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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOWTHE INSTRUCTIONS ON PAGES 9-19 <br />FOR INSURANCE COMPANY USEBuilding Streel Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No, <br />2913 Dapple Gray Way <br />State: WA Ztp Code: 98926City;Ellensburg <br />Company NAIC Number: <br />Policy Number: <br />sEcTloN G - CoMMUNTTY TNFORMATTON (RECOMIITTENDED FOR COMMUN|TY OFF|C|AL COMPLETTON) <br />The local official who is authorized_by law orordinance lo administer the community's floodplain management ordinance can complete <br />Section A, B, C, E, G, or H of this Eklvation Certificale, Complete lhe applicable iteinls) and sign bebd when: <br />G1' f fne information in Section C was taken from other documenlation that has been signed and sealed by a licensed surveyor, <br />engineer, or architect who is authorized by slate law lo certify elevation information. (lndicale the source and date of the <br />elevation data in the Comments area below.) <br />Gz.a. fl A bcal official completed Section E for a building localed in Zone A (wilhout a BFE), Zone AO, or ZoneAR/AO, or when item <br />E5 is completed for a building located in Zone AO. <br />Gz.b. E A bcal official completed Section H for insurance purposes. <br />G3. f] tn the Commenls area of Section G, the local offlcial describes specific corrections to the information in Sections A. B, E and H <br />G4. E fne following information (ltems GS-Gl 1) is provided for community floodplain management purposes. <br />G5. Permit Number FD-22-OOO14 G6. Date permit tssuedt 0310212022 <br />G7, Date Certificate of Compliance/Occupancy lssued: <br />G8. This permit has been issued for: E ru"* Construction I Subrtanli"l lmprovement <br />G9.a' Ebvation of as-built lowest floor (including basement) of thebuildlng: 1,588.50 I feet I meters Datum: NAVD 1988 <br />G9.b. Elevation of bottom of as.built lowest horizonial structural <br />member:I feet I meters <br />flmeters <br />Dalum: <br />G'|0.a. BFE (or depth in Zone AO) of flooding at the building site: <br />G10'b' 6ortlunity's minimum elevation {or depth in Zone AO) <br />requiremenl for the lowest floor or lowest horizonlal structural <br />member: <br />1,587.00 $ feot Datum: NAVD 1988 <br />1,588.00 Eteet Dmeters Dalum: NAVD 1988 <br />G11. Variance issued? [ Ves [] t'to lf yes, attach documentalion and describe in the Comments area <br />The local official who provides information in Seclion G must sign here. I have_ completgd th9 information in Sectlon G and certify that il is <br />correct to the best ol my knowledge. lf applicable, I have also provided specific corrections in lhe Commenls area ol this section. <br />Local Official's Name: Samantha Cox Title:Water Resources Specialist <br />NFIP Community Name Kittitas Countv <br />Telephone: (509) 962-7523 Ext.Email:oublicworks@co. kittltas.wa. us <br />Address;411 N. Ruby St., Suite 1 <br />City:Ellensburg State: WA Zlp Code: 98926 <br />Slgnature oare:0812112023 <br />Comments <br />Sections A,D. E, <br />of equipment and location, per C2.e; description of any attachments; and corrections to specific informalion in <br />FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122\Page 5 of 19