Westlake 421*Metro Safe Room Rebate Program (MSRRP)
Floodplain Verification Form
Date:6 /2/13
Applicant Information:
Name: Rosana Demelo & Lee Simmons
Address: 421 Westlake Ct.
City: Coppell State:Tx Zip: 75019
Email Address: pts90 @aol.com
Local Floodplain Representative (LFR):
Name: Michael Garza, P.E., CFM
Email Address: mgarza @coppelltx.gov
Phone Number: 214-358-1234
Title: Civil Engineer
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 orconfirm the location of SFHA floodplain areas with
respect to property limits orstructures. Note thatSFHA's on NFIP maps are nota guarantee that any particular location is notsubject
to inundation, only thatitis denoted as reasonablysafe from flooding.
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.