204 Olympia 12/22/2009 13:52 8172612879 GEODATA u
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U.S. DEPARTMENT OF HOMELAND Strt.UKIT' ELEVATION CER 111-1c:A l t v aa �; u Irv. , � , � , Mato . X1.2012
Federal Emergency Management Agency
National Flood Insurance Program Impo rtant: Read the instructions on pages 1 -9.
--r :.
--. SEC'ftON A - PROPERTY INFORMATION = 4 I -?
s
Al. Budding Owner's Name
,,-
A2. Building Street Address (including Apt., Unit. Suite. and/or Bldg. No.) or P.O. Route and Box No.
204 OLYMPIA LANE Z trade 75019
City COPPELL Stets TEXAS
Ny DesarlpUon and t3loek Numbers. Tax Parts) Number. Legal Deetxipdon, etc) r
LOT 17, BLOCK X ALEXANDER COUR RESIDENTIAL
A4. Building Use (e.g., Rea . Non-Residential, Addition, Ae cg �f3. 12" Horizontal Datum: Q NAD 1927 NAD 1983
A5. LatI ude/Lors9itude: Lat. � 57'20.96"N Long.
A6. Attach at leapt 2 photographs of the building if the Certificate B being used to obtain flood kuurenoe. BY GOGGLE EARTH
AT. Building Diagram Number' A9. Fa a building with an attached garage: Aa, For a building re with a of crawispa or r ancloaure( ,q ft a) 8q � footage of unedited garage
set
a) Square footage of txarMapace
or enclosures) b) No. of permanent flood openings In the attached garage
b) en n of permanent Rood openings In d a ant wade or withkn 1.0 loot above adjacent grade
Engineered eetal na l area within
of g f fl ood neered flood openkt90 flood foot above adjacent gradde aq In c) Total net area of flood openings in A9.4 sq In
d) E
d) ln d) Engkseered flood openings? 0 Yes 0 No •
ge� 0 LJ Yea n AB.b No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION -
g2, County Name 83. State
61. NFIP Community Name & Community Number A �
COPFELL 4;0170 Be 89, Base Flood evation(s) (Zone TX
84. ap/Panel umber B5. Suffix B6. Fl index B �evised Date Zone(s) AO, use base flood depth)
48113C0155 J AUG. 23, 01 APR- 23, r 08 (LONR) AE 489
810. indicate the source of the Base Flood Elevation (BEE) data or base flood depth entered M item 99.
0 FIS Profile DO FIRM Community Determined Q Other (Describe)
811. Indicate elevation datum used for BFE In Item B9: ® NGVD 192 0 NAVD 1988 Q Other (Describe)
912. is the building located M a Coastal Barrier Resources system (algal area cEpthervAse Protected Area (OPA)? 0 Yes E No
Designation Date l[] CARS 101 OPA
— SECTION C - BUILDING ELEVATION INFORMATION (S REQUIRED)
•
Building Under Construction' Q Finished Construction
C1. Building elevations are based on: 0 Cpnsiruotton Orawksgs` ® fig
'A new Elevation Certificate will be required when contdruetion of the building is complete.
C2. Elevetions — Zones M-A30, AE, Ali, A (WI h BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE. AR/A1 -A30. ARfAH. AR/AO. Complete items C2.a -h
Wow according to the building diagram spedfled In Item A7. Use the sane datum es the BEE. NAVD 88
Benchmark Utilized CITY OF COPPELL GEODETIC #5 vessels Datum
Conversion /Comments DATUM SHIFT 0.0261' PER VERTCON measurement used.
Chedc the -
.. '492 , 4 feet 8 meters (Puerto Rico only)
e } Top of bottom floor (inoludksg basement. crawtsps�ce. or enclosure boor) _ pi meters (Puerto Rico only)
c) Bottom Top of the next west horizontal . feel ❑ meters (Puerto Rico only) of the lowest structure► member (V Zones only) ' % --- - ---- -- feet 0 meters (Puerto Rico only)
d) Attached garage (top of slab) —'� feet 0 meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment Servicing the building _______...._0 J
(Describe type of equipment and location In Comments) n rem 0 meters (Paella Rico only)
t) Lowest adjacent (finished) grade next tb budding (' LAG) — "--'f meters (Puerto Rico only)
g) Highest adjacent (flntshed) grade next to building (HAG) - - feet feet (Puerto Rico only)
h) Low AIRS, adjacent grade et lowest elevation of deck or kS. Including . t., r
structural sir J . •
•- SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This oertrficallon Is to be signed and sealed by a land auawy0r, engineer, or architect authorized by law to certify elevation
Informetkm. l certify that the information on this Ce►tl8eete represents my beet efforts to interpret the data aveilebta.
