Reserve-CS110418 U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660 -0008
Federal Emergency Management Agency Expires March 31, 2012
National Flood Insurance Program Important: Read the instructions on pages 1 -9.
SECTION A - PROPERTY INFORMATION For Insurance Company Use:
Al. Building Owner's Name BRUCE FOX Policy Number
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number
253 ROSEMONT COURT
City COPPELL State TX ZIP Code 75019
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 2, Block B of THE RESERVE at ELDORADO, COPPELL, DALLAS COUNTY, TEXAS
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat. Long. Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number _IA
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 449 sq ft
b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade NIA
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b NA sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2. County Name B3. State
DALLAS COUNTY & INCORPORATED AREAS 48113C DALLAS TEXAS
B4. Map /Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9 Base Flood Elevation(s) (Zone
48113C 0155 J Date Effective /Revised Date Zone(s) AO, use base flood depth)
06/16/2005 8/23/2001 AE 497.00'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe)
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ® NAVD 1988 ❑ Other (Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No
Designation Date ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations -Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a -h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized ELEV 498.50' Vertical Datum NGVD 1988
Conversion /Comments BM PROVIDED BY DOWDEY. ANDERSON AND ASSOCIATES. Inc.
Check the measurement used.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 501.15 ® feet ❑ meters (Puerto Rico only)
b) Top of the next higher floor 511.15 ® feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters (Puerto Rico only)
d) Attached garage (top of slab) 500.10 ® feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 500.E ® feet ❑ meters (Puerto Rico only)
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) 498.21 0 feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade next to building (HAG) 500.7_9 ® feet ❑ meters (Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A. ❑ feet ❑ meters (Puerto Rico only)
structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. / certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. P '(, t,�.
® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ...144.7.. �8 e . a�� ' '
licensed land surveyor? 0 Yes ❑ No %
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Certifiers Name BARRY RHODES License Number 3691 B ARB �#� ,
Title OWNER, RPLS Company Name RHODES SURVEYING ' . s b ' ,
Address 7509 - 1 `
P CIRCLE City ROWLETT State TX ZIP Code 75088 ' �' �,, S Ss t ( sq. , / ,
Signature III Date 4/18/2011 Telephone 972 -475 -8940
FEMA Form 81 -31, Mar 09 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
253 ROSEMONT COURT Policy Number
City COPPELL State TX ZIP Code 75019
Company NAIL Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments
Signature
1,
Date 4/18/2011
ED Check here
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) attachments
For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B,
and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is N /A. ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and /or equipment servicing the building is N(Q.Q ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA - issued or community - issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owners Authorized Representative's Name
BARRY RHODES
Address 7509 PENNRIDGE CIRCLE City ROWLETT State TX ZIP Code 75088
Signature Date 4/18/2011 Telephone 972 - 475 -8940
Comments
® Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E),
and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA - issued or community - issued BFE) or Zone AO.
G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued I G6. Date Certificate Of Compliance /Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments
FEMA Form 81 -31, Mar 09
Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Insurance Company Use
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
253 ROSEMONT COURT
City COPPELL State TX ZIP Code 75019 Canpany NAIC Nurber
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear Vievd'; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the
reverse.
FRONT VIEW 4/18/2011
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Building Photographs
Continuation Page
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
253 ROSEMONT COURT
City COPPELL State TX ZIP Code 75019 Company NAIC Number
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View" and "Rear View/'; and, if required, "Right Side View" and "Left Side View."
REAR VIEW 4/18/2011
r 1
DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO. 1660 -0015
APPLICATION FORM FOR SINGLE RESIDENTIAL LOT OR STRUCTURE AMENDMENTS TO
NATIONAL FLOOD INSURANCE PROGRAM MAPS Expires February 28, 2014
PAPERWORK BURDEN DISCLOSURE NOTICE
Public reporting burden for this data collection is estimated to average 2.4 hours per response. The burden estimate includes the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. This collection of information is required to
obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send
comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of
Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598 -3005, Paperwork Reduction Project (1660 -0015) NOTE: Do
not send your completed form to this address.
