HomeMy WebLinkAbout6-4-006:03015463 O.M.B. NO. 3067.0077
ELEVATION CERTIFICATE Expires nt%31,1996
FEDERAL EMERGENCY MANAGEMENT AGENCY'
NATIONAL FLOODINSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to
rovide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to
etermine 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
Hawaii Planing Mild Ltd
STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER
L
OTHER DESCRIPTION (Lot and Block Numbers, etc.)
TAXMAP KEY 6-4-06':. 0'"' (3rd Division)
CITY STATE ZIP CODE
Waimea, South Kohala, Hawaii
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
I
(in AO Zones, use depth)
155166
0168
E
May 16, 1994
AE
2745
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): KI NGVD '29 ❑ 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: I I I I I I . U 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 --I— .
(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 l 121746 .lel feet NGVD (or other FIRM datum–see Section B, Item 7).
(b). FIRM Zones Vi -V30, 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 I I I.0 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 LU.0 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 LL 1.0 feet above ❑ or below ❑ (check
one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference
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: `J 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 71, 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 0 No (See Instructions on Page 4) USGS Bench Mark
5. The reference level elevation is based on: a 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:1 121714161 M 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
49 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: I I I I I I.0 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
`iformation when the elevation Information for Zones A1—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
certification. In the case of Zones AO and A(without a FEMA or community issued BEE), 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-breakaway wall,
enclosure size, location of servicing equipment, area use,wall openings,or unfinished area Feature(s),then list the Feature(s) not
included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered.
I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the dot Davila
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sec ,.fi•Y01.-�.fr
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CERTIFIER'S NAME LICENSE NUMBER(or Affix Seal) i
CHRYSTAL THOMAS YAMASAKI LS-4331 6.\., surdPOOR i,J
TITLE COMPANY NAME \ Nio. 4331
Land Surveyor WES THOMAS ASSOCIATES '. ,�M
ADDRESS CITY -\< A4FB, U'�'� ZIP
75-579 Kalawa Street Kailua-Kona Hawaii 96740-1817
SIGNA ! /...; / DATE PHONE
t.
i 4/9/97 80R-3?9-?353
Copies sh. d be made of this Certif . : for: 1) community official,2)insurance agent/company, and 3) building owner.
COMMENTS:
ON WITH ON PILES,
SLAB BASEMENT PIERS,OR COLUMNS
A V A A V
ZONES ZONES 'I'' ZONES ZONES ZONES r
REFERENCE
REFERENCE
BASE
LEVEL REFERENCE
CE
LEVEL1 l '' ELEV It
LEVEL
.I...;::. ?'•:I'•::: :' �:���. BASE
BASE ,. REFERENCE
FLOOD ` '• ADJACENT 4 FLOOD
GRADE :I'fi> LEVEL ELEVATION
ELEVATION REFERENCE ADJACENT i::}C
LEVEL GRADE 6''::.
7,0';.,
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:' :. ': J:;::i:; .::;:,.:.•::;:: fADJACENT:
i.: GRADE
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.
IElevations for all V Zones should be measured at the bottom of the lowest horizontal structural member.
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