Woodmoor 837* Metro Safe Room Rebate Program (MSRRP)
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Floodplain Verification Form
Date:5/30/2013
Applicant Information:
Name: Jose A.Uribe
Address: 837 Wood moor Dr.
City: Coppell State:Tx Zip: 75019
Email Address:j.ale.uribe @gmail.com Phone Number:214-938-0269
Local Floodplain Representative (LFR):
Name:Michael Garza,P.E.,CFM Title:Civil Engineer
Email Address:mgarza @coppelltx.gov Phone Number:972-304-7019
DISCLAIMER:According to the maps provided by the National Flood Insurance Program(NFIP)and available to the local entity,the
property listed above does not appear to be in the Special Flood Hazard Area(SFHA)or in a designated FEMA Flood Zone A.The Local
Floodplain Representative(LFR)listed above does not verify the establishment or confirm the location of SFHA floodplain areas with
respect to property limits or structures.Note that SFHA's on NFIP maps are not a guarantee that any particular location is not subject
to inundation,only that it is denoted as reasonably safe from flooding.
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LFR Signature: -,
Applicant:
Please upload/submit the completed document as your name_FPVerification"with your application as you set-up your user profile
at:www.nctsaferoom.com.