1 understand that any false statement may be punishable bylVms or knprlsonment tinder 18 U.S. Code, Section 1001. tE► OFD f r
IM Check here it comments are provided on back of form. ' Were Imltude end longitude in Section A by a �t -• 1S T *'•-. q •
licensed land surveyor? Dyes LJ No \ ' � 9 O p
',.A
Ce eP N ame L Z I ' mbar GLENN W. MILLER
GLENN W. MILL _I_ p rr •
�� Ii 4 h -4
Tim gds GEODA'a XSURVEING,INC. Code — address ' TEXAS 76 9 ~ F 'Stj>v 4O
1510 GINA DRI ARL
Sign ature Date Telephone 7 -2ts1 -2878
1t, —1'7 — 'ZOO
� See reverse side for continuation. Replaces all previous editions
FEMA Form 81.31, Mar 09
12/22/2889 13 :52 8172612874 GEODATA r-PAnam. cry
th0 6oR�P°ndM'9 information froiM SWIM A.
— a
IMPORTANT! M aro S(Ig�s ►' • and/or Bldg. No.) or P.O. Route end Sax No. t ,
9ulkHn S treeI Address (Indudht0 Apt. Unit. - err
204 OLYMPIA LAME ZIP Bode •
Stele 7 5019 t . }
City COPPELL TEXAS
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION CONTINUED
Copy both sides of this Elevation Certificate for (1) oommtmlly
official, (2) Insurance agenVcompenY• and (3) building owner.
ommMts um ....�tscr * a AJUS C r•; r c r • r r , r :A1 a,
OF
•
beta ❑ Check here If attachments
• Signature OUT t3F
SECTION E - BUILDING ELEVATION INFORMATION SURVEY NOT REQUIRED) FOR ZONE AO AND ZONJE A Se OUT l
and For E
to Items E1•E5. H the Garble Is intended to support a LOMA or LOMR -F request. coring
For C. Fo r t It arts A (without n ems E1 - E4, use nre tur, ral grade, if available. Check the measurement used. In P Rico only enter meters.
eat
E1. Provide elevation Information for the following and check the appropriate boxes to show whether the elevation i9 above or below the hi gin adjacent
e
grade (HAG) and the lowest adJnt grade (LAG). or enclosure) is _ ❑feet meters ❑eve or below the HAG.
a) Top 01 bottom floor (Including basement. ❑ ctmve or below the LAG.
b) Top of bottom Roos' Qncludktg basement. ice, or enclosure) is g-9 of Instructions). the next higher floor
rmanent flood openings p►�� In Sed1g.i► Kerns 8 or 9 (see pages
E2. For (elevation Building b In the l 9 hank! pe test Li s above or (_,•! balm" the HAG.
( elevation Cr.b In the diagrams) al the buNding is a 0 In above or 0 below the HAG.
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 ❑
If no flood depth number Is available. Is the top of the bottom floor sleuthed M accordance with the community's floodplain management
E5. Zone AO only T he loom 0(IId i must certify this lnfonr►�o le Section G.
ordinance? ❑ Vas ❑ No ❑ un�`�+r• CERTIFlCA110N
SECTION F - IsROPERTY OWNER (OR OWNE'S REPRESENTATIVE) M or eorrxnurhtty- issued BFE)
The Zone property owner
or owner's authorized representative who completes Sections A. B. and E for Zone A (without
a FE
or Zone AO roust sign Moro. The statements In Sections A, 8, sod 8 acs °� to the asst of my
Property
Owner's ar Owner's Authorized Representative's Neme
City State ZIP Code
Addrees Telephone
Date
Signature
Comments
❑ .,.,_.. . eIta -�,1h
---
_
SECTION G COMMUNITY fNFORMATION
The local oftkial wAho is authorized by law or ordinance to admWstar the uommunKy's floodplaln management ordinance can complete Sections A. B. C (or E).
� (s) and sigh below. Cheek the measurontent used In Items G8 end De.
and G of this Elevatlah Certificate. Complete the applicable and sealed by a licensed surveyor. en ghheer. or architect who
G t . ❑
The Information In Section C was taken iron other documentation that has been signed area e inee
Is authorized by law to certify elavalkin Information. (Indicate the source end date of the elevation dela In the Comments
G2. ❑ A community ofMM ei completed Sedion E for a building located In Zane A (without a FEMMasued or community- Issued BFE) or Zone AO.
G3. ❑ The following Informetla► (Items 134-G9) Is provided for con nunMY floodpieln management purposes.
Certificate Of Compliance/Occupancy Issued
134. Permit Number 133. Date Permit issued
G7. This permit has been Issued for: ❑ New Construction ❑ Substantial improvement •
❑ feet ❑ h �meters (pft) Datum
08. Elevation of es.bulit lowest floor (Including basement) of the building -- ❑ feet 0 m ers (PR) Datum
09. BFE br (In Zone AO) depth of flooding at the building sits [] feel ❑meters (PR) Datum
G10. Community's design flood elevation
Tide
Local Official's Name Telephone
Community Name •
Dais
Signature
Comments •
❑ s. .1 is
Replaces all previous editions
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TOP FORM = 492.4' 22.ir W v ED g 4 PAD ELEV. = 490.9
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