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IMPORTANT: ln those spsces' copy the oonesponding informalion lrom Section A,FOR INSURANCE COMPANY USE <br />Bulldlng Street Address (lncludlng Apt., Unit, Sulte, and/or Bldg' No.) or P.O. Route and Box No. <br />3010 Dapple Gray Way <br />Poliry Number: <br />Gily State <br />Washington <br />ZIP Code <br />98926Ellonsburg <br />Company NAIC Number <br />sEcTtoN E - BUTLDING ELEVATION INFORMATION (SURVEY <br />FORZONEAO ANDZONE A (WTHOUT BFEI <br />NOT REQUIRED) <br />For Zones AO and A (wlthout BFE), complete ltems E1-E5. lf the Certilicate ls lntended 1o supporl a LOMA or LOMR-F requosl, <br />comploto Soctions A,'B,and C. Foi ltems gl-E4, use natural grade, lf avallable. Checkthe measurement usad. ln Puerto Rico only, <br />entei meters. <br />El. Provide elovatlon lnformation for the following and check lhe approprlate boxee to ahow whether the elevation ls ebove or below <br />the hlghesl adJacenl grade (HAG) and lhe lowest ad,lacent grade (tAG)' <br />a) Top of boltom floor (including bagemenl, <br />crawlspace, or enclosure) ls <br />b) Top of boltom floor (lncludlng basement, <br />crawlspace, or enclosure) is <br />Fteet E meters E aboveor I belowlhe HAG. <br />I feet E meters I above or flbolow lhe LAG' <br />E2. For Bullding Dlagrams 6-9with permanent <br />the next hlgher floor (elevation C2.b ln <br />the dlagrams)of the building is <br />E3. Attached garage (top of slab) is <br />flood openlngs provlded ln Section A ltems 8 and/or 9 (see pages l-2 of lnstructions), <br />E feet fJmsters E above or E below the HAG. <br />fl feet fi meiers E above or E below the HAG. <br />E4. Top of platform of machinery and/or equipmenl <br />seivlcldg the bullding ie flfeet D meters E abovo or flbelow the HAG. <br />E5. Zone AO only: lf no flood depth number is avallabte, ls lhg llop of the bottom floor elevated in accordance with the communlty's <br />lloodplain minagement ordiiranoo? [ Yes D No l] Unknown, The local official muet cerliff this lnformatlon ln Section G. <br />9ECTION F - PROPSRTY OWNER (OR OWNER'S REPReSENTATIVE) CERTIFICATION <br />The orooerlv owner or owner's authorized represenlatlve who comoletes Seclions A, B, and E for Zone A (wlthout a FEMA'issued or <br />oorirrmuriity-fssueC Afel or Zone AO must slgn here. The statemerits ln Seclions A, B, dnd E are correc,t to lhe best of my knowledge, <br />Property Owner or Owna/s Authorlzed Representallve'e Name <br />$colt Henson <br />Addloss <br />1224 S PloneerWay <br />City <br />Moses Lake <br />State <br />Washington <br />ZIP Code <br />98837 <br />Slgnature <br />"i!,"rful <br />Date Telephone <br />(50e) 855-51 12']/t,n t-.tt ,'),//yh07.7 <br />Commenls <br />E ctreot trere if attaohments. <br />ELEVATION CERTIFICATE <br />OMB No. 1660-0008 <br />Explralion Dale: November 30' 2022 <br />FEMA Form 086-0-33 (tilf 9)Replaces all prevlous edltions,Form Page 3 of6