HomeMy WebLinkAbout1-4-068:002O.M.B. NO. 3067.0077
ELEVATION CERTIFICATE Expires May 31,1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
P,ATTENTION:
rovide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to
determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE
BUILDING OWNER'S NAME POLICY NUMBER
Akeshi & Mitsuko Hashimoto
' STREET ADDRESS.(Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
14-5010 Waioiae Street
{ OTHER DESCRIPTION (Lot and Block Numbers, etc.)
TMK: 3rd Div. 1-4'-68:02 _Lot 15 of Vacationland Hawaii (File Plan 814)
.CITY. STATE ZIP CODE
Pahoa �= HI 96778
...r SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Provide the following from the proper FIRM (See Instructions):
1. COMMUNITY NUMBER
2. PANEL NUMBER
3. SUFFIX
4. DATE OF FIRM INDEX
5. FIRM ZONE .
6. BASE FLOOD ELEVATION
(in AO Zones• use depth)
155166
1400
C
9/16/88
VE
15.0'
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): YJ NGVD '29 r '' Other (describe on back)
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
the community's BFE: Ix.)101 feet NGVD (or other FIRM datum–see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1. Using the Elevation Certificate Instructions, indicate the' diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level 5
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
of I I I 1 1 1.LJ feet NGVD (or other FIRM datum -see Section B, Item 7).
(b). FIRM Zones V1430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from
the selected diagram, is at an elevation of! I I i 1! 5i 61 feet NGVD (or other FIRM datum -see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is feet above ❑ or
below ❑ (check one) the highest grade adjacent to the building.
(d). FIRM Zone AO. The floor used as the reference level from the selected diagram is ' _ feet above - or below a (check
i one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
i level) elevated in accordance with the community's floodplain management ordinance? Yes' " No ` Unknown
3. Indicate the elevation datum system used in determining the above reference level elevations: X NGVD '29 - Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on
the FIRM (see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.)
4. Elevation reference mark used appears on FIRM: Yes _X No (See Instructions on Page 4)
5. The reference level elevation is based on: ; X actual construction - construction drawings
(NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which
case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate
will be required once construction is complete.)
6. The elevation of the lowest grade immediately adjacent to the building is: 8 . 1 .feet NGVD (or other FIRM datum -see
Section B, Item 7).
SECTION D COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1
is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest
floor" as defined by the ordinance is: _ feet NGVD (or other FIRM datum -see Section B, Item 7).
2. Date of the start of construction or substantial improvement
FEMA Form 81-31, MAY 93 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION
SECTION E CERTIFICATION
This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation
information when the elevation information for Zones Al—A30, AE. AH, A (with BFE),V1—V30,VE, and V (with BFE) is required.
ommunity officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the
ertification. In the case of Zones AO and A (without a FEMA or community issued 8FE), a building official, a property owner, or an
owner's representative may also sign the certification.
Reference level diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-brea{ all,
enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list th akKre(� �
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be enter A
l certify that the information in Sections B and C on this certificate represents my best efforts to interpret the d t aildWENSED
l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sac ti PROFESSIONAL A
LANA
Rodney M. Kawamura HI Land Surveyor 2671
SURVEYOR
CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal)
President Hilo Engineering, Inc. �'9i�., ., ,, SP•
TITLE COMPANY NAME �
484 Kalanikoa Street Hilo HI 96720
ADDRESS CITY STATE ZIP
November 22, 1996 (808) 961-3_7_06
SIGNATURE DATE PHONE
Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner.
COMMENTS:
ON
SLAB
A v
ZONES ZONES
FLOOD
ELEVATION
ON PILES,
PIERS, OR COLUMNS
A v
The diagrams above illustrate the points at which the elevations should be measured in.A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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WITH
BASEMENT
A
ZONES
BASE
FLOOD
ELEVATION
E :,+:
ADJACNT :; •
REFEREN
CE
GRADE ' " iv,;
LEVEL
ON PILES,
PIERS, OR COLUMNS
A v
The diagrams above illustrate the points at which the elevations should be measured in.A Zones and V Zones.
Elevations for all A Zones should be measured at the top of the reference level floor.
Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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