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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 <br />FOR INSURANCE COMPANY USE <br />Company NAIC Number <br />Policy Number: <br />Building street Address (including Apt., Unit, suite, andior Bldg. No.i or P.o. Route and Box No. <br />98926CityEllensb <br />2915 Gray Way <br />state: WA ZIP code: <br />(RECOMFORMATION LETIONNUCOMPITYOFFICIALENMEDDCOMMFORGcoMUMINNITYNECTIOs <br />The local oflicial who is aulhorized by law or ordinance to administer the community q 1l."oggt_ql-nan€gement ordinance can complete <br />Slj"ti"" A, e, C E, G, ;in;ii6l etdvition Certificate. Complele the applicable itein(s) and sign below when: <br />G1. n fn" information in Seclion C was taken from other documentation that has been signed and sealed by a licensed surveyor' <br />enqineer, or architect who is authorized by state law to certify elevation information. (lndicate lhe source and date of the <br />eleialion data in the Comments area below,) <br />GZ.a. I A local official completed section E for a building located in Zone A (wilhout a BFE), Zone Ao, or Zqne AR/AO' or when ilem <br />ES is completed foi a building localed in Zone AO. <br />G2.b. m A local official completed Section H for insurance purposes' <br />G3. n tn the Comments area of Section G, the local official describes specifio conections lo the information in Seclions A, B' E and H <br />G4 . E fn" following information (ltems G5-G 1 1 ) is provided for community floodplain managemenl purposes. <br />G5. Permit Number: FD-22-00013 G6. Date Permit lssued:03t02t2022 <br />G7. Date Cerlificate of Compliance/Occupancy lssued: <br />Gg, This permit has been issued for: E ttuw Conslruction il Substantial lmprovement <br />G9.a. E1sv61;on ol as-buill lowest floor (including basementi of the <br />building: <br />G9.b' E16vs11on o{ bottom of as'built lowest horizonlal struclural <br />member: <br />G10.a. BFE (or depth in Zone AO) ol flooding at the building site: <br />G10'b' gonr*rnity's minimum elevation (or depth in Zone AO) <br />requiremenl for the lowesl floor or lowest horizontal slructural <br />member: <br />1,590.00 EJ feet I melers p61um. NAVD 1988 <br />t.,J lR flreet f] melers <br />n meters <br />Dalum: <br />1,588.50 Elfeet gslurn. NAVD 1988 <br />1 589.50 fi feet fl melers Datum NAVD 1988 <br />G11. Variance issued? [ yes E ruo I yes, attach documentation and describe in the Comments area' <br />The local official who provides information in Section G musl sign here. !have compleled the lnformation in Section G and cenify thal tl ls <br />;;;;;ii; ti;;;;iir fr;i k;;;,i;';;; y";;p:in;bt"',1 nivC a,tso frovided spectfic coirections in the comments area ot this section. <br />Local Official's Name Samantha Cox Title Water Resources SPecialist <br />NFIP CommunilY Name:Kittitas Countv <br />Telephone: (509) 962-7523 Ext.Email: Pu blicworks@co. kittilas.wa. us <br />Address 411N.Street, Suite'l <br />CitY;Ellensburg Srate: WA 71P 6s6s 98926 <br />Signature:oare: 09128/2023 <br />Comments <br />Sections A, <br />of equipment and location, per C2.e', description of any attachments; and correclions to specific information in <br />FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10!22)Page 5 of 19