <br />2. PANEL NUMBER <br />3. SUFFIX <br />4. DATE OF FIRM INDEX <br />5. FIRM ZONE <br />6 BASE FLOOD ELEVATION <br />(MAO zones. use depth) <br />155166 <br />0890 <br />C <br />09-16-88 <br />Floodway/ <br />170 Ft. <br />7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 0NGVD '29 El Other (describe on back) <br />8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate <br />the community's BFE: 1 1 1 I 1 I.0 feet NGVD (or other FIRM datum -see Section B. Item 7). <br />SECTION C BUILDING ELEVATION INFORMATION <br />1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best <br />describes the subject building's reference level 5 <br />2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation <br />of I 1 111,71J feet NGVD (or other FIMA datum -see Section B, Item i). <br />(b). FIRM Zones V1 430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from <br />the selected diagram, is at an elevation of I l l l l l .0 feet NGVD (or other FIRM datum -see Section B, Item 7). <br />(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LU.0 feet above ❑ or <br />below ❑ (check one) the highest grade adjacent to the building. <br />(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is {U.i _{ feet above ❑ or below ❑ (check <br />one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference <br />level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown <br />3. Indicate the elevation datum system used in determining the above reference level elevations: 0 NGVD'29 Q Other (describe <br />under Comments on Page 2). (NOTE. if the elevation datum used in measuring the elevations is different than that used on <br />the FIRM (see Section B, Item 71, then convert the elevations to the datum system used on the FIRM and show the conversion <br />equation under Comments on Page 2.) <br />4. Elevation reference mark used appears on FIRM: ® Yes ❑ No (See Instructions on Page 4) <br />5. The reference level elevation is based on:lwactual construction ❑ construction drawings <br />(NOTE. Use of construction drawings is only valid_if the building does not yet have the reference level floorin place, in which <br />case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Cer0cale <br />will be required once construction is complete.) <br />6. The elevation of the lowest grade immediately adjacent to the building is: U11 q7 iJ feet NGVD (or other FIRM datum -see <br />Section B, Item 7). <br />SECTION D COMMUNITY INFORMATION <br />1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 <br />is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest <br />floor' as defined by the ordinance is: I I I I I I.0 feet NGVD (or other FIRM datum -see Section B, Item 7). NIA <br />'ate of the start of construction or substantial improvement <br />FEMA Form 81-31; MAY 90 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION <br />
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