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Home My WebLink About2-4-079:033FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL -FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME k11LI.lAM V. MLHANT>a BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX N0. 115E HIAL_0A. STREET CITY 4 ILO STATE a -I O.M.B. No. 3067-0077 Expires December 31, 2005 For Insurance Company Use: Policy Number Company NAIC Number PROPERTY DESCRIPTION Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT F, KAOMLA 1 (trtoVa tS( 1SMV1d100 , LjNIT ) . TMK 2.4-/D'19 o33 IAL- ( ##° - ##'- ##.##" or ##.#I####°) area, ZIP CODE 96-72-0 L1 NAD 1927• L1 NAD 1983 SOURCE: L_1 GPS (Type): L_1 USGS Quad Map 1_1 Other SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER 82. COUNTY NAME --f-B3. STATE Hawaii County 155166 Hawaii County Hawaii B4. MAP AND PANEL 85. SUFFIX B6. FIRM INDEX B7: FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER C DATE EFFECTIVEIREVISED DATE ZONE(S) (Zone AO, use depth of flooding) I 155166 0$8D 4/02/04 16 -Sr f T- 88 A+� A-++, l B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. i_1 FIS Profile IYFIRM 1-1 Community Determined 1_1 Other (Describe): B11. Indicate the elevation datum used for the BFE in B9:1VI NGVD 1929 1_1 NAVD 1988 1_1 Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes 1X I No Designation Date:uZA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: 1_1Construction Drawings" 1-1Building Under Construction" 1_1Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number _9 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations – Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from #he'�atum used #or the BFE •in Section B, -convert-the -datum to that used forthe BFE. 'Show 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 - Conversion/Comments Elevation reference mark used 1° L WOOUMCAiT Does the elevation reference mark used appear 2,n the FIRM? 1_1 Yes 1 KNo ❑ a) Top of bottom floor (including basement or enclosure) A'q'8 0 fl.(m) d C3b) Top of next higher floor _ W A _ ft -(m) a �J� N' MV9q, ❑ c) Bottom of lowest horizontal structural member (V zones only)_ /,A, ft.(m) Do 'n Q LICENSED ❑ d) Attached garage (top of slab) 4-4-6 8 ft. (m) E � QPROFESSIONAL ❑ e) Lowest elevation of machinery and/or equipment d t LAND SURVEYOR servicing the building (Describe in a Comments area.) ft.(m) E ❑ f) Lowest adjacent (finished) grade (LAG) 41l-2 $ ft.(m) Na. LS -7589 ❑ g) Highest adjacent (finished) grade (HAG) 446 - ft.(m) c ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade� N ❑ 1) Total area of all permanent openings (flood vents) in C3.h A sq. in. (sq. cm) ' 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. / certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME pAuL He M UrZTA Y L-?" " LICENSE NUMBER LS -158Q ICGKSGV ROSSID&_ LAOD SS box 1 l89 'O K 2O-ocT.os I�.1A01 y t AssocIha_:6 , L c, STATE �f i. ZIP CODE 01612 I TELEPHONE p�p �SQ- Qsp i FEMA Form 81-31, January 2003 `u See reverse side for continuation. Replaces all previous editions SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) opy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. _RIC WOGST EQUIPMCAT S6RVlCim6 'THt= WitbW6 U 10 'Tttr=, 4-j�.n A.0 to S-roreA<,c _ 1_1 Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1, through E5. If the Elevation Certificate is intended for use as supporting• information for a LOMA or LOMR-F, Section C must be completed. E1. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed – see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is 1_1_1 ft. (m)1._1_1 in. (cm) Ll above or 1-1 below (check one) the highest adjacent grade. (Use natural grade, if available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is I_I_I ft. (m) 1-1_1in. (cm) above the highest adjacent grade. Complete Items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is 1_1-1 ft. (m) 1_1_J in. (cm) 1_1 above or 1_1 below (check one) the highest adjacent grade. (Use natural grade, if available.) E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's' floodplain management ordinance? 1_ 1 Yes I_-1 No 1_1 Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS CITY STATE ZIP CODE GNATURE DATE TELEPHONE COMMENTS _ 1 .1 Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer 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. G1. 1_1 The information iri Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in'the Comments area below.) G2. 1_1 A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. 1_1 The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED G7. This permit has been issued for: 1_1 New Construction 1_1 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: _ft. -(m) Datum: G9. BFE or (in Zone AO) de of oding at the buildingsite is: —ft. (m) Datum: �ie Weparfinenf of p-ubfic Fork LOCAL OFFICIAL'S NAME nglneeritlC (,'I'VisiOn has rtr«Iewed TITLE COMMUNITY NAME r; cel HIRI Ife ager TELEPHONE Ell SIGNATURE DATE does ri:;i� 1'tw.C�1Fi`ttit�t�C� " COMMENTS i'mcil cIppI'O'trtii FEMA Form 81-31, January nts Replaces all previous editions