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U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATEOMNo. 1660-0008 <br /> Federal Emergency Management Agency I ExpiresB 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 N :Poll Number - <br /> {{t]�C A LPr( / L/ES�sT S/ 4-L C- �r <br /> A2. Building Street Address(including Apt.,Unit,Suite and/or Bldg.No.)or P.O.Route and Bok No. _Company NAIL Number <br /> 77- 1 rA� v , 5�117rC'i�8 - <,,1s28/zft- <br /> LLQ _ onta <br /> +A. ^tStaerc= ig. aID 1c 0-24 - <br /> A3. Property Description(Lot and Block N mbers,Tax Parcel Number,Legaall(iescripti`on,,etc.) <br /> - - o ' ii <br /> ,, , , , SSS -1,i 3a,44' <br /> A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) G { Lit <br /> A5. Latitude/Longitude:Lat.N• ilo.2:Z.Sai O Long.W. (SS• q/Z.7 Horizontal Datum: 0 NAD 1927 MAD 1983 <br /> A6. Attach at least 2 photograph of the building if the Certificate is being used to obtain flood insurance. <br /> A7. Building Diagram Number <br /> A8. For a building with a crawl space or endosure(s),provide: A9. For a building with an attached garage,provide: <br /> a) Square footage of crawl space or endosure(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 /> endosure(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 B2.County Name B3.State <br /> Hawaii County 155166 Hawaii County Hawaii <br /> B4.Map/Panel Number I B5.Suffix I B6.FIRM Index I B7.FIRM Panel I 88.Flood I B9.Base Flood Elevation(s)(Zone <br /> „�;,� 'nw ^�wvw.Twa.1BGY Data Zoi s; AV,U YOac n.;uvpuq <br /> 1551664'ib I G I 4/02/04 1 ((.11=S 7 L fl& 1 `i . O <br /> B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89. <br /> 0 FIS Profile FIRM 0 Community Determined 0 Other(Describe) <br /> B11. Indicate elevation datum used for BFE in Item 89: 1N NGVD 1929 0 NAVD 1988 0 Other(Describe) <br /> B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® No <br /> Designation Date 0 CBRS 0 OPA <br /> SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) <br /> Cl. Building elevations are based on: -. 0 Construction Drawings' 0 Building Under Construction' pi 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/AO. Complete Items C2.a-g <br /> below according to the budding diagram specified in Item A7. <br /> Benchmark Utilized RMA 6;5 Vertical Datum NC:v(3 192 <br /> Conversion/Comments _ P-.1. e <br /> Check the measurement used. <br /> a) Top of bottom floor(including basement,crawl space,or enclosure floor) I' _ feet 0 meters(Puerto Rico only) <br /> b) Top of the next higher floor '2-( II. feet 0 meters(Puerto Rico only) <br /> c) Bottom of the lowest horizontal structural member(V Zones only) feet ❑meters(Puerto Rico only) <br /> d) Attached garage(top of slab) n feet 0 meters(Puerto Rico only) <br /> e) Lowest elevation of machinery or equipment servicing the building I .12®feet ❑meters(Puerto Rico only) <br /> (Describe type of equipment in Comments) <br /> f) Lowest adjacent(finished)grade(LAG) t is ., Meet 0 meters(Puerto Rico only) <br /> g) Highest adjacent(finished)grade(HAG) 11 .SeI 5 feet ❑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. /certify that the information on this Certificate represents my best efforts to interpret the data available. <br /> I understand that any false statement maybe punishable by fine orimprisonment under 18 U.S.Code,Section 1001. ,o ff` R. 4400 <br /> Check here if comments are provided on back of form. R7, 1Q <br /> D <br /> Cert'��are • i ur, / f L Lice se Ngmber * T <br /> PR A <br /> �. ARdf * <br /> Ti Com an am �-� <br /> L� s ��•i i t No. 5404 �! <br /> A ss Ci State IP e <br /> tzf <br /> Signature ! /PI <br /> � <br /> t'771."7-42T lei Z. i An, 13• .1 <br /> FEMA Form ; :1,February 2006 See reverse side for continuation. Replaces all previous editions <br />