949 Deforest Rd 06/11/2002 13:30 9723043514 COPPELL FIRE DEPT PAGE 06
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Expird frsrJu ly 311,,2002
, NATIONAL FLOOD INSURANCE PROGR/
ELEVATION CERTIFICATE ::,..1 , r ' .
• •Im. •rtant: Read the Instructions on •a•as 1 -7.
' SECTION A-PROPERTY OWNER INFORMATION r „' /`i�°'I''; "`"'"
ion �• 'yT.'=' i� R�A.VY�I .. 1:9.'.i.Yn[ it
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BUILDING OWNER'S NAME • !I •i,:; 'cliy , ,,IM ogl Ski
1!iGf�ibilti,;;IrF::«� m. Y fi3ll
�1 {{�� ''''rr Ilh��,I�prw�i�y61hil0�iil
' giro, i Y.,,;4::;A �i'�i"�.ilrfi44%I :�i iiiNl�,•ryl•o!i�li!�
BUILDING STREET ADDRESS(Including ,Unit,Suite,and/or Bldg.No.)OR P.O-ROUTE AND BOX NO .,•Coin 1'aI �i' 1dri.1Prp ,�r ti ;;�;*,
949 1,6 FGF.EbZ' Z � Ili-i,rini nalt- >iili:liii.1�'Il:i:l�li:ll:,il=i
.�� ,wlc�:lNli::;�.�•�ur,N�,ul�9Y•7W7I At:pl:�:��Ifi�ll�,
CITY STATE .. ZIP CODE
cop'PE'LL.. -re ,A6 -7S0iy
PROPERTY DESCRIPTION(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
L o-r 9 7N__ci c K, lbs y.J 1N1-D5011L EelriPerr-b AiAr, ITIdd
BUILDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. Use Comments section if necessary.) .
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: U GPS(Type):
( Mr-0'-N.*#" or #0.1Werl Mr) LI NAD 1927 LJ NAD 1983 LI USGS Quad Map U Other.
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP COMMUNITY NAME b COMMUNITY NUMBER 82.COUNTY NAME 83.STATE
S,P_ liL,i 4-BO 7D LL k �FsNTOf�1 5
B4.MAP AND PANEL ' 135:SUFFIX Be.FIRM INDEX • 87.FIRM PANEL • 88.FLOOD 89.BASE FLOOD ELEVATION(S)
NUMBER DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO,use depth of flooding)
460110 0010 E APRIL IS i AMR. IS. 1t194 .. • Are 432.
B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
I_I FIS Profile IJ FIRM (community Determined LI Other(Describe):
m
B11.Indicate the elevation datu used for the BFE In B9: .h1GVD 1929 .I J.NAVD 1988.Li Other(Describe):
B12.Is the building located In a Coastal_Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 1_1 Yes jNo'
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
C1. Building elevations are based on: LlConstruction Drawings' tiOuilding Under Construction' LiFlnished Construction .
'A new Elevation Certificate will be required when construction..of the building is complete.
C2. Building Diagram Number I (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 building,provide a sketch or photograph.)
C3. Elevations-Zones Al-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 C3a-i below according to the building diagram specified in Item C2.State the datum used. If the datum is different from
the datum used for the BFE in Section 9,convert the datum to that used for the BFE.Show field measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section 0,as appropriate,to document the datum conversion.
Datum ' Conversion/Comments
Elevation reference mark used oes the elevation reference mark used appear on the No
❑ a)Top of bottom floor(including basemen or enclosure) L„�ft.(le>) ' 45 ... .EA•fi��
O b)Top of next higher floor -_-•ft.(m) 9 e Q. , , FO.'�1�
❑ c)Bottom of lowest horizontal structural member(V zones only) - 1J ft.(m) (9 . `a =•,.
O d)Attached garage(top of slab) ____456 ..a.ft-4110 ' ••G . •RY S.RHODES
O e)Lowest elevation of machinery and/or equipment •• • •.■..............
servicing the building 1k ._ft.(m) f • • , '1 `'t•
At.4
O f)Lowest adjacent grade(LAG) • 4-eta .lL ft.(a0 41' E_• ,o\
O g)Highest adjacent grade(HAG) 461 .4 ft.(I�) �j1 8( ,
❑ h)No.of permanent openings(flood vents)within 1 ft.above adjacent 9r-ede iJk • J
❑ I)Total area of all permanent openings(flood vents)in C3h NA' sq.in.(sq.cm) ("
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;B,and Con this certificate represents my best efforts to interpret the data available.
I understand that an false statement ma be .unishable b line or i .rlsonment under 18 U.S. Code, Section 1001.
CER -'S NAME LICENSE NU ■BER
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TITLE •, - Y
ADDRE S TY STA ZIP CODE
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SIGNATUR•'�a DATE LEPHON
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FEMA Fo ' IP-1,AUG +' SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS