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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 <br />Building Street Address (including Apt.. Unit, Suite, and/or Bldg. No.)or P.O. Route and 8ox No. <br />3009 Dapple Gray Way <br />City:Ellensburg State: WA ZIP Code: 98926 <br />FOR INSURANCE COMPANY USE <br />Policy Number; <br />Company NAIC Number: _ <br />sEcTloN G - coMMUNTTY TNFORMATION (RECOMMENDED FOR COMMUNITY OFFTC|AL COMPLETTON) <br />The local oflicial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complele <br />Section A, B, C, E, G, or H ol this Elevation Certificate. Complete lhe applioable item(s) and sign below when: <br />G 1 ' f] m" information in Section C was taken from other documenlation that has been signed and sealed by a licensed surveyor, <br />engineer, or architecl who is aulhorized by state law lo certify elevation information. (lndicale the source and date of the <br />elevalion data in lhe Comments area below.) <br />G2.a f A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zane AR/AO, or when item <br />E5 is compleled for a building located in Zone AO. <br />El A local oflicial completed Section H for insurance purposes. <br />f] ln thu Comments area of Seclion G, the local official describes specific corrections lo the information in Sections A, B, E and H <br />E f ne following information (ltems G5-G11) is provided for community floodplain management purposes. <br />PermitNumber: FD-22-00007 G6. Date Permit lssued:0310a2a22 <br />Date Certificate of Gompliance/Occupancy lssued: <br />G2.b <br />G3. <br />G4, <br />G5, <br />G7. <br />GB. <br />G9.a <br />This permit has been issued for: EJ tl"w Construction I Subst"ntiul lmprovement <br />Elevation of as-buill lowest tloor {including basement) of thebuilding: 1,597.60 I teet I meters Datum: NAVD 1988 <br />G9'b. Epu"1lon of bollom of as-buill lowesl horizontal structural <br />member:h/ lA fl reer I melers <br />f] meters <br />Dalum: <br />G10.a. BFE (or depth in Zone AO) of flooding at the building site: <br />G10'b' g666unily's minimum elevation (or depth in Zone AO) <br />requirement {or the lowest floor or lowest horizontal structural <br />member: <br />1,595,50 EJ feet Daturrr: NAVD 1S88 <br />1,596.50 @ teet I melers Datum: NAVD 1988 <br />G11. Variance issued? f] Ves I t'to ll yes, allach documentation and desoribe in the Comments area. <br />The local official who provides informalion in Section G must sign here. I have completed the informatian in Section G and certlfy that it is <br />correct lo the besl of my knowledge, ll applicable, I have also provided specific correclions in lhe Commenls area of this seclion. <br />Local Official's |1sms. Sornsntha Cox Tille: Water Resources Specialist <br />NFIP Community Name: Kittitas Cou <br />Telephone:(50S)962-7523 Ext.:_ 96611;publicworks@co.kittitas.wa.us <br />Address:411 N. Rubv Street. Suite 1 <br />City:Ellensburg State: WA Zlp CoOe: 98926 <br />Signature: <br />Comments <br />Seclions A, <br />of <br />Oate:0912812023 <br />and location, per C2.e; description of any atlachmenls; and corrections to specific informalion in <br />or ): <br />FEMA Form FF-206-FY-22-152 {formerly 086-0-33) (10122)Page 5 of 19