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HomeMy WebLinkAbout2-5-059:041U.S. DEPARTMENT OF HOMELAND SECURITY "ELEVATION CERTIFICATE OMB No.1St30.0008 Federal EmagWM Management Agency I Expires March 31, 2012 National Flood Insurance Program Important: 'Read the insinictlons on pages 1-9. SECTION A - PROPERTY INFORMATION For insurance Company Use: Al. Richard and/or Bldg. No.) or P.O. Route and Box No. 1111 Werale'ale Piece I I City Hilo State HI ZIP Code 987220 A3. Property Description (Lot and Bbclk Numbers, ax Parcel Number, Legal , eta) Lot 224 of Land Court Appllcatton 292, Map 14 TW V DN. 2-5459:041 A4. Building Use (e.g.. Residential, Non-Resklentlal, Addition, Accessory, etc.) gQgildenfla AS. Letitude/Longltude: Let 19.711¢$ Long. 21 Horizontal Datum: ❑ NAD 19210 NAD 1983 ,. A8. Attach at least 2 photographs of the building If the CertMoste is being used to obtain flood insurance. A7. 8ufiding Diagram Number 16 Ae. For a building with a crawrispece or anclosure(s): A9. For a building with on attached garage: a) Square footage of orewlspaoe or endosure(s) W► *q ft a) Square footage of attached garage Mg aq It b) No. of permanent flood openings In the c rowlepece or b) No. of permanent flood openings In the attached garage enclosure(*) within 1,0 foot above adjacent grade jffi within 1.0 foot above adjacent grade WA c) Total net area of flood openings in A8.b hffi eq M c) Total net area of flood openings In A9.b jyffi sq In d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION 8 - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 81. NFIP Community Name & Community Number B2 Munty Name T 83. State Hawafi County 155166 I County of Hawalt I Hawali 84. MeplPenel Number 85. Suffix 136. FIRM Index 87. FIRM Panel138. load B9. SonFlood Elevation(*) (Zone t 551860859 D Dab ElfecNe/Revlaed Dab Zone(*) AO, use base flood depth) ❑ feet ❑ meters (Puerto Rico only) April 2,2004 August 23,2010 X & AE 655 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89. ❑ FIS Profile ® FIRM ❑ Community Oetennined ❑ Other (Describe) , 811. Indicate elevation datum used for BFE in Item 89: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) 812. 1* the building located Ina Coastal Senior Resources System (CSRS) area or Otherwise Protected Area (OPA)? ❑ Yes IN No Designation Date WA ff CORS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings• ❑ Bulldbhg Under Construction' ® Finished Construction •A new Elevation Certlflcate wm be required when constructim of the building Is complete. C2. Elevations —Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, ARIA, ARIAE, AR/Al-A30, ARIAH, AR/AO. Complete items C2." -below ecoording to the building diagram specified in item A7. Use the same datum as the BFE. Benchmark Udltzed PIIHONU -1t) Vertical Datum NGW1229 ComerelonlComments SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a landsurveyor, ON!neer, W prphttect authorized by law to ceNy ektvatlon Information. I Coro that the lnfomsallon on MIS Cerfllfcate represents my best enbrta to Interpret the are evelts /e.l understand that any false afefemant maybe punishable by Finns or hriFsr $0aMnt under f8 U.S. Code, Secom 1001. ❑ Check hero If comments are provided on back of farm. Were latitude and longitude In Section A provided by a licensed land rsunroyor? 0 Yee ❑ No Certifiets Name Wayne A Subica Jr. License Number 13717 Itle Land Surveyor Company Name Imets & Assoc., Inc. FEMA Form W-311. Mar 09 See reverse side for continuation. Py�� pP,. sue, Lto PRO NAL * SURVEYOR No. 13717 y�WAit, U U. Replaces ell previous editions Check the measurement used, e) Top of bottom floor (including basement, cnWspace, or enclosure floor) =.Q ® The ❑ meters (Puerto Rico only) b) Top of the next higher floor MA ® feet ❑ meters (Puerto Rico only) c) Raom of the lowest horizontal structural member (V Zones only) &A ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) Q$¢.$ ® feet 0 meters (Puerto Rico only) e) Lowest elevation of rnaclih"iy or equipment servicing the building §H.i ® feet ❑ meters (Puerto Rion only) (DeauU type ofequlpment and locatlon In Comments) Q Lowest adjacent (finished) grade next to building (LAG) 01.2 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) $Qg.$ ®/lest ❑ meters (Puerto Rbc only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including jy(0 ❑ feet ❑ meters (Puerto Rbc only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a landsurveyor, ON!neer, W prphttect authorized by law to ceNy ektvatlon Information. I Coro that the lnfomsallon on MIS Cerfllfcate represents my best enbrta to Interpret the are evelts /e.l understand that any false afefemant maybe punishable by Finns or hriFsr $0aMnt under f8 U.S. Code, Secom 1001. ❑ Check hero If comments are provided on back of farm. Were latitude and longitude In Section A provided by a licensed land rsunroyor? 