HomeMy WebLinkAbout2-4-073:01106/18/2004 10:40
BUILDING OWNER'S NAME
BUILDING STREET ADORES
CITY
9618933
COH-DPW-ENG
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Important: Read the instructions on oases 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION
Bldg. -No.) OR P.O. ROUTE AND BOX NO
STATE
area, if necessary.
PAGE 02
O.M.S. No: 3067-0077 `J
Expires December 31, 2005
Policy Number
Company NAIC Number
LATITUDEILONGITUDE (OPTIONAL) HORIZONTAL DATUM:
or #01.40#w) ITI NAD 1627' i_I NAD 1983 SOURCE: I—fGPS (Type):
I_I USGS Quad Mep MOthar
SECTION S - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION.
Bt. NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2. COUNTY NAME 83. STATE
Hawaii County 155166. Hawaii CDLMty Hawaii
84. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
67. FlkM PANEL_.
D""
B9, BAS FLOOD ELEVATIONS)
NUMBER
G
'DATE
EFFECTIVE/REVISED DATE
ZONES) ';
(Zone AO, use d8oh of flooding)
155166 o
4/02/04
9140
B10. Indicate the source of the Base Flood Elevation (BFE) data or base ood depth entered. in B9,
IJ FIS Profile 1J FIRM IJ Community Determined I_I Other (Describe):
B11. Indicate the elevation datum used -for the BFE In 89: 1_I NGVD 1929 I_I NAVD 1988 "Other (Describe):
B12, Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? I—I Yes IX I No.
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Ci, Building elevations are based. -on: IJConstruction Drawings' iJBuilding Under Construction' LIFinished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
02, Building Diagram Number _J_(Select the building diagram most similar to the building for which thls certificate Is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations -.Zone's Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, ARIAE, AR/Ai-A30, AR/AH; AR/AO
Complete Items C3.9 -i below according to the building diagram specified in Item C2. Stato 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. Show field measurements and datum conversion
calculation s t e space provided or the Commen area Section D or Sec n G, as'a prl tee,/to d menthe d�I conversion.
Datum Conversion/Comments fd (iV 1• _ ltle) AU fi V 1"D `�.
Elevation reference mark used 1f�s1� �� Do s the elevation referencemar used appear on the FlFtIZ. Yes ) No
O a) Top of bottom floor (including basement or enclosure)
O b) Top of next higher -floor _ ft,(m)o t0i{/c
U c) Bottom of lowest horizontal structural member (V zones only) .— ft.(m) o LICENSED
O d-) Attached garage (top of slab) ----7 n.(m) e
.0 e) Lowest elevation of machinery and/or equipment w A _ ��
servicing the building (Describe in a Comments area.) �j'2 3 ft.(m) �e', =` �:NGINEER �
0 f) Lowest adjacent (finished) grade (LAG) 7 tt.(m) 2k k T
❑ g) Highest adjacent (finished) grade (HAG) � ` • h_(�/o
Q h) No, of permanant openings (flood vents) within 1 ft. above adjacent gra e
❑ 1) Total area of all permanent openings (flood vents) In C3.h sq. In. (sq. Cm) . �- i
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT Ci iRTIFICATION % e—Z
This certification Is to be signed and sealed by a land surveyor, engineer, or architect authorized by taw to 4rtify elevation I i tion,
/ Certify that"the information In Sections A, B, and C on this Certificate represents my best efforts to interpret the data evailabitf