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ELEVATION CERTIFICATE <br />OMB No. 1660-0009 <br />Expiration Date: Novemhpr nn 9n7,2 <br />IMPORTANT. In these spaces, copy the corresponding information from Section A. <br />FOR INSURANCE COMPANY USE <br />Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. <br />Policy Number. <br />171 HERON FARM LANE <br />City State ZIP Code <br />Company NAIL Number <br />ELLENS13URG Washington 98926 <br />SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br />C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction* Ig 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, VI—V30, V (with BFE), AR, ARIA, ARAE, AR/A1—A30, AR/AH, AR/AO. <br />Complete Items C2.a—h below ac ording to the building diagram specified in Item A7. In Puerto Rico only, enter meters. <br />Benchmark Utilized: RM 2 Vertical Datum. NGVD 1929 <br />Indicate elevation datum used for the elevations in items a) through h) below. <br />❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: <br />Datum used for building elevations must be the same as that used for the BFE. <br />Check the measurement used. <br />a) 'fop of bottom floor (including basement, crawlspace, or enclosure floor) 1442.0 Z feet ❑ meters <br />b) Top of the next higher floor 1445.6 ❑x feet r] meters <br />c) Bottom of the lowest horizontal structural member (V Zones only) NIA ❑ feet ❑ meters <br />d) Attached garage (top of slab) 1444.2 ❑x feet E] meters <br />e) Lowest elevation of machinery or equipment servicing the building <br />(Describe type of equipment and location in Comments) 1444.8�]x feet ❑ meters <br />f) Lowest adjacent (finished) grade next to building (LAG) 1443.3 ❑x feet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 1444.3x❑ feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including <br />structural support N/A ❑ feet [] meters <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 Information. <br />I certify that Ow Information on this Cerdfical a represents my best efforts to intarpmt the data available. I understand that any false <br />statement may be punishable by fine or inWrisonment under 48 U.S. Code, Section 1001. <br />Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here if attachmen . <br />Certifiees Name License Number <br />CHRISTOPHER C. CRUSE 36815 <br />Title <br />PROFESSIONAL LAND SURVEYOR <br />°j x rt <br />Company Name <br />CRUSE & ASSOCIATES <br />Address <br />P.O. BOX 959 <br />�OJyrq� LAS <br />City State ZIP Code <br />ELLENSBURG Washington 98926 <br />Signature ` Date Telephone Ext. <br />06-23-2021 (509)962-8242 <br />Copy all pages of this Elevation riificate and all attachments for (1) community, official, (2) insurance agent/oompany, and (3) building owner. <br />Comments (including type of equipment and location, per C2(e), if applicable) <br />C2a_ EARTHEN CRAWL SPACE, C2b. FINISHED FLOOR; C2d. CONCRETE SLAB ON GRADE, C2e. HEAT PUMP, <br />THIS CERTIFICATE REPLACES THE PREVIOUS CERTIFICATE DATED 6-21-2021 TO CORRECT LINE A7. <br />FEMA Form D86-0-33 (12119) Replaces all previous editions. Form Page 2 of 6 <br />