930 Deforest Rd 06/11/2002 13:30 9723043514 COPPELL FIRE DEPT PAGE 03
NA IUNAL rLURJU IN�UhtANGE PRO(itiAM expires July 31, 2002 I
ELEVATION CERTIFICATE
Important Read the instructions on pages 1-7.
SECTION A•PROPERTY OWNER INFORMATION For Insurance Company Use:
BUILDING OWNERS NAME Poky Number .'
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,and/or Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
930 DEFOREST ROAD
CITY STATE ZIP CODE
COPPELL TX 75009
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Panel Number,Legal Description,etc)
LOT 5 BLOCK B OF WINDSOR ESTATES
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use a Comments area,if necessary.)
RESIDENTIAL ..
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑GPS(Type):
( OW-OW-saw or #4h A1hiaf#t' ®NAD 1927 la NAD 1983 ❑USGS Quad Map 14 Other,
SECTION B•FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
81,NFP COMMUNITY NAME&COMMUNITY NUMBER ' 132.CCUNIY NIWE B3.STATE
COPPELL 4130170 DENTON TEXAS
B4.MAP AND PANEL 85.SUFFIX 137,FIRM PANEL 89.BASE FLOOD ELEVATION(S)
NUMBER BE FIRM LADE)(DATE EFFECTIVEIEVISED DATE B8.FLOOD ZONE(S) (Zone AO,tee deph of flooding)
0155 J 08-23.01 AE 452
810.Indicate the source of the Base Flood Elevation(BFE)data or base loan depth entered in 89.
❑FIS Profte (2 FIRM 0 Community Determined ❑Other(Describe):
B11.hdipte the elevadon datum used f o r the BFE In B9:E E 1929 ❑NAVD 1988 ❑Other(Describe):
812.Is the bulding located In a Coastal Barrier Resources System(CBRS)area cc Otherwise Protected Area(OPA)? ❑Yes ®No Designation Date
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1.Building elevations are based on:❑Construction Drawings' ❑Building Under construction' ®Finished Construction
'A new Elevation Certificate wiN be required when construction of the bulling Is complete.
C2,Building Diagram Number 1(Select the building diagram most similar to the building for which this certificate is being completed-see pages 6 and 7. If no diagram
accurately represents the bulking,provide a sketch or photograph.)
C3.Elevations–Zones A 1,A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARJAE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3,-ai below according to the building dAgram seeded In Item C2.State the datum used.if the datum Is different from the datum used for the BFE In
Section B,convert the datum to that used for the BFE Show field measurements and datum conversion calculation. Use the space provided or tie Comments area of
Section D or Section 0,as appropriate,to document the datum ahnversion.
Datum ConversiontConinents --
Elevation reference mark used Does the elevation reference mark used appear on the FIRM? ❑Yes ®No r •v ..T " .
O a)Top of bottom floor(Inducing basement a enclosure) �,Q,.Eon) - / �pws ikszp�
O b)Top of need higher floor ,____film)
❑c)Bottom of lowest horizontal structural member(V zones only) ._f.(m) _ """.1.ROWELL•""•
•Y I.ROWELL
0 d)Attached garage(top of slab) _ft.(m) 1...a.;59;••••••• ••
❑e)Lowest elevation of machinery and/or equipment ' it ,
servicing the buidng(Describe in a Cormhents area) __film) •\- �tF .,,4p4`
❑f)Lowest adjacent(finished)grade(LAG) —._film) Z y •
0 g)l-ghest adjacent(finished)grade(HAG) _. _fl.(m) S
O h)No.of permanent openings(flood vents)within 1 it.abate adjacent grade_
❑i)Total area of all permanent openings(flood vents)in C3.h sq.in,(sq.an)
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.
I certify that the Information in Sections A,8,and Con this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine Orb prisonment under 18 U.S, Code`Section 10
CERTIFIERS NAME HARRY ROWELL LICENSE NUMBER 4597
TITLESURVEYOR COMPANY NAME HARRY ROWELL COMPANY
ADDRESS CITY STATE ZIP CODE
1301 ELM STREET STE.201 1 CARROLLTON TX 75006
SIGNATURE_ ?v/ /, DATE TELEPHONE
—% 06-0602 (972)2425679
FEMA Form 81-31,JUL SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS