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ELEVATION CERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9.1S <br />Building Street Address (including Apt.. Unil, Suite, and/or Bldg. No.) or P.O. Route and Box No. <br />2911 Dapple Gray Way <br />City:Ellensbu Srare; WA Zlp Code: 98926 <br />FOR INSURANCE COMPANY USE <br />Policy Number: <br />Company NAIC Number: <br />sEcTtoN G - GOMMUNTTY TNFORMATTON (RECOMMENDEO FOR COMMUN|TY OFF|C|AL COMPLETTON) <br />E and H. <br />The local official who is authorized by law or ordinance lo adminisler the communily's floodplain management ordinance can complete <br />Section A, B, C, E, G, or H of this Elevation Certificate, Complete the applicable item(s) and sign below when; <br />G1. f] fne information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, <br />engineer, or architect who is authorized by state law to certify elevation information. (lndicate the source and date of the <br />elevation data in the Comments area below.) <br />[-l R Ocat official completed Section E lor a building located in Zone A (wilhout a BFE), Zone AO, or Zone AR/AO, or when item <br />E5 is completed for a building located in Zone AO. <br />G2.a <br />G2.b. <br />G3, <br />G4. <br />G5. <br />G7, <br />G8. <br />G9.a. <br />G9.b. <br />G10.a. <br />G10.b. <br />E I tocat official completed Section H for insurance purposes. <br />ff tn tre Comments area of Section G, the local official describes specific correclions to lhe information in Sections A, B, <br />El fne following informalion (ltems G5-G1 1) is provided for communiry floodplain management purposes. <br />Permit Number; FD-22-00015 G6. Date Permil lssued 0310212022 <br />Dale Cerlilicate of Compliance/Occupancy tssued: 0811812023 <br />This permit has been issued for: E ru"w Construclion I Substantial lmprovement <br />Elevation ol as-built lowest floor (including basement) of thebuilding: 1,588.00 [ feet I meters Darum: NAVD 1988 <br />Elevalion of boltom of as-built lowest horizontal structural <br />member:f, feet I meters <br />I meters <br />Datum <br />BFE (or depth in Zone AO) of flooding at the building site 1,585.90 E feet Darum: NAVD 1988 <br />Community's minimum elevation (or depth in Zone AO) <br />requirement for lhe lowesl floor or lowest horizontal slructural <br />member:1,586.90 I reet I meters Datum; NAVD 1988 <br />G11. Variance issued? ! Ves [J f.lo lf yes, attach documentalion and describe in the Comments area, <br />The local official who provides information in Section G must sign here. I have completed the inlormation in Seclion G and cerlify that it is <br />conect lo fAe 0est of my knowledge. lf applicable, I have also provided specilic correclions in the Comments area of this section. <br />Local Official's 11srng; Samintha Cox Title:Water Resources Specialist <br />NFIP Community Name: Kittitas County <br />Telephone: (509) 962'7523 <br />Address:411 N. Ruby St.. Suite 1 <br />Exl.: Email:publicworks@co. kittitas.wa. us <br />City;Ellensburg State: WA Ztp Code: 98926 <br />Signature:Oate: 08/18/2023 <br />Commenls (Lncludtng lype of equipment and location, per C2.e; description of eny attachments; and conections to specitic information in <br />Sections A, B, D, E, or H): <br />FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10122)Page 5 of 19