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0 / /c <br /> I U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 <br /> Federal Emergency Management Agency <br /> Expires February 28.2009 <br /> National Flood insurance Program Important: Read the instructions on pages 1-8. <br /> SECTION A-PROPERTY INFORMATION For Insurance Company Use: <br /> Al. Building Owner's Name kA k4,64., L_L-G Policy Number <br /> A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number • <br /> 131`6 c1-AA.' Ot-itA' 0 PL- <br /> 4.C...=-City 14-t LO State 1.41 Z1P Code 9(:;-12_,=" <br /> A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc. <br /> L--oT S-A , 1e-.A.k.lf4,tt_Af.)1 aIZ.oV>G -1-1.4 ..(1) 2-+-p-11 = C'13 <br /> i <br /> A4. Building Use(e.g.,Residential,No�-Residential,Addition,Accessory,etc.) as d �1 T/41-- <br /> A5. Latitude/Longitude:Lat. 11-71 4r-8 6 Long. 308 943 Horizontal Datum: 0 NAD 1927 12 NAD 1983 <br /> A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. <br /> A7. Building Diagram Number S <br /> A8. For a building with a crawl space or enclosure(s),provide: A9.•For a building with an attached garage,provide: <br /> a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage sq ft <br /> b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage <br /> enclosure(s)walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade <br /> c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in • <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION <br /> B1.NFIP Community Name&Community Number 92.County Name B3.State <br /> Hawaii County 155166 Hawaii County Hawaii <br /> B4.Map/Panel Number 85.Suffix 136.FIRM Index B7.FIRM Panel 88.Flood 99.Base Flood Elevations)(Zone <br /> Date Effective/Revised Date Zone(s) AO,use base flood depth) <br /> ' 155166- o '9 o*, a .o-c1) 4/02/04 16- Gr-88 A. 4-6 2- <br /> 1310. Indicate the source of th Base Flood Elevation(BFE)data or base flood depth entered in Item B9. <br /> 0 FIS Profile D{1 FIRM 0 Community Determined []Other(Describe) <br /> Bi 1. Indicate elevation datum used for BFE in item 99:1NGVD 1929 0 NAVD 1988 0 Other(Describe) <br /> 912. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? D Yes in No <br /> Designation Date 0 CBRS []OPA <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) • <br /> Cl. Building elevations are based on: ❑.Construction Drawings* []Building Under Construction' 2 Finished Construction <br /> 'A new Elevation Certificate will be required when construction of the building is complete. <br /> C2. Elevations-Zones Al A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,ARAE,AR/Al-A30,AR/AH,AR/A0. Complete Items C2.a-g <br /> below according to the building diagram specified in Item A7. The Department of Public Works <br /> Benchmark Utilized Vertical Datum Engineering Divi=sion has reviewed;. <br /> Conversion/Comments <br /> Check the TI AsPaiiMiggid.CCertificate and <br /> co <br /> a) Top of bottom floor(including basement,crawl space,or enclosure floor) 46 6 f II'eet ��' meters Ic�tf$`Rfco only) <br /> b) Top of the next higher floor 468 . l feetMI 1 r �(I Ao lnftend <br /> c) Bottom of the lowest horizontal structural member(V Zones only) 1.1A _❑feet fiiIIrrdppt6+PCW Rico only) <br /> d) Attached garage(top of slab) -4-&C , . ( feet 0 meters(Puerto Rico only) <br /> e) Lowest elevation of machinery or equipment servicing the building -4-62 8 .9-afeet Ep meters(Puerto Rico only) <br /> (Describe type of equipment in Comments) <br /> I) Lowest adjacent(finished)grade(LAG) kS�}' .8 feet 0 meters(Puerto Rico only) <br /> g) Highest adjacent(finished)grade(HAG) '(i .A.Effeet D meters(Puerto Rico only) . <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 law to certify elevation • <br /> information. I certify that the information on this Certificate represents my best efforts to interpret the data available. <br /> 1 understand that any false statement maybe punishable by fine or imprisonment under 18 U.S.Code,Section 1001. . \)\-t4. M(/RR <br /> 1 Check here if comments are provided on back of form. P -Y <br /> Q LICENSED <br /> Certifiers Name License Number L C s 2 * PROFEESrSIIONAL <br /> 'AUL �IuRR��P U. �* <br /> Title 1 0 �waicyoK_ Company Name ?AUL 11 ►^UK '? 4 Assocu�-T•t-C ,1 { r SURVEYOR . <br /> 1�H '�'t 7 `d' t� VVV No. LS-7589 <br /> Address ' •'RO') im City ILO State iili ZIP CodeCl/Till <br /> Signa - l� A 1 Date Tele honEtlyi i y <br /> '�'y �t 5"P <br /> FEMA Form 81-31, February 2006 41•••°""" See'reverse side for co tinuation. Replaces all previous editions <br />