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6-9-006:024
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7/11/2014 4:09:20 PM
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Date
11/26/2013
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Elevation Certificate
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U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 <br /> FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date:July 31, 2015 <br /> National Flood Insurance Program IMPORTANT:Follow the instructions on pages 1-9. <br /> SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br /> Al. Building Owner's Name Kaiakea LLC Policy Number: <br /> A2. Building Street Address(includingApt.,Unit,Suite,and/or Bldg.No.)or PO.Route and Box No. CompanyNAIC Number: <br /> 69-1886 PUAKO BEAH DRIVE <br /> City KAMUELA State HI ZIP Code 96743 <br /> A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) <br /> (3)6-9-006-024 <br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) <br /> A5. Latitude/Longitude:Lat. 19 961119 Long. -155.85478 Horizontal Datum: ❑NAD 1927 ❑x 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 5 <br /> A8. For a building with a crawlspace or enclosure(s): A9.For a building with an attached garage: <br /> a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage 640 sq ft <br /> b) No.of permanent flood openings in the crawlspace or b) Number of permanent flood openings in tt aattached garage <br /> enclosure(s)within 1.0 foot above adjacent grade 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 Da sq in <br /> d) Engineered flood openings? ❑Yes ❑No d) Engineered flood openings? ❑Yes ❑x No <br /> SECTION B-FLOOD INSURANCE RATE MAP(FIRM) INFORMATION <br /> 61. NAP Community Name&Community Number B2.County Name B3.State <br /> HAWAII COUNTY-155166 HAWAII COUNTY HAWAII <br /> B4. Map/Panel Number B5.Suffix 86.FIRM Index Date B7.FIRM Panel Effective/ 88.Flood Zone(s) 89.Base Flood Elevation(s)(Zone <br /> Revised Date A0,use base flood depth) <br /> 0278C C APR 02,2004 September 16, 1988 AE X 8 <br /> B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89: <br /> 0 FIS Profile ❑x FIRM 0 Community Determined ❑Other/Source: <br /> 611.Indicate elevation datum used for BFE in Item B9: D NGVD 1929 ❑NAVD 1988 ❑Other/Source: <br /> 1312.1s the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑x No <br /> Designation Date: / / 0 CBRS ❑OPA <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) <br /> Cl. Building elevations are based on: 0 Construction Drawings* 0 Building Under Construction* ❑x 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,AR/AE,AR/A1-A30,AR/AH,AR/A0.Complete Items <br /> C2.a-h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. <br /> Benchmark Utilized:RM 34 Vertical Datum:9.49 <br /> Indicate elevation datum used for the elevations in items a)through h)below. ❑x NGVD 1929 ❑NAVD 1988 ❑Other/Source: <br /> Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. <br /> a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 10 2 Cl feet ❑meters <br /> b) Top of the next higher floor 21 4 ❑x feet ❑meters <br /> c) Bottom of the lowest horizontal structural member(V Zones only) 8 6 j feet ❑meters <br /> d) Attached garage(top of slab) 8 4 ❑x feet ❑meters <br /> e) Lowest elevation of machinery or equipment servicing the building 11 0 ❑x feet ❑meters <br /> (Describe type of equipment and location in Comments) <br /> f) Lowest adjacent(finished)grade next to building(LAG) 6 9 ❑x feet ❑meters <br /> g) Highest adjacent(finished)grade next to building(HAG) 8.4 ❑x feet ❑meters <br /> h) Lowest adjacent grade at lowest elevation of deck or stairs,including 8 6 NI feet ❑meters <br /> structural support <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 /> I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. Q. F�F <br /> [.$Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Fi�j <br /> El Check here if attachments. licensed land surveyor? El Yes ❑No a LICENSED <br /> Certifier's Name License Number <br /> te PROr S�SfifNAL ' <br /> Roger Dean Fleenor LS 7276tO_ <br /> Title CompanyName * SURVEYOR <br /> Owner Roger ean Fleenor LPLS LLC No. 7276 <br /> Address City State ZIP Code <br /> PO Box 383414 Waikoloa HI 96738 '449IVq n, vSP' <br /> Signature Date Telephone <br /> 11-26-2013 808-880-9441 <br /> FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions. <br />
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