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ELEVATION CERTIFICATE OMB No. 1660-0008 <br />Expiralion Dale: November 30,2Q22 <br />IMPORTANTT ln these spscea, copy the correspondlng lnformallon from $eclion A.FOR INSURANCE COMPANY USE <br />Building slreel Address (including Apl.. unil, suilo, andlor Blds. No,) or p.o. Route and Box No, <br />3012 Dapple cray Way <br />Pollcy Number: <br />City State <br />Washlngton <br />ZIP Code <br />98926Ellensburg <br />Company NAIC Number <br />SECTION E - BUILDING ELEVATION INFORMATION NOT REQUTRED) <br />FOR ZONE AO AND ZONE A BFE) <br />For Zones AO.and A (wilhout BFE), compLete ltems E1-E5. If lhe Corlilicats is lntended lo support a LOMA or LOMR-F requesl, <br />complete Sections A, B,and c. For ltems E1-E4, use nalural grade, if availabte. Check tho m6isurement used. ln Puerlo Fiico only, <br />enter melers. <br />E1. Provide elevation informatlon for lhe following and check the appropriate boxo$ to show whether lhe elevation is above or below <br />lhe hlghest adJacent grade (HAG) and the lowesl adJacont grade (LAG). <br />a) Top of bottom floor (including basemenl, <br />crawlspace, or onclosure) is <br />b) Top of bottom floor (including basemenl, <br />crawlspace, or onclosure) is <br />flfeet fJmeters fl abovo or I botow the HAG. <br />flfeet I meters ! abovo or I bobw tho LAG. <br />E2. For Bulldlng Diagrams 6-9 wilh permanenl flood <br />lhe nexl higher lloor (elevation C2.b in <br />lhe diagrams) of lhe building is <br />E3. Altached garago (top of slab) ls <br />E4. Top of platform of machinory and/or equipment <br />ssrvicing lhe building ls <br />openings provided ln Sectlon A ltems B and/or 9 (see pages 1-2 of lnstruclions), <br />!feet Imeters Iaboveor [bebwlheHAG. <br />I feet I meters I above or I below lhe HAG. <br />flfeel Imelers Iaboveor flbetowtheHAG. <br />E5. Zone AO only: lf no llood depth number is available, ls lhe top of lhe boltom floor elevalsd in accordance with lhe community's <br />lloodplain management ordinance? fl Yes I No f] Unknown, The local oflicial must c€rtiry thi6 inlormaton ln Seillon G. <br />SEGT|ON F - pROpERTy OWNER (OR OWNER'S REPRESENTATTVE) CERTIF|CAT|ON <br />The proporly ownsr or gwnor's aulhorizod represenlallvo who complelos Seclions A, B, and E for Zone A (wlthout a FEMA-issuod orcommunity-issued BFE) or Zone AO must slgn here. The statemerits ln Seclions A, B, and E are conect lci the best of my knowledge. <br />Proporiy Owner or Owner's Aulhorized Represenlalive's Name <br />Scolt Henson <br />Address <br />1224 S Pioneer Way <br />City <br />Moses Lake <br />State <br />Washington <br />ZIP Code <br />98837 <br />Date <br />(509) 865-5112 <br />Commonls <br />fl Ctreck hero if attachments. <br />FEMA Form 086-0-33 (12119)Replaces all previous editions.Fom Page 3 of 6