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U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date: July 31, 2015 National Flood Insurance Program IMPORTANT: Follow the instructions on pages 1-9. SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building owner's Name KAI V TORNGREN, III & LAURIE ANN V CARIAGA-TORNGREN Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P0. Route and Box No. Company NAIC Number: 61 HOONANI PLACE City HILO State HI ZIP Code 96720 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) (3) 2-2-045-183; LOT 12-A, HILO HOONANI SUBDIVISION A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 19-40-59.62 N Long. 155-03-47.43 W Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 5 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawlspace or b) Number of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 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 d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number HAWAII COUNTY - 155166 B2. County Name HAWAII COUNTY [33AAw HA B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone na Q feet ❑ meters Revised Date ❑x feet A0, use base flood depth) 890 C APR 02, 2004 AE 117.0 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ® FIS Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: Bll. Indicate elevation datum used for BFE in Item 139: x❑ NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: / / ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x 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-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: USGS 1957 5YY Vertical Datum: NGVD 1929 Indicate elevation daturn used for the elevations in items a) through h) below. ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. h k h d a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 115.4 Z feet ❑ meters 117.9 ❑x feet ❑ meters 117.2 Z feet ❑ meters 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. I certify that the information 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. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a x❑ Check here if attachments. licensed land surveyor? M Yes ❑ No Certifier's Name License Number LAN Z INABA 5626 LPLS Title Com any Name INA6A ENGINEERING, INC City State AVE HILO HI Date Teleph 04/06/2015 808-9 FEMA Form(Q96-0-33 (7/12) See reverse side for continuation. -3727 PSN Z rNA�9 LICENSED PROFESI40NAL 'LAND SUAVE" Nm 56'26 ygrVAll, v 5�' Replaces all previous editions. C ec t e rneasurement use . 119 4 ❑x feet ❑ meters 120.0 Z feet ❑ meters na Q feet ❑ meters na ❑x feet ❑ meters 118. 7 x❑ feet ❑ meters 115.4 Z feet ❑ meters 117.9 ❑x feet ❑ meters 117.2 Z feet ❑ meters 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. I certify that the information 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. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a x❑ Check here if attachments. licensed land surveyor? M Yes ❑ No Certifier's Name License Number LAN Z INABA 5626 LPLS Title Com any Name INA6A ENGINEERING, INC City State AVE HILO HI Date Teleph 04/06/2015 808-9 FEMA Form(Q96-0-33 (7/12) See reverse side for continuation. -3727 PSN Z rNA�9 LICENSED PROFESI40NAL 'LAND SUAVE" Nm 56'26 ygrVAll, v 5�' Replaces all previous editions.