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Home My WebLink About7-2-010:004 Bungalows 28 & 29 U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATEOMNo. 1660-0008 Federal Emergency Management Agency I ExpiresB February 28.2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION .For insurance Company:Use: Al. Building Owner's Name N :Poll Number - {{t]�C A LPr( / L/ES�sT S/ 4-L C- �r A2. Building Street Address(including Apt.,Unit,Suite and/or Bldg.No.)or P.O.Route and Bok No. _Company NAIL Number 77- 1 rA� v , 5�117rC'i�8 - <,,1s28/zft- LLQ _ onta +A. ^tStaerc= ig. aID 1c 0-24 - A3. Property Description(Lot and Block N mbers,Tax Parcel Number,Legaall(iescripti`on,,etc.) - - o ' ii ,, , , , SSS -1,i 3a,44' A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) G { Lit A5. Latitude/Longitude:Lat.N• ilo.2:Z.Sai O Long.W. (SS• q/Z.7 Horizontal Datum: 0 NAD 1927 MAD 1983 A6. Attach at least 2 photograph of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawl space or endosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or endosure(s) sq ft a) Square footage of attached garage sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage endosure(s)walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade • c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION . B1.NFIP Community Name&Community Number B2.County Name B3.State Hawaii County 155166 Hawaii County Hawaii 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 „�;,� 'nw ^�wvw.Twa.1BGY Data Zoi s; AV,U YOac n.;uvpuq 1551664'ib I G I 4/02/04 1 ((.11=S 7 L fl& 1 `i . O B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89. 0 FIS Profile FIRM 0 Community Determined 0 Other(Describe) B11. Indicate elevation datum used for BFE in Item 89: 1N NGVD 1929 0 NAVD 1988 0 Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® No Designation Date 0 CBRS 0 OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: -. 0 Construction Drawings' 0 Building Under Construction' pi Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. 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 below according to the budding diagram specified in Item A7. Benchmark Utilized RMA 6;5 Vertical Datum NC:v(3 192 Conversion/Comments _ P-.1. e Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) I' _ feet 0 meters(Puerto Rico only) b) Top of the next higher floor '2-( II. feet 0 meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) n feet 0 meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building I .12®feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) t is ., Meet 0 meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 11 .SeI 5 feet ❑meters(Puerto Rico only) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. /certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement maybe punishable by fine orimprisonment under 18 U.S.Code,Section 1001. ,o ff` R. 4400 Check here if comments are provided on back of form. R7, 1Q D Cert'��are • i ur, / f L Lice se Ngmber * T PR A �. ARdf * Ti Com an am �-� L� s ��•i i t No. 5404 �! A ss Ci State IP e tzf Signature ! /PI � t'771."7-42T lei Z. i An, 13• .1 FEMA Form ; :1,February 2006 See reverse side for continuation. Replaces all previous editions •.••��....r..co,uvNy u1C t.uI Iespunuing inrormation rrom section A. For Insurance Company Use: Building St Address(inducing Apt.,Uniemit)t,Suite.anc�d/*Bldg. or P.t�Rou to and Box No. Z Policy Number , . ] ��' .. V State , W,t_ A. 9zl�r�e Company NAIC Number C�Pa 01t 141: SECTION D-SURVEYOR,ENGINEER,OR ARCHIT CT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Ai iz 46 ciNap rrovNi INS- o(P reyki ...r. 1:, 4:15- F.,=, .54 445, Signature Date �fi•�� 0 Check here N attachments SECTION - ILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B. and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation Is above or below the highest adjacent grade(HAG)anctthe lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is _❑feet 0 meters 0 above or Ed below the HAG. b)Top of bottom floor(Including basement,crawl space,or enclosure)is 0 feet 0 meters 0 above or below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in SectiW.Items 8 and/or 9(see use 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ._0 feet LI meters 0 above or Ibelow the HAG. E3. Attached garage(top of slab)is 0 feet 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _❑feet 0 meters 0 above or 0 below the HAG. E5. 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? 0 Yes ❑No 0 Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B.and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my knowledge. Pripe Owners or of Au%rued a sen five' Nart�, � rs -�.- 2 w�i1lk� City -.let State � Signature rii tel Comments a z�jSlo'8 s rg°t , , 8 702 0 Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) 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. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. GI. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who Is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. 0 A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. 0 The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: 0 New Construction 0 Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: 0 feet 0 meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: 0 feet 0 meters(PR) Datum Local Official's Name Title Community Name Telephone Signature ENGINE it 70N Date Comments ReviQ^"! -- Date /2--/ 7/0g, (ADDfoved ri Not Approved 0 Approved as Noted ❑Check here if attachments FEMA Form 81-31,February 2006 Replaces all previous editions