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Home My WebLink About6-9-006:028FEDERAL EMERGENCY: -MANAGEMENT AGENCY O.M:B. No. 3067-0077 NATIONAL FLOOD•INSURANCE PROGRAM Expires December 31, 2005 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 - 7. SECTION A - PROPERTY OWNER INFORMATION _ I For Insurance Company Use: BUILDIN OWNER'S NAME Policy Number <4 f OR- 7-11-4 AW g.6;R 2 BUILDING STREET ADDRESS (including Apt., Unit, Suite and/or Bid : No.) OR P.O. ROUTE AND BOX N0. Company NAIC Number 101 9 ,ovs� J<u 6.4cs,� P - 40 r /4/ CITY STATE ZIP CODE /4/ ��i�i/ J?6 X43 PROPERTY DESCRIPTION (Lot and Block Numbers. Tax Parcel Number..Lecal Descriotion. etc.) .4o7' /.i 7'4f9; C3);��&,40::oG� BUILDING USE (e.g., Residential, Non-residential, Addition, Acces=ory, etc. Use a Comments area, if necessary,) ,t7P/V 7-441— LATITUDE/LONGITUDE /4LLATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: (J GPS (Type): ( ##0-##'-##.##' or ##.#####) (J NAD 1927 ' `"'NAD 1983 (�51'USGS Quad Map Other SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Hawaii County 155166 1 '`Hawaii County I Hawaii B4. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX B7. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S) NUMBER DATE EFFEc�,IVE/REVISED DATE () (Zone AO, use depth of flooding) 155166 Z- 610 95 y-'16- 88 :fi/E 6 •S" 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9." 1_1 FIS Profile FIRM 1J Community Determined 12:d Other (Describe): *,VP B11. Indicate the elevation datum used for the BFE in B9: I [ NGVD 1929 L_j NAVD 1988 1J Other (Describe): 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 Designation Date: - SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REbUIRED) 1. Building elevations are based on: (_/Construction Drawings' I (Building Under Constructian' finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. ' C2. Building Diagram Number 6 (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, VII -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO 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 the datum used for the BFE in Section B, convert.tfie datum'to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section b or Section G, as appropriate, to document the datum conversion. Datum Conversion/Comments ' Elevation reference mark used `Does_ the elevation reference mark usetl,appear on the FIRM? 1- = Yes No tt<7 a) Top of bottom floor (including basement or enclosure) li, 7Z ft.(m�, N O it C+d"_/b) Top of next higher floor /� . 72ft.(m� a � Q c) Bottom of lowest horizontal structural member (V zones only) /3 vr8ft.(vra .' y ®. , sJ Qi(d) Attached garage (top of slab) 6, 72 ft0 o LICENSF .(a� . EZ ROFESSIO AL LE(e) Lowest elevation of machinery and/or equipment ANf 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 ) Highest adjacent (finished) grade (HAG) (o ft.(na� . U h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N4 O i) Total area of all permanent openings (flood vents) in C3.h /Y,4 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 lew to certify elevation information. l certify that the information in Sections A, B, and C on this certificate represents my best efforts to inierbret the data available. / understand that any false statement may be punishable by fine -or imprisonment under 18 U.S. Code, Section 1001. i'S NAME T��%rV,f%`D Ci /// c - 014_f 4o 4 //-- 24- C. �tK .49/01.114 %tiross� ue v�y/NC � .Z.frc . TA—TEZI ZIP CODE -- I LEPHONE FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPORTANT, In these spaces, copy the corresponding infonmatlon from Section A. WFor InsiAkipce Company Use: BUILDING STR 7 ADDRESS Including Apt., U ll, Suite; and/or Bldg: No, OR P.O. ROUTE AND BOX NO. Policy Number �9— e �0141<o �F1fC# . fir,,. 4. 4,o7~ / */ CITY STATE, ZIP CODE Company NAiC Number SECTION D - SURVEYOR,--ENGINEER:;!,-,OR ARCHITECT CERTIFICATION (CONTINUED) py both sides of this Elevation Certificate for (1) community official, -(2) insurance agent/company;-and (3) building owner. Tf1,6 , /s ys/i ryry 7ff.E N 4, l—I 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) I -1_I in. (cm) i_I above or 1!1 below (check one) the highest adjacent grade. (Use natural grade, (f`available.) E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (eleyation b) of the building is I -1_I ft. (m) 1,1_Iin. (cm) above the highest adjacent grade. Complete Items C3.h and C3J 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_1in. (cm) 1_1 above or 1,1 below (check one) the highest adjacent grade. (Use natural grade, [f 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 I Yes 1__1 No 1: 1 Unknown. The local official must ceelify-this information in Section G. SECTION F - PROPERTY OWNER (OWOWNER'S REPRESENTATIVE) CERTIFICATION , The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.b and C3J only), and E for Zone A (without a FEMA -issued or community -issued BFE) or Zonee-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 'NATURE DATE TELEPHONE COMMENTS SECTION G.; --COMMUNITY INFORMATION (OPTIONAL)'. Check here it attachments 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. Coihplete the applicable item(s) and sign' eiow. G1. 1_1 The information in 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. I—I A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. 1. G3. 1_i The following information (items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER I G5. DATE PERMIT ISSUED I ATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for: 1_1 New Construction I�I Substantial Improvement G8. Elevation of as -built lowest floor (including basement).of•the building is: —ft. (m) Datum: G9. BFE or (in Zone AO) dgpth oploodin at i e b it e ' T ft. (m) Datum: :arra oft%arks LOCAL OFFICIAL'S NAME"3 ivts:L�ri l't5 e TITLE COMMUNITY NAME r ' y6 TELEPHONE cis SIGNATURE i"- i =:es)not recorntttertd DATE COMMENTS t tr'1 cc Ase I 2- 03--. I I Check here it attachments FEMA Form 81-31, January 2003 Replaces all previous editions