This form should be used to request that the Department of Homeland Security's Federal Emergency Management Agency (FEMA) remove a single structure or legally
recorded parcel of land or portion thereof, described by metes and bounds, certified by a registered professional engineer or licensed land surveyor, from a
designated Special Flood Hazard Area (SFHA), an area that would be inundated by the flood having a 1 %- chance of being equaled or exceeded in any given year (base
flood), via Letter of Map Amendment (LOMA). It shall not be used for requests submitted by developers, for requests involving multiple structures or lots, for
property in alluvial fan areas, for property located within the regulatory floodway, or requests involving the placement of fill. (NOTE: Use MT -1 forms for such
requests). Fill is defined as material from any source (including the subject property) placed that raises the grade to or above the Base Flood Elevation (BFE). The
common construction practice of removing unsuitable existing material (topsoil) and backfilling with select structural material is not considered the placement of fill if
the practice does not alter the existing (natural grade) elevation, which is at or above the BFE. Also, fill that is placed before the date of the first National Flood
Insurance Program (NFIP) map showing the area in an SFHA is considered natural grade.
A letter from DHS -FEMA stating that an existing structure or parcel of land that has not been elevated by
LOMA: fill would not be inundated by the base flood.
A — This section may be completed by the property owner or by the property owner's agent. In order to process your request, all information on
this form must be completed in its entirety, unless stated as optional. Incomplete submissions will result in processing delays.
1. Has fill been placed on your property to raise ground that was previously below the BFE?
® No ❑ Yes — If Yes, STOP!! — You must complete the MT -1 application forms; visit
http: / /www.fema.gov /plan /prevent /fhm /dI mt- 1.shtm
or call the FEMA Map Information eXchange toll free: (877 -FEMA MAP) (877- 336 -2627)
2. Legal description of Property (Lot, Block, Subdivision or abbreviated description from the Deed) and street address of the Property (required):
253 ROSEMONT COURT, COPPELL, TX, LOT 2, BLOCK B, OF THE RESERVE AT ELDORADO, COPPELL, DALLAS COUNTY, TEXAS
3. Are you requesting that a flood zone determination be completed for (check one):
❑ A structure on your property? What is the date of construction? (MM /YYYY)
❑ A portion of your legally recorded property? (A certified metes and bounds description and map of the area to be removed, certified by a
registered professional engineer or licensed land surveyor, are required. For the preferred format of metes and bounds descriptions,
please refer to the MT -EZ Instructions.)
® Your entire legally recorded property?
All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be
punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001.
Applicant's Name (required): E -mail address (optional) (® By checking here you may receive correspondence
electronically at the email address provided):
RHODESSURVEYING @YAHOO.COM
Mailing Address (include Company name if applicable) (required): Daytime Telephone No. (required):
Fax No. (optional):
Signature of Applicant (required) Date (required)
4/18/2011
End of Section A
DHS - FEMA Form 086 -0 -22, FEB 11 MT -EZ Form Page 1 of 3
t
B — This section must be completed by a registered professional engineer or licensed land surveyor. Incomplete submissions will result in processing delays.
NOTE: If the request is to have a flood zone determination completed for the structure, and an Elevation Certificate has been completed for this property, it
may be submitted in lieu of Section B. If the request is to have a flood zone determination completed for the entire legally recorded property, or a portion
thereof, the lowest elevation on the lot or described portion must be provided in Section B.
Applicable Regulations
The regulations pertaining to LOMAs are presented in the National Flood Insurance Program (NFIP) regulations under Title 44, Chapter I, Parts 70 and 72, Code of
Federal Regulations. The purpose of Part 70 is to provide an administrative procedure whereby DHS -FEMA will review information submitted by an owner or lessee of
property who believes that his or her property has been inadvertently included in a designated SFHA. The necessity of Part 70 is due in part to the technical difficulty of
accurately delineating the SFHA boundary on an NFIP map. Part 70 procedures shall not apply if the topography has been altered to raise the original ground to or
above the BFE since the effective date of the first NFIP map [e.g., a Flood Insurance Rate Map (FIRM) or Flood Hazard Boundary Map (FHBM)] showing the property to
be within the SFHA.
Basis of Determination
DHS - FEMA's determination as to whether a structure or legally recorded parcel of land, or portion thereof, described by metes and bounds, may be removed from the
SFHA will be based upon a comparison of the Base (1%- annual- chance) Flood Elevation (BFE) with certain elevation information. The elevation information required is
dependent upon what is to be removed from the SFHA. For Zones A and AO, please refer to Page 7 of the MT -EZ Form Instructions for information regarding BFE
development in those areas and supporting data requirements.
