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IMPORTANT: ln lhese $paces, copy the corrpspondinq information from Section A,FOR INSURANCF COMPANY USE <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 />City Stale <br />Washington <br />ZIP Code <br />98926ELLENSBURG <br />Company NAIC Number <br />sEcTloN E- BUILDING ELEVATTON TNFORMATTON (SURVEY NOT REQUIRED) <br />FOR ZONE AO AND ZONE A {W|THOUT BFE) <br />For Zones AO and A (without BFE), complete ltem6 E1-E5. lf the Certificate is intended to support a LOMA or LOMR-F request, <br />complele Sections A, B,and C. For ltems E1-E4, use natural grade, lf available. Check the measurement used. ln Puerto Rico only, <br />enter meters, <br />E1. Provide elevation information for the following and check the appropriale boxes to show whether the elevation is above or below <br />the highest adjacent grade (HA,G) and the lowest adjacent grade (LAG). <br />a) Top of bottom floor (including basement, <br />crawlspace, or enclosure) is <br />b) Top of bottom floor (including basement, <br />crawlspace, or enclosure) is <br />! feet I meters ! above or ! below the HAG. <br />I feet ! meters f] above or n below the LAG. <br />E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A ltems 8 and/or I (see pages 1-2 of lnstructions), <br />the next higher floor (elevation C2.b in <br />the diagrams) of the building is <br />E3. Attached garage (top of slab) is <br />E4. Top of platform of machinery and/or equipment <br />servicing the building is <br />I feet f] meters I above or [below the HAG. <br />I feet I meters I above or I below the HAG. <br />lfeet ! meters I above or [below the HAG. <br />E5. Zone AO only: lf no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's <br />floodplain management ordinance? fl Yes n No I Unknown. The local official must certiff this information in Section G. <br />sEGnoN F - PROPERTY OWNER (OR OWNER'S REPRESENTATTVE) CERT|F|CAnON <br />The properly owner or owne/s authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or <br />community-issued BFE) or Zone AO musi sign here. The statements in Sections A, B, and E are conect to the best of my knowledge. <br />Property Owner or Owner's Authorized Representrative's Name <br />Address City State ZIP Code <br />Signature Date Telephone <br />Commentrs <br />I Ctrect< here if attachments. <br />ELEVATION CERTIFICATE OMB No. 166&0008 <br />Expiration Date: November 30,2022 <br />FEMA Form 086-0-33 (12l19)Replaces all previous editions.Form Page 3 of6