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U.S. DEPARTMENT OF HOMELAND SECURITY OMB No.1660-0008 <br />Federal Emergency Management Agency Expiration Date: November 30, 2022 <br />National Flood Insurance Program <br />ELEVATION CERTIFICATE <br />Important Follow the instructions on pages 1-9. <br />Copy all pages of this Elevation Certificate and all attachments for (1) commuNty official, (2) Insurance agent/company, and (3) building owner. <br />SECTION A — PROPERTY INFORMATION <br />FOR INSURANCE COMPANY USE <br />A1. Building Owner's Name <br />Policy Number: <br />SSHI LLC. <br />A2. Bulkling Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and <br />Company NAIC Number: <br />Box No. <br />2916 Roan Drive <br />city state ZIP code <br />Ellensburg Washington 98926 <br />A3. Property Description (Lot and Blodc Numbers, Tax Parcel Number, Legal Description, do.) <br />Division 6 Lot 3,961888 <br />A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential <br />AS. Latitudell-ongitude: Lat. N47001'30.46667" Long.W120°303.83831" Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 <br />AS. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance. <br />A7. Building Diagram Number 1 BB <br />AS. For a building wflh a orawispaoe or enclosure(s): <br />a) Square footage of crawlepace or enclosure(s) NIA aq ft <br />b) Number of permanent flood openings in the crawlepac:e or enclosure(s) within 1.0 foot above adiacent grade WA <br />c) Total net area of flood openings In AB.b NIA sq in <br />d) Engineered flood openings? ❑ Yes M No <br />A9. For a building with an attached garage: <br />a) Square footage of attached garage 520.00 sq R <br />b) Number of permanent flood openings In the attached garage within 1.0 foot above adjacent grade 0 <br />c) Total net area of flood openings In A9.b 0.00 sq in <br />d) Engineered flood openings? ❑ Yes ❑x No <br />SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION <br />B1. NFIP Community Name & Community Number <br />B2. County Name <br />83. State <br />KITTITAS COUNTY, 530095 <br />KITTTAS <br />Washington <br />B4. Mep/Panel <br />86. Suffix <br />06. FIRM Index <br />B7. FIRM Patel <br />68. Flood <br />SO. Base Flood Elevation(s) <br />Number <br />Date <br />Eifecti W <br />zone(s) <br />(Zone AO, use Base Flood Depth) <br />Revised Date <br />53037CIO64 <br />D <br />09-24-2021 <br />09 24-2021 <br />AE <br />1698.1 ft <br />B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered In Item B9: <br />a] Fla Profile ❑ FIRM ❑ Community Determined ❑ Other/Source: <br />B11. Indicate elevation datum used for BFE In item 89. ❑ NGVD 1929 Ej NAVD 1988 ci Other/Source: <br />B12. is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No <br />Designation Date: ❑ CBRS ❑ OPA <br />FEMA Form Ot36 "3 (12119) Replaces all previous editions. Form Page 1 of 6 <br />