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U.S. DEPARTMENT OF HOMELAND SECURITY <br />Federal Emergency Management Agency <br />National Flood lnsurance Program <br />ELEVATION CERTIFICATE <br />lmportant: Follow the instructions on pages 1-9. <br />OMB No. 1660-0008 <br />Expiralion Date: November 3O,2022 <br />Copy all pages of lhis Elevallon Cefilflcate and all ettachments for (1) oomrnunlV offlclal, (2) lnsurance agenUcompany, and (3) building owner. <br />SECTION A- PROPERTY INFORMATION FOR INSURANCE COMPANY USE <br />A1. Building Owne/s Name <br />ssHt LLc. <br />Pollcy Number: <br />A2. Bulldlng Slreet Address (indudlng Apt., Unit, Suile, and/or Bldg. No.) or P.O. Route and <br />Box No. <br />3012 Dapple Gray Way <br />Company NAIC Number: <br />City <br />Ellensburg <br />Siate <br />Washington <br />ZIP Code <br />98926 <br />A3. Properly Description (Lot and Block Numberg Tax Parcel Number, Legal Descrlplion, elc.) <br />Divlslon 6 Lot 5, 961890 <br />A4. Buildlng Use (e.9., Residential, Non-Residentiat, Additlon, Accessory, etc.) Residenlial <br />A5. Latllude/Longitude: Lat.N47"0'l'33.23464 1ong.Wl20"34'34.5883"HorlzontalDaium; I NAD 1927 E NAD 1983 <br />46. Attach at least 2 photographs of the building if the Cerlificate is belng used to obtaln llood Insurance. <br />A7. Building Diagram Number 1B <br />A8. Fora bultding wlth a crawlspace or enclosure(s): <br />a) Square footago of crawlspace or enclosure(s) N/A sq ft <br />b) Number of permanent flood openings ln the crawlspace or enclosure(s) wllhln 1.0 foot above adJacent grade N/A <br />c) Total netarea offlood openings inA0.b N/A sq in <br />d) Engineered flood openlngs? fl yu" E ruo <br />A9. For a building with an aitaohed garage: <br />a) Square footage of attaohod garage 620.00 sq ft <br />b) Number of permanent flood openings in lhe attached garage within 1.0 foot above adjacent grade O <br />c) Tolal nel area of flood openings ln Ag.b 0.fi) sg in <br />d) Engineered flood openings? fl Yes El No <br />sEcTtoN B - FLOOD TNSURANCE RATE MAp (F|RM) TNFORMATTON <br />81" NFIP Community Name & Community Number <br />KITT]TAS COUNTY; 5300095 <br />82. County Narne <br />KITTITAS <br />83, State <br />Washington <br />84. Map/Panel <br />Number <br />53037C1064 <br />85. Suflix <br />D <br />86. FIRM lndex <br />Dale <br />09-24-2021 <br />87. FIRM Panel <br />Effectlve/ <br />Revised Date <br />09-24-2021 <br />BB. Flood <br />Zone(s) <br />AE <br />89. Base Flood Elevation(s) <br />(Zone AO, use Base Flood Deplh) <br />15S7.0 ft <br />810. lndicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in ltem 89: <br />$ FIS Profile D FIRM I Community Determined I Other/Source: <br />811. lndlcate el€valion datum used for BFE in ltem Bg: f] NGVD 1929 El NAVD 19BB I olher/Source: <br />812. ls the bullding located in a Coaslal Banier Resouroes System (GBRS) area or Othenflise Protected Area (OPA)? f] Ves [] No <br />Deslgnatlon Date:fl cBRs I oPA <br />FEMA Form 086'0€3 (12ltg)Replaces all provious editions.Form Pago 1 of 6