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FEDERAL EMERGENCY: -MANAGEMENT AGENCY O.M:B. No. 3067-0077
<br />NATIONAL FLOOD•INSURANCE PROGRAM Expires December 31, 2005
<br />ELEVATION CERTIFICATE
<br />Important: Read the instructions on pages 1 - 7.
<br />SECTION A - PROPERTY OWNER INFORMATION _ I For Insurance Company Use:
<br />BUILDIN OWNER'S NAME Policy Number
<br /><4 f OR- 7-11-4 AW g.6;R 2
<br />BUILDING STREET ADDRESS (including Apt., Unit, Suite and/or Bid : No.) OR P.O. ROUTE AND BOX N0. Company NAIC Number
<br />101 9 ,ovs� J<u 6.4cs,� P - 40 r /4/
<br />CITY STATE ZIP CODE
<br />/4/ ���i�i/ J?6 X43
<br />PROPERTY DESCRIPTION (Lot and Block Numbers. Tax Parcel Number..Lecal Descriotion. etc.)
<br />.4o7' /.i 7'4f9; C3);��&,40::oG�
<br />BUILDING USE (e.g., Residential, Non-residential, Addition, Acces=ory, etc. Use a Comments area, if necessary,)
<br />,t7P/V 7-441—
<br />LATITUDE/LONGITUDE
<br />/4LLATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM:
<br />SOURCE: (J GPS (Type):
<br />(
<br />##0-##'-##.##' or ##.#####) (J NAD 1927 ' `"'NAD 1983
<br />(�51'USGS Quad Map Other
<br />SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
<br />Hawaii County 155166 1 '`Hawaii County I Hawaii
<br />B4. MAP AND PANEL
<br />B5. SUFFIX
<br />B6. FIRM INDEX
<br />B7. FIRM PANEL
<br />B8. FLOOD
<br />B9. BASE FLOOD ELEVATION(S)
<br />NUMBER
<br />DATE
<br />EFFEc�,IVE/REVISED DATE
<br />()
<br />(Zone AO, use depth of flooding)
<br />155166 Z-
<br />610 95
<br />y-'16- 88
<br />:fi/E
<br />6 •S"
<br />1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9."
<br />1_1 FIS Profile FIRM 1J Community Determined 12:d Other (Describe): *,VP
<br />B11. Indicate the elevation datum used for the BFE in B9: I [ NGVD 1929 L_j NAVD 1988 1J Other (Describe):
<br />612, is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? I_1 Yes i X I No
<br />Designation Date: -
<br />SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REbUIRED)
<br />1. Building elevations are based on: (_/Construction Drawings' I (Building Under Constructian' finished Construction
<br />'A new Elevation Certificate will be required when construction of the building is complete. '
<br />C2. Building Diagram Number 6 (Select the building diagram most similar to the building for which this certificate is being completed -see
<br />pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
<br />C3. Elevations —Zones Al -A30, AE, AH, A (with BFE), VE, VII -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO
<br />Complete Items C3.a-1 below according to the building diagram specified in Item C2. State the datum used. If the datum is different from
<br />the datum used for the BFE in Section B, convert.tfie datum'to that used for the BFE. Show field measurements and datum conversion
<br />calculation. Use the space provided or the Comments area of Section b or Section G, as appropriate, to document the datum conversion.
<br />Datum Conversion/Comments '
<br />Elevation reference mark used `Does_ the elevation reference mark usetl,appear on the FIRM? 1- =
<br />Yes No
<br />tt<7 a) Top of bottom floor (including basement or enclosure) li, 7Z ft.(m�, N O it
<br />C+d"_/b) Top of next higher floor /� . 72ft.(m� a �
<br />Q c) Bottom of lowest horizontal structural member (V zones only) /3 vr8ft.(vra .' y ®. ,
<br />sJ
<br />Qi(d) Attached garage (top of slab) 6, 72 ft0 o LICENSF
<br />.(a� . EZ
<br />ROFESSIO AL
<br />LE(e) Lowest elevation of machinery and/or equipment ANf
<br />Cyoservicing the building (Describe in a Comments area.) M�VD F�Qft.(M) ; E tfR«f Lowest adjacent (finished) grade (LAG) yr ft.*;I., m N (ftp. X868
<br />) Highest adjacent (finished) grade (HAG) (o ft.(na� .
<br />U h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N4
<br />O i) Total area of all permanent openings (flood vents) in C3.h /Y,4 sq. in. (sq, cm)
<br />SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
<br />This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by lew to certify elevation information.
<br />l certify that the information in Sections A, B, and C on this certificate represents my best efforts to inierbret the data available.
<br />/ understand that any false statement may be punishable by fine -or imprisonment under 18 U.S. Code, Section 1001.
<br />i'S NAME T��%rV,f%`D Ci /// c -
<br />014_f 4o 4
<br />//-- 24- C.
<br />�tK .49/01.114
<br />%tiross� ue v�y/NC � .Z.frc .
<br />TA—TEZI ZIP CODE --
<br />I LEPHONE
<br />FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions
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