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U.S. DEPARTMENT OF HOMELAND SECURITY <br />Federal Emergency Management Agency <br />Nalional Flood lnsurance Program <br />ELEVATION CERTIFIGATE <br />lmportanl: Followthe instruclions on pages 1*9. <br />Copy all pages of lhls Elevatlon Certllicate and all attachments for (1) communlty offlclal, (2) lnsuiance agenVcompany, and (3) bulldlng owner. <br />OMB No. 1660-0008 <br />Expiration Dale: November 3A,2O22 <br />SECTION A - PROPERTY ]NFORMATION FOR INSURANCE COMPAAIY USE <br />41. Building Owne/s Name <br />SSHI LLC <br />Policy Number: <br />A2. $uilding Slreot Address (includlng Apt., Unit, Sulte, and/or Bldg. No.) or P.O. Route and <br />Box No. <br />2917 Dapple Gray Way <br />Company NAIG Numbel <br />City <br />Ellensburg <br />Slale <br />Washlngton <br />ZIP Code <br />98926 <br />A3. Property Descriplion (Lot and Block Numbers, Tax Parcel Number, Legal Description, eto.) <br />Division 7 Lot 7, 982123 <br />A4. Building Use (e.9., Residential, Non-Residenlial, Addltion, Accessory, etc.) Residential <br />A5. Latitude/Longltude: Lat. N47'0129.56751"Long.W120"34'44.95771" Horlzontal Dalum:fINAD 1e27 E NAD 1983 <br />46. Atlach at least 2 photographs of lhe building if the Gertificate is being used to obtain llood lnsuranc€. <br />A7, Buildlng Diagram Number 1El <br />A8. For a bulldlng wlth a crawlspace or enclo$ure(s): <br />a) Squarefootageofcrawlspacoorondosure(s) N/A sqfl <br />b) Number of psrmanent flood openings in lhe crawlspac€ or enclosure(s) withln 1.0 foot above adlacent grade IVA <br />c) Total nei area offlood openings in A8.b N/A sq in <br />d) Engineered flood openings? fJ ys" E ruo <br />A9. For a bullding wilh an allached garage: <br />a) Squarefoolageofattachedgarage 604.00 sqfl <br />b) Number of permanont flood openings in the attached garage wilhin '1.0 foot above adjacent grade 0 <br />c) Tolal net area of flood openlngs in A9.b 0.00 sq in <br />d) Engineered flood openings? [ Yes E No <br />sEcTroN B - FLOOD INSURANCE RATE MAP (F|RM) TNFORMATTON <br />81. NFIP CommunilyName & Communlty Number <br />KITTITAS COUNTY; 530095 <br />82, County Name <br />KITTITAS <br />83. State <br />Washington <br />84. Map/Panel <br />Number <br />53037C1004 <br />85. Sufllx <br />D <br />86. FIRM lndex <br />Dale <br />09-24-2021 <br />87. FIRM Panel <br />Effeclive/ <br />Revised Date <br />09-24-202'l <br />88. Flood <br />Zone(s) <br />AE <br />89, Base Flood Elevation(s) <br />(Zone AO, use Base Flood Deplh) <br />1590.2 <br />810. lndicate lhe source of the Base Flood Elevation (BFE) data or base flood depth eniered in ltem 89: <br />B FIS Profile n FIRM fl Community Determlned fl Other/Source; <br />Bl 1. lndicate elevation datum used for BFE in ltem Bg: n NGVD 1929 El NAVD 19BB fl Other/Source: <br />812. ls the bulldlng locetod in a Coaslal tsarrier Resources System (CBRS) area or Othenruise Prolected Area (OPAP I Yes @ No <br />Designation Date:fl CBRS fl oPA <br />FEMA Forn 086-0-33 (12l19l Replaces all previous editions Form Page 1 of6