0 Yee ❑ No Certifiets Name Wayne A Subica Jr. License Number 13717 Itle Land Surveyor Company Name Imets & Assoc., Inc. FEMA Form W-311. Mar 09 See reverse side for continuation. Py�� pP,. sue, Lto PRO NAL * SURVEYOR No. 13717 y�WAit, U U. Replaces ell previous editions IMPORTANT: in these spaces, coPY the COrMPonding Infonmtlitfon from Section A. For Insurance Company Use: Building Street Address (irtduding Apt., Unit, Suite, andfor Bldg. No.) or P.O. Route and Box No. Policy Number 1111 warowsle Place Cfly Hilo State HI ZIP Code 96720 r..,..,,..,., MAR*- L....._. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CER11FICATION (CONTINUED) Copy both aides of this Elevation Certificate for (1) oommuntty offldal, (2) Insurance agentloompany, and (3) building owner. Comments C2. Bench mark was established by the County of Hawaii Department of Public Work s(F=58). A metal plug in concrete located along the south edge of Lahl Street, approxfmately 300 feet wast of Afnakc Avenue. C2e. The lowest elevation of machinery and/or equlpmW serWdng the building b the liquid pro"as tank gp.tbe e)Mng concrete pavement on the south side of the building. The tank to visible In photo fabled "Left ViewV. R _Check here H attacnmenta SECTION E -BUILDING 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, 8, and C. For items EI -E4, use natural grade, If available. Check the measuranent used. in Puerto Rico only, enter meters. Et. Provide elevation Information for the following and ceedk the appropdste boxes to show whsttror the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including baserneni, crewispace, or enclosure) is W. 0 feet 0 meters 0 above or ; below the HAG. b) Top of bottom floor (including basement. 00WISPOW, or enclosure) is W& 0 feet 0 masters 0 above or 0 below the IAO. E2. For Building Diagrams 8.9 with permanent flood openings provided to Section A Items 8 and/or 9 (see pages 6-9 of instructions), the next higher floor (elevation C2.b In the diagrams) of the building is WA. Q feet © meters 0 above or 0 below the HAG. • E3. Attached garage (top of stab) is WA. ❑ feat 0 meters 0 above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is W 0 feet 0 melena 0 above or 0 below the HAG. £5. Zone AO only: if no flood depth number is available, la the top of the bottom floor elevated In accordance with the communitys floodplain management ordinanoe4 C] Yes 0 No 0 Unknown. The local official must cer ft this information In Section G. SECTION F • PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners auft ted representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or oommunllyassued BFE) or Zone AO must sign hers. lbs statements In Sectibrrs A, 8, and E are correct to the best of my knowledge. Property Ownees or Owner's Authorized Representative's Name Address City Stats ZIP Code Signature Date Telephone Comments we `�� 11 Check here Math SECTION 0 w COMMUNITY INFORMATION (OPTIONAL,) ""— Thp iml 0fte1 who Is authorized by law or ordinance to administer the oOXrlmunffys floodplain management ordinance can oomplete Sacgons A. 8, C (or E), and Got this Elevation Certificate. Complete the applicable ftem(s) and sign below. Check the measurement used in items Go and Go. 01. j] The information In Section C was taken from other documentation that has been signed and seated by a licensed surveyor, engineer, or architect who Is authortzad by law to certify elevation information. (Indicate the source and date of the elevation data In the Comments area below.) 02.0 A community of iclal completed Section E for a building located In Zone A (without a FEMAdssued or communitydssued BFE) or Zone AO, G3.0 The following irfarmation (Items G4 -G9) Is provided for community PoWpietn management purposes. Deb Permit Issued IG5. Date Certiflaate Of COMPIMoatOocupancY Issued 07. This permit has been Issued for: j] New construction 0 Substantial improvermem G9. Etevadon Of as•buflt WOW floor {Inotuding basement) of the building: 0 feet 0 meters (PR) Datum G9. SFE or pn tone AO) depth of flooding at the building site: 0 feet 0 meters (PR) Datum GiO. Communkys design flood elevation 0 feet 0 meters (PR) Datum Local O fidars Name TRIO Community Name Telephone Slone" Dab f Comments Cfreck here /netts h�+•r�: FEMA Form 81.31, Mar ()9 Replaces all previous editions