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U.S. DEPARTMENT OF HOMEI.AND SECURITY <br />Federal Emergency Management Agency <br />National Flood lnsurance Program <br />ELEVATION CERTIFICATE <br />lmpoltanfi Follow the instructions on pages 1-9. <br />Copy all pages of ttis Elevation Certificate and all attadrmenb for (1) community oficial, (2) insurance agenUcompany, and (3)building owner. <br />OMB No. 1660-0008 <br />Expiration Date: November 3Q,2022 <br />SECNON A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br />A1. Building Owner's Name <br />GARY FAUSSET <br />Policy Number: <br />A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or p.O. Route and <br />Box No. <br />390 HERON FARM LANE <br />Company NAIC Number: <br />civ <br />ELLENSBURG <br />State ZIP Code <br />98926Washington <br />A3. Property Description (Lot and Block Numbers, Tax Description, etc.) <br />TAX PCL. # 17-19-19053-0004; LOT llDWRlcHT CLUSTER PLAT <br />A4. Building Use (e.9., Residential, Non-Residentiat, Additon, Accessory, etc.) RESIDENTIAL <br />A5. LatituderLongitude; Lat. N46.9436"Long. W120.5134'Horizontal Datum: fl NAD 1927 E NAD 1983 <br />A6. Attach at least 2 Photographs of the building lf the Certificate is being used to obtain frood insurance <br />A7. Building Diagram Number I <br />A8. For a building with a crawlspace or encloerre(s): <br />a) Square footage of cralvlspace or enclosure(s) 21 76.00 sq fi <br />b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1-0 foot above adjacent grade 31 <br />c) Total net area of flood openings in A8.b 2263.00 sq in <br />d) Engineeredflood openings? [ yes E ruo <br />A9. For a building wilh an attached gerage: <br />a) Square footage of attached garage 740.00 sq ft <br />b) Number of permanentflood openings in the attached garage within 1.0 foot above adjacent grade N/A <br />c) Total net area of ffood openings in Ag.b N/A sq in <br />d) Engineered f,ood openings? fl Yes fil No <br />SECNON B - FLOOD INSURANCE RATE MAP (FIRM) INFORIIIATIoN <br />81. NFIP Community Name & Community Number <br />KITTITAS COUNTY, WA 530095 <br />82. County Name <br />KITTITAS <br />83. State <br />Washingrton <br />84. Map/Penel <br />Number <br />53037C1284 <br />85. Suffix <br />D <br />86. FIRM lndex <br />Date <br />09-24-2021 <br />87. FIRM Panel <br />Effec{ive/ <br />Revised Date <br />09-24-2021 <br />B8. Flood <br />Zone(s) <br />AE <br />89. Qase Flood Elevation(s) <br />(Zone AO, rse Base Flood Depth) <br />1445.5' <br />810. lndicate the sourc€ of the Base Flood Elevation (BFE) data or base iood depth entered in ltem 89: <br />I FIS Profile f] FIRM fi Community Determined I Other/Source: <br />Bl 1 . lndicate elevation datum used for BFE in ltem 89: I NGVD 1929 E NAVD 1 988 [ Other/Source: <br />812, ls the building located in a Coastal Banier Resources System (CBRS) area or Otherwise Protected Area (OPA)? [ Ves ffi Ho <br />Designation Date:fl CBRS n oPA <br />FEMA Form 08€-0-33 (12119)Replaces ell previous edilions.Form Page 1 of6