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ELEVATION CERTIFICATE <br />OMB No. 1660-0008 <br />Expiration Date: November 30, 2022 <br />IMPORTANT:In these spades, copy the corfesponding Inlbrmation 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 />390 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" © Finished Construction <br />*A new Elevation Certificate will be required when construction of the building is complete. <br />C2. Elevations -Zones A1A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARJAE, ARIA1 A30, ARIAH, AR/AO, <br />Complete Items C2.a-h below according to the building diagram specified in Item A7. in Puerto Rico only, enter meters. <br />Benchmark Utifizsd: NGS MONUMENT SBO592 Vertical Datum: NAVD88 <br />Indicate elevation datum used for the elevations in items a) through h) below. <br />❑ NGVD 1929 [g 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 (inducting basement, crawispace, or enclosure floor) 14433 ® feet ❑ meters <br />b) Top of the next higher floor 14470 ® 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) 1445.6 ® feet ❑ meters <br />e) Lowest elevation of machinery or equipment servicing the building <br />(Describe type of equipment and location in Comments) 1447.0 ® feet ❑ meters <br />f) Lowest adjacent (finished) grade next to building (LAG) 1444.1 ® feet ❑ meters <br />g) Highest adjacent (finished) grade next to building (HAG) 1444.5 ® feet ❑ meters <br />h) LaNestgrade at lowest elevation of deck or stairs, including <br />adjacent N/A C] feet C] meters <br />structural <br />SECTION D - SURVEYOR, ENt31NEER, 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 />1 ce►#fy that the information on this Certincate represents my best efforts to urterpret the date available. I understand that any false <br />statement may be punishable by Titre or krWiftonment under 16 U.S Code, section 1001. <br />Were latitude and longitude in Section A provided by a licensed land surveyor? Z Yes ❑ No ❑ Check here if attachments. <br />Certifier's Name License Number <br />CHRISTOPHER C. CRUSE 38815 <br />TitlepH <br />PROFESSIONAL LAND SURVEYOR <br />°y <br />Company Name <br />CRUSE & ASSOCIATES <br />ryr <br />Address <br />P.Q. BOX 959 <br />3138i5 <br />SlONvI R <br />City Sh" ZIP Code <br />ELLENSBURG Washington 98926 <br />Signature Date Telephone Fart. <br />02 20-2023 (509) 982-8242 <br />Copy an of this Elevation'Certificaft and all attachments for (1) community official, (2) insurance agenticompany, and (3) building owner. <br />Comments (inducting type of equipment and location, per C2(e), if applicable) <br />C2a. CRAWL SPACE; C2b. FINISHED FLOOR; C2d. CONCRETE SLAB ON GRADE; C2e. HEAT PUMP <br />USED EXPIRED CERTIFICATE PER FEMA BULLETIN W-22020. <br />69 & B10 - BASED ON KITTITAS COUNTY FLOOD PERMIT FD-21-00002. <br />FEMA form Ut D-33 02119) Replaces all previous editions. Form Page 2 of 6 <br />