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ELEVATION GERTIFICATE OMB No. 1660-0008 <br />Expiration Date: November 30,|022 <br />IMPORTANT: ln these the corresponding information from Section A.FOR INSURANCE COMPANY U <br />Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. <br />490 HERON FARM LANE <br />Policy Number: <br />ELLENSBURG 98926Washington <br />sEcTloN c - BUILDING ELEVATTON TNFORMATTON (SURVEY REQUTRED) <br />C1. Building elevations are based on: ! Construction Drawings* [ Building Under Construction* [} Finished Construction <br />"A new Elevation Certificate will be required when construction of the building is complete. <br />C2. Elevations -Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. <br />Complete ltems C2.a-h below according to the building diagram specified in ltem A7. ln Puerto Rico only, enter meters. <br />Benchmark Utilized: RM 2 Vertical Datum: NGVD 29 <br />lndicate elevation datum used for the elevations in items a) through h) below. <br />I NGVD 1929 ! NAVD'1988 [ Olher/Source: <br />Datumusedforbuildingelevationsmustbethesame"'th" <br />Check the measurement used. <br />a) Top of bottom floor (including basemenl, crawlspace, or enclosure floor) <br />b) Top of the next higher lloor <br />c) Bottom of the lowest horizontal structural member (V Zones only) <br />d) Attached garage (top of slab) <br />e) Lowest elevation of machinery or equipment servicing the building <br />(Describe type of equipment and location in Comments) <br />f) Lowest adjacent (finished) grade next to building (LAG) <br />g) Highest adjacent (finished) grade next to building (HAG) <br />h) Lowest a.djacent grade at lowest elevation of deck or stairs, including <br />structural support <br />1442.3 <br />1444.2 <br />1440.8 <br />N/A <br />1439.1 ffi feet ! meters <br />1M2.8 I feet I meters <br />N/A fl feet I meters <br />1441 A fl feet I meters <br />! feet I meters <br />$ feet <br />[] feet <br />fl feet <br />I meters <br />I meters <br />fl meters <br />sEcTtoN D - suRVEyoR, ENGINEER, OR ARCHTTECT CERTIF|CAT|ON <br />This certification is to be signed.end sealed by a land surveyor, engineer, or architect authorized by law to certifu elevation information.t ce.rtlfy that the lntorm{igi gn.this Certiftcatei represents my bbit Eiois'to iiterpret the data avaitlbie. t unaeiitand-nii-aii riiii""- ' <br />statement may be punishable by fine or imprisonment unddr I I U.S. Code, Seciion 1001 . <br />Were latitude and longitude in Section A provided by a licensed land surveyor? E Yes n ruo n Chect< here if attachments, <br />CHRISTOPHER C. CRUSE <br />Name <br />LS 36815 <br />License <br />Title <br />PROFESSIONAL LAND SURVEYOR <br />CRUSE AND ASSOCIATES <br />Address <br />P.O. BOX 959 <br />ZIP Code <br />98926ELLENSBURGWashington <br />Signature Telephone <br />(509) 9624242 <br />Date <br />08-09-2021 <br />Ext. <br />Copy all of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building ownerpages <br />Comments (lncluding type of equipment and location, per C2(e), if applicabte) <br />C2a. CRAWL SPACE; C2b. FINISHED FLOOR; C2e. HOTWATER TANK INSIDE GARAGE <br />FEMA Form 086-0-33 (12119)Replaces all previous edilions.Form Page 2 of6