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n IT -RAL EMERGENCY MANAGEMENT AG' `:Y O.M.B. No. 3067-0077 NATIONAL FLOOD INSURANCE PROGRAm' Expires July 31, 2002 ELEVATION CERTIFICATE rtant: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number BUILDING STREET ADDRESS (including Apt.. Unit, Suite, and/or OR P.O. ROUTE AND BOX NO. Company NAIC Number CITY STATE ZIP CODE South Kohala. Island and Countv of Hawaii. State of Hawaii 96743 Orchid at Mauna Lani BUILDING USE (e.g., Residential, Non- r ion, ccessory; a c. ction if necessary.) Commercial — Restaurant Relocation of Restuarant service station and storage addition LATITUDEILONGITUDE (OPTIONAL) ( Mf - ##' - ##.##" or ##.###/#f) HORIZONTAL DATUM: SOURCE: LI GPS (Type): i J NAD 1927 1_1 NAD 1983 Li USGS Quad Map IJ Other: SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER Hawaii B2. COUNTY NAME Hawaii I 63. STATE Hawaii B4. MAP AND PANEL NUMBER 155166 0278 B5. SUFFIX C B6. FIRM INDEX DATE 9/18/88 I B7. FIRM PANEL EFFECTIVE/REVISED DATE 9/18/88 B8. FLOOD ZONE(S) AE B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 1 8 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. I_I FIS Profile L,) FIRM 1_1 Community Determined L_* Other (Describe): USGS Data 611. Indicate the elevation datum used for the BFE in B9: L(NGVD 1929 LJ NAVD 1988 1J Other (Describe): B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1_1 Yes L_I No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based -on: i_(Construction Drawings' L{Building Under Construction* (X JFinished Construction *A new Elevation Certificate will be required when construction of the building Is complete. C2. Building Diagram Number 1 (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, ARAE, AR/A1-A30, AR/AH, AR/AO Complete Items C3a-i below according to the building diagram specified in Item C2. State 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. 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 Local Bench MarkDoes the elevation reference mark used appear on the FIRM? LJ Yes 13 N I a) Top of bottom floor (including basement or enclosure) 9.9 ft.(i* g 0 b) Top of next higher floor _ ft.(m) ❑ c) Bottom of lowest horizontal structural member (V zones only) ft.(m) � _fg 0 d) Attached garage (top of slab) r ft.(m) E 0 � ❑ e) Lowest elevation of machinery and/or equipment `U to servicing the building — ft.(m) r=„ C)A f) Lowest adjacent grade (LAG) ft.(w Z( DA g) Highest adjacent grade (HAG) 9.7--ft-OW '2_ No. 451 '-• 0 h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade y tq;�ti, VS 0 I) Total area of all permanent openings (flood vents) in C3h sq. in. (sq. cm) January .2001 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. I certify that the information in Sections A, B. and C on this certificate represents my best efforts to interpret the data available. / understand that anv false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. FFMA Fnrm A1.11 Al fr. 00 \ / SFF RF\/ERBF SIr1F Fr1R r.r)NTINI IATI0N PFPI Ar:FG Al 1 PRFmoi I.R ;:nITir)N.R