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ELEVATION CERTIFICATE <br />OMB No. 1660-0008 <br />Expiration Date. November 30, 2022 <br />IMPORTANT., In these spaces, copy the corresponding Information from Section A. <br />FOR INSURANCE COMPANY USE <br />Building Sireet Address (including Apt., Unit, Sufle, andfor Bldg. No.) or P.O. Route and Box No. <br />Poky Number. <br />2011 Roan Drive <br />City State ZIP Code <br />Company NAIL Number <br />Ellensburg Washington 98926 <br />SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) <br />FOR ZONE AO AND ZONE A (WITHOUT BFE) <br />For Zones AO and A (without SIFE), complete Items El —Ea. If the Cerliiioate is intended to support a LOMA or LOMR-F request, <br />complete Sections A, Band C. For Items E1-134, use natural grade, If available. Check the measurement used. In Puerto Rdoo only, <br />enter meters. <br />E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation Is above or below <br />the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). <br />a) Top of bottom floor (including basement, <br />amwlspece, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />b) Top of bottom floor (including basement, <br />crawispace, or enclosure) Is ❑ feet ❑ meters ❑ above or ❑ below the LAG. <br />E2. For Building Diagrams 82 with permanent flood openings provided In Section A Items 8 andfor 9 (see pages 1 2 of InsWctlonsy <br />the next higher floor (elevation C2b in <br />the diagrams) of the building is ❑ feet ❑ meter: ❑ above or ❑ below the HAG. <br />E3. Attached garage (top of slab) Is ❑ feet ❑ meters ❑ above or ❑ below the HAG. <br />E4, Top of platform of machinery andlor equipmant <br />servicing the building Is _ ❑ feet ❑ meters ❑ above or d below the HAG. <br />ES. Zone AO only. If no flood depth number is available, Is the top of the bottom floor elevated In accordance with the communtVa <br />floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information In Section G, <br />SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION <br />The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-Issued or <br />oommunrlyissued BM or Zone AO must slgn here. The statements In Sections A. B, and E are correct to the best of my knowledge. <br />Property Owner or Owners Authorized Representative's Name <br />Scott Henson <br />Address Cily State ZIP Code <br />1224 S Pioneer Way Moses Lake Washington 98837 <br />Signature,, Date Telephone <br />(509) 855.6112 <br />Commerce <br />❑ Check hers N attachments. <br />FEMA Form 086-0-33 (12f1g) Replaces all previous editions. Form Page 3 of 6 <br />