Determination Requested For: (check one) Elevation Information Required: (complete Item 5)
Lowest Adjacent Grade to the structure (the elevation of the lowest ground
❑ Structure located on natural grade (LOMA)
touching the structure including attached patios, stairs, deck supports or garages)
Elevation of the lowest ground on the parcel or within the portion of land to be
® Legally recorded parcel of land, or portion thereof (LOMA)
removed from the SFHA
1. PROPERTY INFORMATION
Property Description (Lot and Block Number, Tax Parcel Number, or Abbreviated Description from the Deed, etc.):
LOT 2, BLOCK B, OF THE RESERVE AT ELDORADO, DALLAS COUNTY
2. STRUCTURE INFORMATION
Street Address (including Apt. Unit, Suite, and /or Bldg. No.):
253 ROSEMONT COURT
What is the type of construction? (check one) ❑ crawl space ® slab on grade ❑ basement /enclosure
❑ other (explain):
3. GEOGRAPHIC COORDINATE DATA
Please provide the Latitude and Longitude of the most upstream edge of the structure (in decimal degrees to nearest fifth decimal place)
Indicate Datum: ❑ WGS84 ® NAD83 ❑ NAD27 Lat. . Long. .
Please provide the Latitude and Longitude of the most upstream edge of the property (in decimal degrees to nearest fifth decimal place)
Indicate Datum: ❑ WGS84 ® NAD83 ❑ NAD27 Lat. . Long. .
4. FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
NFIP Community Number: Map Panel Number: Base Flood Elevation (BFE): Source of BFE:
48113C 0155 497.00 FEMA MAP
5. ELEVATION INFORMATION (SURVEY REQUIRED)
• Lowest Adjacent Grade (LAG) to the structure (to the nearest 0.1 foot or meter) 498.71 ft. (m)
• Elevation of the lowest grade on the property; or within metes and bounds area (to the nearest 0.1 foot or meter) 498.71 ft. (m)
• Indicate the datum (if different from NGVD 29 or NAVD 88 attach datum conversion) ❑ NGVD 29 ® NAVD 88 ❑ Other (add attachment)
• Has FEMA identified this area as subject to land subsidence or uplift? ® No ❑ Yes (provide date of current releveling):
This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation information.
All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be punishable by fine or
imprisonment under Title 18 of the United States Code, Section 1001.
Certifier's Name: BARRY RHODES License No.: 3691 Expiration Date: 12 -31 -2011 r + '(F. OF T
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Company Name: RHODES SURVEYING Telephone No.: 9724758940 Fax No.: 9724759036 J QL .2.
EmaiI:RHODESSURVEY ■ �YAH••.COM 1` BARFM DET'
% 3691 ....M.
Signature: v
Date: :ti0� O +a
441/
4/18/2011 e
4/18/2011 `�'0 � _` O . t
DHS - FEMA Form 086 -0 -22, FEB 11 MT -EZ Form Page 2 of 3
In addition to this form (MT -EZ), please complete the checklist below. ALL requests must include one copy of the following:
® Copy of the effective FIRM panel on which the structure and /or property location has been accurately plotted
® Copy of the Subdivision Plat Map (with recordation data and stamp of the Recorder's Office)
OR
❑ Copy of the Property Deed (with recordation data and stamp of the Recorder's Office), accompanied by a tax assessor's map or other certified map
showing the surveyed location of the property relative to local streets and watercourses. The map should include at least one street intersection that is
shown on the FIRM panel.
® Please include a map scale and North arrow on all maps submitted.
Please do not submit original documents. Please retain a copy of all submitted documents for your records
DHS -FEMA encourages the submission of all required data in a digital format (e.g. scanned documents and images on Compact Disc [CD]). Digital
submissions help to further DHS - FEMA's Digital Vision and also may facilitate the processing of your request.
Incomplete submissions will result in processing delays. For additional information regarding this form, including where to obtain the supporting documents
listed above, please refer to the MT -EZ Form Instructions located at
http: / /www.fema.gov /plan /prevent /fhm /dl mt- ez.shtm.
Mail your request to:
LOMC CLEARINGHOUSE
7390 COCA COLA DRIVE, SUITE 204
HANOVER, MD 21076
Attn.: LOMA Manager
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