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EI.EVATION C ERTIFICATE <br />IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 <br />Building street Address (including Apt., unit, suite, andior Bldg. No.i or P,O. Route and Box No,: <br />2905 DaPPle Gray Way <br />City:Ellensbu State: . WA ztP CoOe: 98926 <br />FOR INSURANCE COMPANY USE <br />Policy Number._-__- <br />Company NAIC Number: <br />SE CTION G COMMU Ntw IN FORMA TI ON (RECOMMEN DED FOR COMMUN tw OFFI CIAL coMPLETION) <br />The local ofiicial who is Euthorized by law or ordinance to administer the community's floodplain management ordinance can complete <br />Secfion A-9, C, E. G, or H of this El6vation Certificate. Complete the applicable item{s) and sign below when: <br />G1. D fne information in Section C was taken from other documenlation lhat has been signed and sealed by a licensed surveyor, <br />engineer, or archilect who is aulhorized by state law to cerlify elevalion information. (lndicate the source and date of the <br />ele-valion data in the Comments area below.) <br />G2.a. ! A local officiat comptered Section E for a building located in Zone A (withoul a BFE), Zone AO, or Zone AR/AO, or when item <br />E5 is completed foi a building located in Zone AO' <br />G2.b. K A local official completed Section H for insurance purposes. <br />GB. f] tn tne Commenls area of Seclion G, the local official deseribes specific correclions to the information in Sections A, B, E and H <br />G4, E Tn"followinginlormation(ltenrsGS-G11)isprovidedforcommunityfloodplainmanagementpurposes' <br />G5. Permit Number:FD-22-00018 G6. Date Permit lssued:o310212022 <br />G7. Date Ce(ificate of Compliance/Occupancy lssued: <br />GB. This permit has been issued for: E t,tew Construction I Substantiat lmprovement <br />G9'a. 6;sv61;on of as-built lowest floor (including basement) of the <br />building:1,587.40 B leet n meters Datum: NAVD 1988 <br />G9.b. E1ev31ion of boltom of as-built lowesl horizontal struclural <br />member:ry- tn flfeet I meters Datum: <br />G10.a. BFE (or depth in Zone AO) of flooding at the building sile: <br />G 10'b' g6lnnlenity's minimum elevation {or depth in Zone A0) <br />requirement for the lowest floor or lowest horizontal slructural <br />member; <br />1 584.80 E feet I meters Datum: NAVD 1988 <br />1,585.80 B feet n melers Datum: NAVD 1988 <br />G11. Variance issued? fl Yes E tto lf yes, attach documentation and describe in lhe Comments area. <br />The local oflrciat who provldes informalion in section G must sign here- I have, comple-t?d t!P_if9r^3!on^in Seclion G.and celtily that it is <br />;;;r;;t t; ti;E;iiior ki iniiltii6l6. i iipiii"iore-,i nive atso phvided speciric coriections in the comments area or this sedion. <br />Local Official's 11srng; Sam€ntha Cox Title Water Resources SPecialist <br />NFIP CommunilY Name:Kittitas Countv <br />Telephone: (509) 962-7523 Ext.:Email:Pub licworks@co. kiltitas,wa.us <br />Address:411 N, Ruby Street, Suite 1 <br />CitY:Ellensburg State: WA ZIP Code: 98926 <br />- <br />Signature:oarc:0912812023 <br />Commenls <br />Sections A. <br />of eguipment and location, per CZ.e; descriplion ol any attachments; and corrections lo specilic informalion in <br />): <br />FEMA Form FF-206-FY-22-152 {formerly 086-0'33) {10122)Page 5 of 19