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r I vjca.a iVv. Ill%I .J.G FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAMtl O.M.B. No. 3067-0077 Expires July 31, 2002 ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: BUILDING OWNER'S NAME Policy Number Roman Catholic Church - NEW STORAGE SHED BUILDING STREET ADDRESS(Including Apt..Unit.Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number 65-1235 Kawaihae Road CITY STATE ZIP CODE Kamuela, Hawaii 96743 PROPERTY DESCRIPTION(Lot and Block Numbers.Tax Parcel Number,Legal Description,etc.) Lot 13. Block 4 of Waimea Homesteads (HIS Plat 405-A) Grant 10324 TMK: 6-5-03: 029 (r Division) BUILDING USE(e.g.,Residential.Non-residential.Addition.Accessory.etc. Use Comments section if necessary.) Storage Shed _ LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: Ij GPS(Type). ( #4°-##'-##.##" or ##.#####°) 1_1 NAD 1927 I_I NAD 1983 IJ USGS Quad Map U Other: SECTION B -FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP COMMUNITY NAME&COMMUNITY NUMBER B2.COUNTY NAME B3.STATE Hawaii Hawaii Hawaii B4.MAP AND PANEL B5.SUFFIX B6.FIRM INDEX B7.FIRM PANEL N.FLOOD B9.BASE FLOOD ELEVATION(S) NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding) 155166 0168 E June 2, 1995 May 16, 1994 AE 2663.2 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9. l_X FIS Profile I_I FIRM I_I Community Determined I_I Other(Describe): B11. Indicate the elevation datum used for the BFE in B9: I N NGVD 1929 I I NAVD 1988 1 J Other(Describe): B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? I_I Yes L. No Designation Date: SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl.Building elevations are based on: 1_IConstruction Drawings* LjBuilding Under Construction* IX'Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. :2. 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 A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,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 MarkDceS the elevation reference mark used appear on the FIRM? II Yes LX No ❑ a)Top of bottom floor(including basement or enclosure) 2662.30 ft.(d() TO O b)Top of next higher floor n/a _ft(m) F.L- T' Y44i / • ❑ c)Bottom of lowest horizontal structural member(V zones only) n/a ft,(m) 3 �� O d)Attached garage(topof slab) a 8 fie' LICENSED i• 9 9 n/a _ft.(m) lr . ❑ e)Lowest elevation of machinery and/or equipment w o CV PI�FESSIO fi! . servicing the building No electricity n/a ft(m) E a * 0'•• ❑ f)Lowest adjacent grade(LAG) 2661.5 ft.(rX) z' � . Lk g)Highest adjacent grade(HAG) ft a 1, ,"••4831 2661:9— (00 = n I q ' O h)No. of permanent openings(flood vents)within 1 ft.above adjacent grade 8 "J ,t ' W411.05. CI i)Total area of all permanent openings(flood vents)in C3h 416 sq. in.(sq.cm) 1. ' ugus , 102 SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFIC•TION 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. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER Chrystal Thomas Yamasaki LS-4331 TITLE COMPANY NAME gDLasd Surveyor WES THOMAS &T ASSOCIATESY , IN /� 749 Kalawa - - SATE ZIP CODE SIG T • . ' ' • • 1- �y 4, DATE ELEPHONE ? - • • r r : 1 : - • - FEMA Firm R1-41 Al In(xi arSFP REVERSE sir rnr?r:r1NTINI IATIi1N PFPI AC:FS Al I PRF1/101 IC FIIITIr1NS