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ELEVATION CERTIFICATE <br />OMS No. 1660-0008 <br />Expiration Date. November 30, ?022 <br />NPORTANT: 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 />490 HERON FARM LANE <br />City State ZIP Code <br />Company NAIC Number <br />ELLENSBURG Washington 98926 <br />SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) <br />C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x 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, V14130, V (with SFE), AR, ARIA, AR/AE, ARIA1—A30, ARIAH, ARIAO. <br />Complete Items C2.a—h below according to the building diagram specified in Item AT In Puerto Rico only, enter meters. <br />Benchmark Utilized: RM 2 Vertical Datum: NGVD 29 <br />Indicate elevation datum used for the elevations in items a) through h) below. <br />0 NGVD 1928 ❑ 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) Top of bottom floor (including basement, crawlspaoe, or enclosure floor) 1439.1 0 feet ❑ meters <br />b) Top of the next higher floor 1442.8 x❑ feet ❑ meters <br />c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑ feet [] meters <br />d) Attached garage (top of slab) 1441.4 x❑ feet 0 meters <br />e) Lowest elevation of machinery or equipment servicing the building ❑ feet x <br />(Describe type of equipment and location in Comments) 14423 ❑ meters <br />f) Lowest adjacent (finished) grade next to building (LAG) 1440.2 x❑ feet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 1440.8 0 feet ❑ meters <br />h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ feet ❑ meters <br />structural support N/A <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 the information on this Certificate represents my best efforts to interpret the data available. I understand that any false <br />statement maybe punishable by line or imprisonment under 18 U.S. Code, Section 1001. <br />Were latitude and longitude in Section A provided by a licensed lend surveyor? Z Yes ❑ No ❑ Check here if attachments, <br />Certifieft Name License Number <br />CHRISTOPHER C. CRUSE LS 36815 <br />dtio w C <br />Title <br />PROFESSIONAL LAND SURVEYORS <br />� <br />bx ink. <br />Company Name <br />CRUSE AND ASSOCIATES <br />-q , <br />7� <br />Address <br />P.O. BOX 959 <br />!O t <br />N'`IL <br />City State ZIP Code <br />ELLENSBURG Washington 98926 <br />LAl`� <br />Signature Date Telephone Eat. <br />0"� 08-09-2021 (509) 982-8242 <br />Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner, <br />Comments (including type of equipment and location, per C2(e), if applicable) <br />C2a. CRAWL SPACE; C2b. FINISHED FLOOR; C2e, HOT WATER TANK INSIDE GARAGE <br />FEMA Form 086-0-33 (12119) Replaces all previous editions_ Form Page 2 of 6 <br />